Quantifying amount of adsorption of levothyroxine by percutaneous endoscopic gastrostomy tubes

JPEN. Journal of Parenteral and Enteral Nutrition
Anastasios ManessisIven Young

Abstract

It has been the authors' clinical experience that hypothyroid patients who achieve a euthyroid state on a steady dose of oral levothyroxine often become hypothyroid over time if the medication is given via a feeding tube. The authors hypothesize that the tubing and enteral feeds may adsorb a significant percentage of the levothyroxine and thereby reduce its bioavailability. To the authors' knowledge, no previous research has been reported on this subject. They therefore performed an in vitro assessment of the degree of levothyroxine adsorption to quantify the amount of drug adsorbed to the percutaneous endoscopic gastrostomy (PEG) tube and how enteral tube feeds mitigate or exacerbate this adsorption. Using levothyroxine radiolabeled with an I 125 tracer, a known dose of levothyroxine was passed through 60 new PEG tubes. One-half of the tubes were pretreated with Jevity feeds, and the other half were not. The authors measured the activity of the radiolabeled levothyroxine before and after it had passed through the tubes and, using a subtraction analysis, inferred the amount of thyroxine left within the tube. Tubes presoaked with feeds had a greater uptake in radioactivity by 326.4 cpm (95% confidence interval, 226.7-426.1), cor...Continue Reading

References

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Citations

Jan 16, 2013·Pharmaceutical Development and Technology·Irina Kadiyala, Elijah Tan
Dec 9, 2010·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Roland N DickersonRex O Brown
Mar 2, 2018·PloS One·Min Yew ThongKathryn J Steadman
Aug 12, 2009·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Paul D WohltJeffrey T Fish
Apr 4, 2021·Pharmaceuticals·Agnieszka WiesnerPaweł Paśko

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