New formulations of thyroxine for treatment of hypothyroidism

New formulations of thyroxine available in Australia

A new brand of thyroxine is now available in Australia. The Therapeutic Goods Administration has approved a new generic and new strength brand of thyroxine under product names of Eltroxin, Aspen thyroxine and Thyroxine Aspen in 2014, sponsored by Aspen Pharma Pty Ltd. This brand of throxine has been widely used in Europe and other countries. Previously we only had two brands of thyroxine in Australia, Oroxine and Eutroxsig.

Eltroxin tablets come in a plastic bottle in new strengths of thyroxine sodium – 25, 50, 75, 88, 100, 112, 125, 137, 150 or 200mcg tablets. They also do not need refrigeration (not above 25 degrees C) which may be useful when traveling for example or for finer adjustment of hormones. Eltroxin might be an easier option for some people who are taking two doses of Eutroxsig at different days of a week (like myself). When changing from on brand of thyroxine to another, it is important to note that dosing may not be interchangeable due to different fillers present in tablets as they may change the bio-availability of thyroxine in individuals. It is important to monitor hormonal levels when changing from Eutroxsig/Oroxine to Eltroxin, which may be slightly less bio-available when compared to Oroxine (you might need to take a slightly higher dose). I have not tried Eltroxin but would be very interested in any comments from people who take it or switched from one brand to another.

New liquid thyroxine (not available in Australia just yet)

SERB company in France has developed a liquid formulation of thyroxine, levothyroxine in drops. One drop contains 5 mcg of thyroxine. This formulation might be beneficial for young children and older people who have problems swallowing tablets.

FDA in USA has also approved a liquid formulation-Tirosint-SOL (levothyroxine sodium oral solution; IBSA). It is supplied in unit gel capsule containing following strengths (mcg/mL): 13, 25, 50, 75, 88, 100, 112, 125, 137, 150, 175, 200 (colour labelled). It contains only levothyroxine, gelatin, glycerin, and water.  It has been developed by Italian Swiss Company IBSA and it has been available in Italy since 2012.

References:

    1. URL: https://www.tga.gov.au/auspar/auspar-thyroxine-sodium-1
    2. URL: https://serb.eu/products/l-thyroxine-150mg/
    3. Salvatore Benvenga, Giovanni Capodicasa and Sarah Perelli. Thyroxine in an oral liquid or softgel formulation ensures more normal serum levels of Free T4 in patients with central hypothyroidism. Front Endocrinol (Lausanne). 2017; 8: 321.
    4. URL: https://www.empr.com/news/tirosint-sol-hypothyroidism-thyroid-thyroxine/article/638154/
    5.  URL: https://www.rxlist.com/tirosint-sol-drug.htm
    6. URL: https://www.tirosint.com/why-tirosint/what-makes-tirosint-different/

 

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