In February, Pfizer stopped shipping all strengths of Levoxyl and issued a voluntary recall due to complaints of an uncharacteristic odor reported by pharmacists and patients after medication bottles were opened. The odor is related to the oxygen-absorbing canister packaged with the medication to enhance product stability. Pfizer has concluded that the odor is not likely to cause any adverse health consequences and there is no need for patients to return or discard the medication they do have. This medication was added to the Food and Drug Administration’s list of drug shortages in March and it is anticipated that Levoxyl may not be available until 2014.
This turn of events provides us with an opportunity to discuss the various available treatment options for thyroid replacement therapy and how a compounding pharmacy might be the answer you are looking for.
Basics of Hypothyroidism
Hypothyroidism is classified as the lack of production of thyroid hormone from the thyroid gland. Common symptoms patients experience include fatigue, constipation, increased sensitivity to cold, dry skin, unexplained weight gain, thinning hair, slowed heart rate, and impaired memory. Many factors can impact thyroid levels including low production, excessive binding, poor conversion to its active form, and a decrease in receptor response to the hormone. One of the most common causes of hypothyroidism is an autoimmune disorder called Hashimoto’s disease where the body’s immune system makes antibodies that attack the thyroid tissue resulting in the gland not being able to make enough thyroid hormone.
Patients with hypothyroidism are mainly treated with thyroid replacement which works by supplying the needed thyroid hormone normally produced by the body. Commercially available products include fixed-dose preparations of Levothyroxine (Levoxyl, Synthroid), Liothyronine (Cytomel, Triostat), or Dessicated Thyroid USP (Armour Thyroid, Nature-Thyroid).
Compounding for Hypothyroidism
The staff at Pharmacy Specialists can help patients and physicians design a thyroid replacement therapy that fits the needs of each individual. Levothyroxine, Liothyronine, or Thyroid USP can be compounded as single ingredient or combination capsules designed to release immediately or over a sustained period of time. This option of therapy can be extremely useful for patients that may not respond optimally to the commercially available thyroid hormone replacement medications. Our ability to compound thyroid preparations allows prescribers to take advantage of supplementing the patient with exactly the right ratio of hormones they need.
Our goal as compounding pharmacists is to meet the individual needs and circumstances of patients and physicians. Without compounded medications patients may be at risk for suboptimal or nonexistent treatment of their medical conditions when medications are on backorder. Give yourself options and be proactive in your own care.
Juan Lopez, PharmD, graduated from Mercer University College of Pharmacy and is proud to be the newest addition to Pharmacy Specialists’ compounding pharmacist staff. Jill Weinstein, RPh, graduated from University of Florida and is the clinical pharmacist who does hormone, nutrition and weight loss consultations at Pharmacy Specialists. Pharmacy Specialists is proud to be the only pharmacy in all of Central Florida and one of only 129 pharmacies in the country that are accredited by the Pharmacy Compounding Accreditation Board (PCAB). We meet or exceed ALL standards for sterile as well as non-sterile compounding and we are the only USP 797 and USP 795 validated compliant pharmacy in all of central Florida. Currently, Sam Pratt, RPh at Pharmacy Specialists is the only Full Fellow of the International Academy of Compounding Pharmacists in the Central Florida area. Please contact Pharmacy Specialists at (407)260-7002 to consult with one of our Clinical Pharmacists or to schedule a patient for a clinical pharmacy consultation.
By Jill Weinstein, RPh and Juan Lopez, PharmD
- King Pharmaceuticals and Pfizer Inc. Levoxyl Recall. [Letter] Bristol, TN. March 2013.
- Pfizer recalls thyroid-disorder drug over odor problem. Fox Business. Available at: www.foxbusiness.com/news/2013/04/03/Pfizer-recalls-thyroid-disorder-drug-over-odor-problem/ Accessed April 22, 2013.
- Hypothyroidism. Mayo Clinic. http://www.mayoclinic.com/health/hypothyroidism/DS00353. Accessed April 25, 2013.
- Paoletti J. Differentiation and treatment of hypothyroidism, functional hypothyroidism, and functional metabolism. International Journal of Pharmaceutical Compounding. Nov/Dec 2008. Volume 12(6):489-497.