Sevelamer Carbonate Markedly Reduces Levothyroxine Absorption

Title:Sevelamer Carbonate Markedly Reduces Levothyroxine Absorption

Volume: 14 Issue: 3

Author(s): Michele Iovino, Nicola Iovine, Alfanso Petrosino, Vito A. Giagulli, Brunella Licchelli, Edoardo Guastamacchia and Vincenzo Triggiani

Affiliation:

Keywords: Dialysis, hyperphosphataemia, hypothyroidism, intestinal absorption, levothyroxine, phosphate binder, sevelamer carbonate.

Abstract: We report the case of a young woman affected by hypothyroidism due to Hashimoto’s thyroiditis, previously well compensated with a full replacement therapy (150 mcg/day of levothyroxine), presenting a clinical picture of myxedema, with a TSH=650 mU/L. Two years earlier she had started a dialysis treatment because of a chronic renal failure and had been under treatment for the last 18 months with sevelamer carbonate, a phosphate binder. No improvement of clinical conditions nor reduction in TSH serum levels was observed even on increasing the dose of levothyroxine up to 300 mcg/day, whereas euthyroidism finally restored by administering the first morning dose of sevelamer carbonate at least 4 hours after levothyroxine administration. This case shows that sevelamer carbonate, in analogy with what has been already reported for sevelamer hydrochloride, can interfere with levothyroxine absorption leading to a condition of hypothyroidism in patients previously well compensated with a given replacement dose.

Cite this article as:

Iovino Michele, Iovine Nicola, Petrosino Alfanso, Giagulli A. Vito, Licchelli Brunella, Guastamacchia Edoardo and Triggiani Vincenzo, Sevelamer Carbonate Markedly Reduces Levothyroxine Absorption, Endocrine, Metabolic & Immune Disorders - Drug Targets 2014; 14 (3) . https://dx.doi.org/10.2174/1871530314666140902151804