Can I split levothyroxine pills?

According to research, T3 levels peak quickly, typically within three to four hours after taking the medication. The short timeframe creates daily peaks and valleys in the T3 levels, and, as the active thyroid hormone, this can affect symptoms. Levothyroxine is long-acting and has a half-life of around seven to eight days.

It is cited in the literature that a more uniform and denser packing resulted in a better uniformity of mass of the subdivided tablet parts. From a theoretical point of view, filler and binder excipients with only a limited elastic recovery after compaction are more suitable for breaking tablets (35). It was observed that for better content uniformity, starch was giving a higher content uniformity results as compared to when HPMC was used as a binder. Thus, formulation development with proper excipient might be able to produce tablets with better splittability. Levothyroxine tablets from each manufacturer were split into two parts in two different ways—using hand-splitting and using a tablet-splitter (Apothecary Products, Inc., Burnsville, MN). Thirty-four intact tablets and 68 split halves of each product were randomly dispensed into individual amber pharmacy container for each time point and closed using a child-resistant cap.

How late in the day can you take a T3 medication?

The time zero refers to the day of 5months before expiry of these tablets since manufacturing dates were unknown. This approach makes it possible to compare various formulations from different manufacturers to see whether the assay values were within the range. A specification range of 90–110% was followed since the tablets were purchased before Oct 2009, after which, the assay specifications was tightened by USP to be within 95–105% (23).

Splitting Thyroid Tablets: Hi Everyone Is it ok… – Thyroid UK

Ultimately, responsible medication management is key, so consult your physician before making any changes to your thyroid medication regimen. Like all medications, thyroid medications can have side effects, though these vary depending on the individual and the dosage. Common side effects include headaches, nervousness, insomnia, weight loss, increased appetite, palpitations, and tremor.

Levothyroxine Interactions with Food and Dietary Supplements–A Systematic Review

In this study we compared the effect of 150 µg dose of Levothyroxine by use of a100 and a 50 µg tablets or one and half 100 µg tablets in Differentiated thyroid cancer (DTC) patients. In summary, while splitting levothyroxine tablets can be an effective method for dose adjustment, it comes with significant risks related to content uniformity and stability. These risks could potentially lead to inconsistent dosing, which is critical for a drug with a narrow therapeutic index like levothyroxine. Therefore, while tablet splitting can be used when necessary, it is generally advisable to use whole tablets whenever possible to ensure accurate dosing and maintain treatment efficacy.

Preparation of Tablets

Some of the concerns relate to weight variation, uneven drug content, and drug stability in the half tablets. These quality concerns can potentially impact the product performance and are especially true for drugs with narrow therapeutic index, drugs with closely spaced multiple strengths and drugs with nonlinear pharmacokinetics. Several studies have indicated that tablet splitting may result in high incidences of weight variation that may or may not be of clinical consequence depending on the drug being split (6–13). McDevitt et al. (12) found that 41% of split tablets deviated from the ideal weight by more than 10% and that 12% of pills deviated by more than 20%. Such differences can be critical with certain heart or thyroid medications with a narrow therapeutic index. In such case, splitting could bring about subpotency or superpotency issues which might cause harm to the patients.

In the literature, concerns have been raised about difficulty breaking tablets, losing tablet mass, unequal splitting, chemical instability, confusion leading to medication errors, and the mistaken splitting of sustained-release preparations. Although some older adults may struggle to split tablets without tablet splitters, little evidence was found to justify tablet-splitting concerns other than the need to avoid splitting sustained-release preparations. With the exception of sustained-release medications, tablet splitting to facilitate lower medication doses and lower medication costs appears safe.

• More serious, but less common, side effects can include irregular heartbeat, chest pain, and allergic reactions.
• This study’s findings are strengthened by its having reviewed the literature systematically, with the use of dual reviewers in the review of titles and abstracts.
• You could always ask the pharmacist- I find they’re very helpful on such matters.

Furthermore, the process of splitting can damage the tablet’s coating, potentially affecting its synthroid hungrier absorption rate and increasing the risk of irritation to the gastrointestinal tract. Finally, some extended-release formulations are specifically designed not to be split, and doing so could negate their intended effect. A Consumer Reports Health prescription drugs survey reported that many people are splitting their pills in half to save money on high-priced prescription drugs. The bad news, however, is that many have also learned to save even more money by taking half-doses of half-a-pill every other day.

• API% is very low in the tablet (200 mcg in 120 mg tablet ~0.167%); hence, if the API is mixed directly with other ingredients without formation of granules, it seems likely that the drug will not be homogeneously mixed with the other ingredients.
• Samples were stored in monitored environmental chambers (Hotpack, Philadelphia, PA or Electrotech, Glenside, PA) under long-term storage conditions (25°C/60% relative humidity (RH)) for 8 weeks.
• To identify and summarise all published concerns related to tablet splitting and to present the experimental evidence that investigates those concerns.
• When you crush or split any tablet, there is bound to be at least a little material loss of the tablet from the process.
• With the exception of sustained-release tablets, which should not be split, and excepting those older people who may struggle to split tablets based on physical limitations, there is little evidence to support tablet-splitting concerns.

Also, it was found that with the tablets which were directly compressed without any granulation step, the distribution of levothyroxine sodium was not homogeneous on the surface of the tablets. Splitting such tablets could prove detrimental if sub- or super-potency becomes an issue for narrow therapeutic drugs. In-house formulation efforts revealed that type of binder plays an important role in splittability of the tablet to provide more consistent dose uniformity for levothyroxine sodium tablets. The current study was undertaken to evaluate the effects of splitting and the potential causes for uniformity failures. Five marketed drug products which included several brand and generic levothyorixne tablets were evaluated for effect of splitting on dose uniformity by performing both assay and content uniformity using the methods described above. The assay for all the five marketed tablets for whole as well as split portions are shown in Fig.

Should you switch to twice-a-day dosing?

Since we found that L-4 was still within the expiry but failed to meet assay specifications, another lot of product was bought and assayed to confirm that the extraction method used was able to extract the drug. Thus, the extraction procedure was adequate and sub-potency of L-4 product might be due to rapid degradation of levothyroxine from the product even though it was within the expiry. In practice, when such failures are observed, the sponsors are required to reduce the expiration dating and recall the lots that failed to meet the quality standards from the market. Potency and stability issues have been prevalent for levothyroxine products, and a better reformulation should prevent future problems. The formulations were undergoing transition to reformulated products so as to meet new USP potency requirements; hence, it was decided to continue with old lot of L-4 product.