Comparison of Treatment Response Achieved by Tablet Splitting Versus Whole Tablet Administration of Levothyroxine in Patients with Thyroid Cancer

Abstract

Objective(s): TSH suppression by Levothyroxine consumption is a mainstayof thyroid cancer treatment. Tablet-splitting is a worldwide approach in doseadjustment in patients. However, it is highly recommended to evaluate the validityof tablet splitting for each distinctive drug by clinical trials before routinely usingtablet halves in clinical practice. In this study we compared the effect of 150 μg doseof Levothyroxine by use of a100 and a 50 μg tablets or one and half 100 μg tablets inDifferentiated thyroid cancer (DTC) patients.Methods: One hundred DTC patients treated with one and half 100 μg Levothyroxinetablets were randomly divided into two groups. The first group continued takingmedication as before and the second group received the same daily dose by taking one100 and one 50 microgram Levothyroxine tablets. The mean changes in TSH and T3levels and patients weight were compared between the groups.Results: 91 patients completed the study. Levothyroxine consumption pattern, age,gender distribution, weight and TSH levels were comparable between groups at thebeginning of the study. The mean change of body weights, serum levels of T3 and TSHshowed no significant difference between groups in different time points during thestudy (P>0.05).Conclusion: This study showed similar efficacy of tablet splitting and two tabletsadministration for Levothyroxine; however, patients preferred two tablets at the endof the study. It can be concluded that tablet splitting can be used as an alternative waywhen the 50 μg tablet is not available.

Keywords

• Tablet splitting
• Differentiated thyroid cancer, TSH, Levothyroxine, suppressive therapy