Identification

Name

Levothyroxine

Accession Number

DB00451

Description

Levothyroxine is a synthetically produced form of thyroxine, a major endogenous hormone secreted by the thyroid gland.¹⁴ Also known as L-thyroxine or the brand name product Synthroid, levothyroxine is used primarily to treat hypothyroidism, a condition where the thyroid gland is no longer able to produce sufficient quantities of the thyroid hormones T₄ (tetraiodothyronine or thyroxine) and T₃ (triiodothyronine or Liothyronine), resulting in diminished down-stream effects of these hormones. Without sufficient quantities of circulating thyroid hormones, symptoms of hypothyroidism begin to develop such as fatigue, increased heart rate, depression⁴, dry skin and hair, muscle cramps, constipation, weight gain, memory impairment, and poor tolerance to cold temperatures.^15,10

In response to Thyroid Stimulating Hormone (TSH) release by the pituitary gland, a normally functioning thyroid gland will produce and secrete T₄, which is then converted through deiodination (by type I or type II 5′-deiodinases)⁸ into its active metabolite T₃. While T₄ is the major product secreted by the thyroid gland, T₃ exerts the majority of the physiological effects of the thyroid hormones; T₄ and T₃ have a relative potency of ~1:4 (T4:T3).¹⁴ T₄ and T₃ act on nearly every cell of the body, but have a particularly strong effect on the cardiac system.⁶ As a result, many cardiac functions including heart rate, cardiac output, and systemic vascular resistance are closely linked to thyroid status.⁷

Prior to the development of levothyroxine, Thyroid, porcine or desiccated thyroid, used to be the mainstay of treatment for hypothyroidism. However, this is no longer recommended for the majority of patients due to several clinical concerns including limited controlled trials supporting its use. Desiccated thyroid products contain a ratio of T4 to T3 of 4.2:1, which is significantly lower than the 14:1 ratio of secretion by the human thyroid gland. This higher proportion of T3 in desiccated thyroid products can lead to supraphysiologic levels of T3 which may put patients at risk of thyrotoxicosis if thyroid extract therapy is not adjusted according to the serum TSH.^10,15

Type

Small Molecule

Groups

Approved

Structure

3D

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MOLSDF3D-SDFPDBSMILESInChI

Similar Structures

Structure for Levothyroxine (DB00451)

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Weight

Average: 776.87
Monoisotopic: 776.686681525

Chemical Formula

C₁₅H₁₁I₄NO₄

Synonyms

• 3,3',5,5'-Tetraiodo-L-thyronine
• 3,5,3',5'-Tetraiodo-L-thyronine
• 4-(4-Hydroxy-3,5-diiodophenoxy)-3,5-diiodo-L-phenylalanine
• L-T4
• L-Thyroxine
• Levothyroxin
• LT4
• O-(4-Hydroxy-3,5-diidophenyl)-3,5-diiodo-L-tyrosine
• O-(4-Hydroxy-3,5-diiodophenyl)-3,5-diiodo-L-tyrosine
• T4
• Thyroxine

Pharmacology

Indication

Levothyroxine is indicated as replacement therapy in primary (thyroidal), secondary (pituitary) and tertiary (hypothalamic) congenital or acquired hypothyroidism. It is also indicated as an adjunct to surgery and radioiodine therapy in the management of thyrotropin-dependent well-differentiated thyroid cancer.

Associated Conditions

• Hypothyroidism
• Myxedema coma
• Euthyroid Goitre
• Thyrotropin dependent Thyroid cancer

Contraindications & Blackbox Warnings

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Pharmacodynamics

Oral levothyroxine is a synthetic hormone that exerts the same physiologic effect as endogenous T₄, thereby maintaining normal T₄ levels when a deficiency is present.

Levothyroxine has a narrow therapeutic index and is titrated to maintain a euthyroid state with TSH (thyroid stimulating hormone) within a therapeutic range of 0.4–4.0 mIU/L.¹⁰ Over- or under-treatment with levothyroxine may have negative effects on growth and development, cardiovascular function, bone metabolism, reproductive function, cognitive function, emotional state, gastrointestinal function and glucose and lipid metabolism. The dose of levothyroxine should be titrated slowly and carefully and patients should be monitored for their response to titration to avoid these effects. TSH levels should be monitored at least yearly to avoid over-treating with levothyroxine which can result in hyperthyroidism (TSH <0.1mIU/L) and symptoms of increased heart rate, diarrhea, tremor, hypercalcemia, and weakness to name a few.¹⁵

As many cardiac functions including heart rate, cardiac output, and systemic vascular resistance are closely linked to thyroid status,⁷ over-treatment with levothyroxine may result in increases in heart rate, cardiac wall thickness, and cardiac contractility and may precipitate angina or arrhythmias, particularly in patients with cardiovascular disease and in elderly patients. In populations with any cardiac concerns, levothyroxine should be initiated at lower doses than those recommended in younger individuals or in patients without cardiac disease. Patients receiving concomitant levothyroxine and sympathomimetic agents should be monitored for signs and symptoms of coronary insufficiency. If cardiac symptoms develop or worsen, reduce the levothyroxine dose or withhold for one week and restart at a lower dose.¹⁵

Increased bone resorption and decreased bone mineral density may occur as a result of levothyroxine over-replacement, particularly in post-menopausal women. The increased bone resorption may be associated with increased serum levels and urinary excretion of calcium and phosphorous, elevations in bone alkaline phosphatase and suppressed serum parathyroid hormone levels. Administer the minimum dose of levothyroxine that achieves the desired clinical and biochemical response to mitigate this risk.

Addition of levothyroxine therapy in patients with diabetes mellitus may worsen glycemic control and result in increased antidiabetic agent or insulin requirements. Carefully monitor glycemic control after starting, changing or discontinuing levothyroxine.

Mechanism of action

Levothyroxine is a synthetically prepared levo-isomer of the thyroid hormone thyroxine (T₄, a tetra-iodinated tyrosine derivative) that acts as a replacement in deficiency syndromes such as hypothyroidism. T₄ is the major hormone secreted from the thyroid gland and is chemically identical to the naturally secreted T₄: it increases metabolic rate, decreases thyroid-stimulating hormone (TSH) production from the anterior lobe of the pituitary gland, and, in peripheral tissues, is converted to T₃. Thyroxine is released from its precursor protein thyroglobulin through proteolysis and secreted into the blood where is it then peripherally deiodinated to form triiodothyronine (T₃) which exerts a broad spectrum of stimulatory effects on cell metabolism. T₄ and T₃ have a relative potency of ~1:4.

Thyroid hormone increases the metabolic rate of cells of all tissues in the body. In the fetus and newborn, thyroid hormone is important for the growth and development of all tissues including bones and the brain. In adults, thyroid hormone helps to maintain brain function, food metabolism, and body temperature, among other effects. The symptoms of thyroid deficiency relieved by levothyroxine include slow speech, lack of energy, weight gain, hair loss, dry thick skin and unusual sensitivity to cold.

The thyroid hormones have been shown to exert both genomic and non-genomic effects.⁹ They exert their genomic effects by diffusing into the cell nucleus and binding to thyroid hormone receptors in DNA regions called thyroid hormone response elements (TREs) near genes.² This complex of T₄, T₃, DNA, and other coregulatory proteins causes a conformational change and a resulting shift in transcriptional regulation of nearby genes, synthesis of messenger RNA, and cytoplasmic protein production.^2,6 For example, in cardiac tissues T₃ has been shown to regulate the genes for α- and β-myosin heavy chains, production of the sarcoplasmic reticulum proteins calcium-activated ATPase (Ca2+-ATPase) and phospholamban, β-adrenergic receptors, guanine-nucleotide regulatory proteins, and adenylyl cyclase types V and VI as well as several plasma-membrane ion transporters, such as Na+/K+–ATPase, Na+/Ca2+ exchanger, and voltage-gated potassium channels, including Kv1.5, Kv4.2, and Kv4.3. ⁷ As a result, many cardiac functions including heart rate, cardiac output, and systemic vascular resistance are closely linked to thyroid status.

The non-genomic actions of the thyroid hormones have been shown to occur through binding to a plasma membrane receptor integrin aVb3 at the Arg-Gly-Asp recognition site.¹² From the cell-surface, T₄ binding to integrin results in down-stream effects including activation of mitogen-activated protein kinase (MAPK; ERK1/2) and causes subsequent effects on cellular/nuclear events including angiogenesis and tumor cell proliferation.^6,11

Target	Actions	Organism
AThyroid hormone receptor alpha	agonist	Humans
AThyroid hormone receptor beta	agonist	Humans
AIntegrin alpha-V	Not Available	Humans
AIntegrin beta-3	Not Available	Humans

Absorption

Absorption of orally administered T4 from the gastrointestinal tract ranges from 40% to 80% with the majority of the levothyroxine dose absorbed from the jejunum and upper ileum. T4 absorption is increased by fasting, and decreased in malabsorption syndromes and by certain foods such as soybeans, milk, and dietary fiber. Absorption may also decrease with age. In addition, many drugs affect T4 absorption including bile acide sequestrants, sucralfate, proton pump inhibitors, and minerals such as calcium (including in yogurt and milk products)³, magnesium, iron, and aluminum supplements. To prevent the formation of insoluble chelates, levothyroxine should generally be taken on an empty stomach at least 2 hours before a meal and separated by at least 4 hours from any interacting agents.

Volume of distribution

Not Available

Protein binding

Circulating thyroid hormones are greater than 99% bound to plasma proteins, including thyroxine-binding globulin (TBG), thyroxine-binding prealbumin (TBPA) and albumin (TBA). The higher affinity of both TBG and TBPA for T4 partially explains the higher serum levels, slower metabolic clearance and longer half-life of T4 compared to T3. Protein-bound thyroid hormones exist in reverse equilibrium with small amounts of free hormone where only unbound hormone is metabolically active.¹⁵

Metabolism

Approximately 70% of secreted T₄ is deiodinated to equal amounts of T₃ and reverse triiodothyronine (rT₃), which is calorigenically inactive. T₄ is slowly eliminated through its major metabolic pathway to T₃ via sequential deiodination, where approximately 80% of circulating T₃ is derived from peripheral T₄. The liver is the major site of degradation for both T₄ and T₃, with T₄ deiodination also occurring at a number of additional sites, including the kidney and other tissues.

Elimination of T₄ and T₃ involves hepatic conjugation to glucuronic and sulfuric acids. The hormones undergo enterohepatic circulation as conjugates are hydrolyzed in the intestine and reabsorbed. Conjugated compounds that reach the colon are hydrolyzed and eliminated as free compounds in the feces. Other minor T₄ metabolites have been identified. ¹⁵

Hover over products below to view reaction partners

• Levothyroxine
  • Liothyronine
    • Reverse triiodothyronine (rT3)
    • Diiodothyronine

Route of elimination

Thyroid hormones are primarily eliminated by the kidneys. A portion of the conjugated hormone reaches the colon unchanged and is eliminated in the feces. Approximately 20% of T₄ is eliminated in the stool. Urinary excretion of T₄ decreases with age.¹⁵

Half-life

T₄ half-life is 6 to 7 days. T₃ half-life is 1 to 2 days.¹⁵

Clearance

Not Available

Adverse Effects

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Toxicity

LD₅₀=20 mg/kg (orally in rat). Hypermetabolic state indistinguishable from thyrotoxicosis of endogenous origin. Symptoms of thyrotoxicosis include weight loss, increased appetite, palpitations, nervousness, diarrhea, abdominal cramps, sweating, tachycardia, increased pulse and blood pressure, cardiac arrhythmias, tremors, insomnia, heat intolerance, fever, and menstrual irregularities.

Affected organisms

• Humans and other mammals

Pathways

Pathway	Category
Thyroid Hormone Synthesis	Metabolic

Pharmacogenomic Effects/ADRs

Not Available

Interactions

Drug Interactions

This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.

• Approved
• Vet approved
• Nutraceutical
• Illicit
• Withdrawn
• Investigational
• Experimental
• All Drugs

Drug	Interaction
Unlock Additional Data
Acalabrutinib	The therapeutic efficacy of Levothyroxine can be decreased when used in combination with Acalabrutinib.
Acarbose	The therapeutic efficacy of Acarbose can be decreased when used in combination with Levothyroxine.
Acebutolol	The risk or severity of adverse effects can be increased when Acebutolol is combined with Levothyroxine.
Acenocoumarol	The therapeutic efficacy of Acenocoumarol can be increased when used in combination with Levothyroxine.
Acetohexamide	The therapeutic efficacy of Acetohexamide can be decreased when used in combination with Levothyroxine.
Acetylsalicylic acid	The therapeutic efficacy of Levothyroxine can be increased when used in combination with Acetylsalicylic acid.
Adenine	The metabolism of Levothyroxine can be decreased when combined with Adenine.
Afatinib	The serum concentration of Afatinib can be decreased when it is combined with Levothyroxine.
Albiglutide	The therapeutic efficacy of Albiglutide can be decreased when used in combination with Levothyroxine.
Aldesleukin	The therapeutic efficacy of Levothyroxine can be decreased when used in combination with Aldesleukin.

Additional Data Available

Extended Description
Extended Description
Extended description of the mechanism of action and particular properties of each drug interaction.
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Severity
Severity
A severity rating for each drug interaction, from minor to major.
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Evidence Level
Evidence Level
A rating for the strength of the evidence supporting each drug interaction.
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Action
Action
An effect category for each drug interaction. Know how this interaction affects the subject drug.
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Food Interactions

• Avoid calcium supplements/calcium rich foods. Calcium may interfere with the absorption of this drug by forming an insoluble complex. Separate medication administration by at least 4 hours.
• Avoid grapefruit products. Grapefruit may delay the absorption of this medication.
• Avoid iron supplements. Iron may interfere with the absorption of this drug by forming an insoluble complex. Separate medication administration by at least 4 hours.
• Avoid multivalent ions. Examples include iron, magnesium, and calcium. These are often found in antacids, vitamins, and supplements - separate medication administration by at least 4 hours.
• Do not take with bran and high fiber foods. Dietary fiber, soybean flour, cottonseed meal, and walnuts may reduce the absorption of levothyroxine.
• Take on an empty stomach. Levothyroxine should be taken on an empty stomach 30-60 minutes prior to the first meal of the day.

Products

Product Ingredients

Ingredient	UNII	CAS	InChI Key
Levothyroxine sodium	054I36CPMN	55-03-8	YDTFRJLNMPSCFM-UHFFFAOYSA-M

Product Images

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International/Other Brands

Eutirox (Merck) / Letrox (Berlin-Chemie) / Levaxin (Nycomed) / Levothyrox (Merck) / Oroxine (GlaxoSmithKline) / Thyrax (Merck)

Brand Name Prescription Products

Name	Dosage	Strength	Route	Labeller	Marketing Start	Marketing End	Region	Image
Unlock Additional Data
Eltroxin	Tablet		Oral	Aspen Pharmacare Canada Inc.	1998-02-11	2018-09-17
Eltroxin	Tablet		Oral	Aspen Pharmacare Canada Inc.	1997-04-02	Not applicable
Eltroxin	Tablet		Oral	Aspen Pharmacare Canada Inc.	1974-12-31	Not applicable
Eltroxin	Tablet		Oral	Aspen Pharmacare Canada Inc.	1998-11-27	Not applicable
Eltroxin	Tablet		Oral	Aspen Pharmacare Canada Inc.	1951-12-30	Not applicable
Eltroxin 150 Tab	Tablet		Oral	Glaxo Canada Inc	1974-12-31	1999-08-12
Eltroxin Tab 100mcg	Tablet		Oral	Glaxo Canada Inc	1951-12-31	1999-08-12
Eltroxin Tab 200mcg	Tablet		Oral	Glaxo Canada Inc	1960-12-31	1998-07-30
Eltroxin Tab 300mcg	Tablet		Oral	Glaxo Canada Inc	1966-12-31	1998-07-30
Eltroxin Tab 50mcg	Tablet		Oral	Glaxo Canada Inc	1951-12-31	1998-07-30

Additional Data Available

Application Number
Application Number
A unique ID assigned by the FDA when a product is submitted for approval by the labeller.
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Product Code
Product Code
A governmentally-recognized ID which uniquely identifies the product within its regulatory market.
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Generic Prescription Products

Name	Dosage	Strength	Route	Labeller	Marketing Start	Marketing End	Region	Image
Unlock Additional Data
Levothroxine Sodium	Tablet	75 ug/1	Oral	Direct_Rx	2019-07-03	Not applicable
Levothyroxine	Tablet	125 ug/1	Oral	Northwind Pharmaceuticals	2014-09-14	Not applicable
Levothyroxine Sodium	Injection, powder, lyophilized, for solution	100 ug/5mL	Intravenous	Piramal Critical Care, Inc.	2018-06-15	Not applicable
Levothyroxine Sodium	Tablet	0.2 mg/1	Oral	Lupin Pharmaceuticals, Inc.	2019-03-20	Not applicable
Levothyroxine Sodium	Tablet	100 ug/1	Oral	Mylan Pharmaceuticals Inc.	2002-11-01	Not applicable
Levothyroxine Sodium	Tablet	88 ug/1	Oral	Goldline Laboratories, Inc.	2010-06-01	2010-06-04
Levothyroxine Sodium	Tablet	150 ug/1	Oral	Goldline Laboratories, Inc.	2010-06-01	2010-06-04
Levothyroxine Sodium	Tablet	0.075 mg/1	Oral	Remedy Repack	2011-06-27	2012-06-27
Levothyroxine Sodium	Tablet	112 ug/1	Oral	Mylan Institutional Inc.	2017-01-19	Not applicable
Levothyroxine Sodium	Injection, powder, lyophilized, for solution	500 ug/5mL	Intravenous	MAIA Pharmaceuticals, Inc.	2018-12-27	Not applicable

Additional Data Available

Application Number
Application Number
A unique ID assigned by the FDA when a product is submitted for approval by the labeller.
Learn more
Product Code
Product Code
A governmentally-recognized ID which uniquely identifies the product within its regulatory market.
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Mixture Products

Name	Ingredients	Dosage	Route	Labeller	Marketing Start	Marketing End	Region	Image
Thyrolar	Levothyroxine sodium (100 ug/1) + Liothyronine sodium (25 ug/1)	Tablet	Oral	Allergan, Inc.	1969-11-21	2010-06-25
Thyrolar	Levothyroxine sodium (12.5 ug/1) + Liothyronine sodium (3.1 ug/1)	Tablet	Oral	Allergan, Inc.	1969-11-21	2010-12-03
Thyrolar	Levothyroxine sodium (150 ug/1) + Liothyronine sodium (37.5 ug/1)	Tablet	Oral	Allergan, Inc.	1969-11-21	2010-09-24
Thyrolar	Levothyroxine sodium (50 ug/1) + Liothyronine sodium (12.5 ug/1)	Tablet	Oral	Allergan, Inc.	1969-11-21	2010-08-26
Thyrolar	Levothyroxine sodium (25 ug/1) + Liothyronine sodium (6.25 ug/1)	Tablet	Oral	Allergan, Inc.	1969-11-21	2010-12-10

Unapproved/Other Products

Name	Ingredients	Dosage	Route	Labeller	Marketing Start	Marketing End	Region	Image
Levothyroxine and Liothyronine Thyroid	Levothyroxine (38 ug/1) + Liothyronine (9 ug/1)	Tablet	Oral	Westminster	2017-09-19	Not applicable
Levothyroxine and Liothyronine Thyroid	Levothyroxine (9.5 ug/1) + Liothyronine (2.25 ug/1)	Tablet	Oral	Westminster	2017-11-15	Not applicable
Levothyroxine and Liothyronine Thyroid	Levothyroxine (19 ug/1) + Liothyronine (4.5 ug/1)	Tablet	Oral	Westminster	2017-09-19	Not applicable
Levothyroxine and Liothyronine Thyroid	Levothyroxine (76 ug/1) + Liothyronine (18 ug/1)	Tablet	Oral	Westminster	2017-11-15	Not applicable
Levothyroxine and Liothyronine Thyroid	Levothyroxine (19 ug/1) + Liothyronine (4.5 ug/1)	Tablet	Oral	bryant ranch prepack	2017-09-19	Not applicable
Levothyroxine and Liothyronine Thyroid	Levothyroxine (57 ug/1) + Liothyronine (13.5 ug/1)	Tablet	Oral	Westminster	2017-09-19	Not applicable
Levothyroxine and Liothyronine Thyroid	Levothyroxine (38 ug/1) + Liothyronine (9 ug/1)	Tablet	Oral	bryant ranch prepack	2017-09-19	Not applicable
NP Thyroid 120	Levothyroxine (76 ug/1) + Liothyronine (18 ug/1)	Tablet	Oral	Preferred Pharmaceuticals Inc.	2017-10-12	2019-11-07
NP Thyroid 120	Levothyroxine (76 ug/1) + Liothyronine (18 ug/1)	Tablet	Oral	Acella Pharmaceuticals, LLC	2017-06-12	Not applicable
NP Thyroid 15	Levothyroxine (9.5 ug/1) + Liothyronine (2.25 ug/1)	Tablet	Oral	Acella Pharmaceuticals, LLC	2016-11-16	Not applicable

Categories

ATC Codes

H03AA01 — Levothyroxine sodium

• H03AA — Thyroid hormones
• H03A — THYROID PREPARATIONS
• H03 — THYROID THERAPY
• H — SYSTEMIC HORMONAL PREPARATIONS, EXCL. SEX HORMONES AND INSULINS

Drug Categories

• Agents used to treat hypothyroidism
• Amino Acids
• Amino Acids, Aromatic
• Amino Acids, Cyclic
• Amino Acids, Peptides, and Proteins
• Cytochrome P-450 CYP2C8 Inhibitors
• Cytochrome P-450 CYP2C8 Inhibitors (moderate)
• Cytochrome P-450 Enzyme Inhibitors
• Cytochrome P-450 Substrates
• Hormones
• Hormones, Hormone Substitutes, and Hormone Antagonists
• Narrow Therapeutic Index Drugs
• OATP1B1/SLCO1B1 Substrates
• OATP1B3 inhibitors
• P-glycoprotein inducers
• Systemic Hormonal Preparations, Excl. Sex Hormones and Insulins
• Thyroid Products
• Thyroxine-binding globulin substrates
• UGT1A1 Substrates
• UGT1A1 substrates with narrow therapeutic index

Chemical TaxonomyProvided by Classyfire

Description

This compound belongs to the class of organic compounds known as phenylalanine and derivatives. These are compounds containing phenylalanine or a derivative thereof resulting from reaction of phenylalanine at the amino group or the carboxy group, or from the replacement of any hydrogen of glycine by a heteroatom.

Kingdom

Organic compounds

Super Class

Organic acids and derivatives

Class

Carboxylic acids and derivatives

Sub Class

Amino acids, peptides, and analogues

Direct Parent

Phenylalanine and derivatives

Alternative Parents

Diphenylethers / Phenylpropanoic acids / Diarylethers / Amphetamines and derivatives / L-alpha-amino acids / Phenoxy compounds / Phenol ethers / O-iodophenols / Aralkylamines / Iodobenzenes / Aryl iodides / Amino acids / Monocarboxylic acids and derivatives / Carboxylic acids / Organoiodides / Carbonyl compounds / Organopnictogen compounds / Organic oxides / Monoalkylamines / Hydrocarbon derivatives

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Substituents

2-halophenol / 2-iodophenol / 3-phenylpropanoic-acid / Alpha-amino acid / Amine / Amino acid / Amphetamine or derivatives / Aralkylamine / Aromatic homomonocyclic compound / Aryl halide / Aryl iodide / Benzenoid / Carbonyl group / Carboxylic acid / Diaryl ether / Diphenylether / Ether / Halobenzene / Hydrocarbon derivative / Iodobenzene / L-alpha-amino acid / Monocarboxylic acid or derivatives / Monocyclic benzene moiety / Organic nitrogen compound / Organic oxide / Organic oxygen compound / Organohalogen compound / Organoiodide / Organonitrogen compound / Organooxygen compound / Organopnictogen compound / Phenol / Phenol ether / Phenoxy compound / Phenylalanine or derivatives / Primary aliphatic amine / Primary amine

show 27 more

Molecular Framework

Aromatic homomonocyclic compounds

External Descriptors

non-proteinogenic L-alpha-amino acid, L-phenylalanine derivative, iodophenol, 2-halophenol, thyroxine (CHEBI:18332) / thyroxine, Other amino acids, Biogenic amines (C01829)

Chemical Identifiers

UNII

Q51BO43MG4

CAS number

51-48-9

InChI Key

XUIIKFGFIJCVMT-LBPRGKRZSA-N

InChI

InChI=1S/C15H11I4NO4/c16-8-4-7(5-9(17)13(8)21)24-14-10(18)1-6(2-11(14)19)3-12(20)15(22)23/h1-2,4-5,12,21H,3,20H2,(H,22,23)/t12-/m0/s1

IUPAC Name

(2S)-2-amino-3-[4-(4-hydroxy-3,5-diiodophenoxy)-3,5-diiodophenyl]propanoic acid

SMILES

N[C@@H](CC1=CC(I)=C(OC2=CC(I)=C(O)C(I)=C2)C(I)=C1)C(O)=O

References

Synthesis Reference

Jivn-Ren Chen, Dimitri C. Papadimitriou, "Stable dosage of levothyroxine sodium and process of production." U.S. Patent US5225204, issued November, 1991.

US5225204

General References

1. Uchino H, Kanai Y, Kim DK, Wempe MF, Chairoungdua A, Morimoto E, Anders MW, Endou H: Transport of amino acid-related compounds mediated by L-type amino acid transporter 1 (LAT1): insights into the mechanisms of substrate recognition. Mol Pharmacol. 2002 Apr;61(4):729-37. [PubMed:11901210]
2. Cheng SY, Leonard JL, Davis PJ: Molecular aspects of thyroid hormone actions. Endocr Rev. 2010 Apr;31(2):139-70. doi: 10.1210/er.2009-0007. Epub 2010 Jan 5. [PubMed:20051527]
3. Chon DA, Reisman T, Weinreb JE, Hershman JM, Leung AM: Concurrent Milk Ingestion Decreases Absorption of Levothyroxine. Thyroid. 2018 Apr;28(4):454-457. doi: 10.1089/thy.2017.0428. Epub 2018 Mar 28. [PubMed:29589994]
4. Tang R, Wang J, Yang L, Ding X, Zhong Y, Pan J, Yang H, Mu L, Chen X, Chen Z: Subclinical Hypothyroidism and Depression: A Systematic Review and Meta-Analysis. Front Endocrinol (Lausanne). 2019 Jun 4;10:340. doi: 10.3389/fendo.2019.00340. eCollection 2019. [PubMed:31214119]
5. Gottwald-Hostalek U, Uhl W, Wolna P, Kahaly GJ: New levothyroxine formulation meeting 95-105% specification over the whole shelf-life: results from two pharmacokinetic trials. Curr Med Res Opin. 2017 Feb;33(2):169-174. doi: 10.1080/03007995.2016.1246434. Epub 2016 Oct 21. [PubMed:27718637]
6. Osmak-Tizon L, Poussier M, Cottin Y, Rochette L: Non-genomic actions of thyroid hormones: Molecular aspects. Arch Cardiovasc Dis. 2014 Apr;107(4):207-11. doi: 10.1016/j.acvd.2014.02.001. Epub 2014 Mar 26. [PubMed:24680385]
7. Klein I, Ojamaa K: Thyroid hormone and the cardiovascular system. N Engl J Med. 2001 Feb 15;344(7):501-9. doi: 10.1056/NEJM200102153440707. [PubMed:11172193]
8. Kaplan MM, Breitbart R: Conversion of thyroxine to triiodothyronine in the anterior pituitary gland and the influence of this process on thyroid status. Horm Metab Res Suppl. 1984;14:79-85. [PubMed:6595194]
9. Hammes SR, Davis PJ: Overlapping nongenomic and genomic actions of thyroid hormone and steroids. Best Pract Res Clin Endocrinol Metab. 2015 Aug;29(4):581-93. doi: 10.1016/j.beem.2015.04.001. Epub 2015 Apr 22. [PubMed:26303085]
10. Jonklaas J, Bianco AC, Bauer AJ, Burman KD, Cappola AR, Celi FS, Cooper DS, Kim BW, Peeters RP, Rosenthal MS, Sawka AM: Guidelines for the treatment of hypothyroidism: prepared by the american thyroid association task force on thyroid hormone replacement. Thyroid. 2014 Dec;24(12):1670-751. doi: 10.1089/thy.2014.0028. [PubMed:25266247]
11. Davis PJ, Leonard JL, Davis FB: Mechanisms of nongenomic actions of thyroid hormone. Front Neuroendocrinol. 2008 May;29(2):211-8. doi: 10.1016/j.yfrne.2007.09.003. Epub 2007 Oct 5. [PubMed:17983645]
12. Bergh JJ, Lin HY, Lansing L, Mohamed SN, Davis FB, Mousa S, Davis PJ: Integrin alphaVbeta3 contains a cell surface receptor site for thyroid hormone that is linked to activation of mitogen-activated protein kinase and induction of angiogenesis. Endocrinology. 2005 Jul;146(7):2864-71. doi: 10.1210/en.2005-0102. Epub 2005 Mar 31. [PubMed:15802494]
13. FDA Approved Drug Products: Synthroid® oral tablets [Link]
14. FDA Label - levothyroxine [File]
15. American Association of Clinical Endocrinologists (AACE): Clinical Practice Guidelines for Hypothyroidism in Adults [File]

External Links

Human Metabolome Database

HMDB0000248

KEGG Drug

D08125

KEGG Compound

C01829

PubChem Compound

5819

PubChem Substance

46507672

ChemSpider

5614

BindingDB

50301375

RxNav

10582

ChEBI

18332

ChEMBL

CHEMBL1624

ZINC

ZINC000003830993

Therapeutic Targets Database

DAP000083

PharmGKB

PA450221

Guide to Pharmacology

GtP Drug Page

PDBe Ligand

T44

RxList

RxList Drug Page

Drugs.com

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Levothyroxine

AHFS Codes

• 68:36.04 — Thyroid Agents

PDB Entries

1eta / 1etb / 1f86 / 1hk1 / 1hk2 / 1hk3 / 1hk4 / 1hk5 / 1ict / 1ie4 …

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MSDS

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Clinical Trials

Clinical Trials

Phase	Status	Purpose	Conditions	Count
4	Active Not Recruiting	Treatment	Endocrine System Diseases / Hypothyroidism / Thyroid Diseases	2
4	Active Not Recruiting	Treatment	Healthy Volunteers	1
4	Completed	Not Available	Hypothyroidism	1
4	Completed	Prevention	Graves´ Disease	1
4	Completed	Treatment	Atherosclerosis / Heart Failure / Thyroid Dysfunction	2
4	Completed	Treatment	Bone Mineral Density / Fractures, Bone / Osteoporosis / Thyroid Dysfunction	1
4	Completed	Treatment	Depression / Subclinical Hypothyroidism	1
4	Completed	Treatment	Euthyroid Sick Syndromes	1
4	Completed	Treatment	Fatigue / Mental Fatigue / Thyroid Dysfunction	1
4	Completed	Treatment	Goiter, Nodular	1

Pharmacoeconomics

Manufacturers

• Institute biochimique sa (ibsa)
• Institut biochimique sa ibsa
• Vintage pharmaceuticals llc
• Alara pharmaceutical corporation
• Lloyd inc
• Merck kgaa
• Mylan pharmaceuticals inc
• King pharmaceuticals inc
• Abbott laboratories
• Jerome stevens pharmaceuticals inc

Packagers

• Abbott Laboratories Ltd.
• Advanced Pharmaceutical Services Inc.
• Akrimax Pharmaceuticals
• Amerisource Health Services Corp.
• Apotheca Inc.
• APP Pharmaceuticals
• A-S Medication Solutions LLC
• Atlantic Biologicals Corporation
• BASF Corp.
• Bedford Labs
• Ben Venue Laboratories Inc.
• Bryant Ranch Prepack
• Cardinal Health
• Caremark LLC
• Comprehensive Consultant Services Inc.
• Corepharma LLC
• Direct Dispensing Inc.
• Direct Pharmaceuticals Inc.
• Dispensing Solutions
• Diversified Healthcare Services Inc.
• Forest Pharmaceuticals
• Genpharm LP
• Giant Food Inc.
• H.E. Butt Grocery Co.
• H.J. Harkins Co. Inc.
• Heartland Repack Services LLC
• Innovative Manufacturing and Distribution Services Inc.
• Jerome Stevens Pharmaceuticals Inc.
• JMI Daniels Pharmaceuticals Inc.
• Kaiser Foundation Hospital
• King Pharmaceuticals Inc.
• Lake Erie Medical and Surgical Supply
• Lannett Co. Inc.
• Liberty Pharmaceuticals
• Lloyd Pharmaceuticals
• Macnary Ltd.
• Major Pharmaceuticals
• Mckesson Corp.
• Medisca Inc.
• Merck KGaA
• Monarch Pharmacy
• Murfreesboro Pharmaceutical Nursing Supply
• Mylan
• Neuman Distributors Inc.
• Nucare Pharmaceuticals Inc.
• Palmetto Pharmaceuticals Inc.
• Patheon Inc.
• PCA LLC
• PD-Rx Pharmaceuticals Inc.
• Pharmaceutical Utilization Management Program VA Inc.
• Pharmacy Service Center
• Pharmedix
• Physicians Total Care Inc.
• Preferred Pharmaceuticals Inc.
• Prepackage Specialists
• Prepak Systems Inc.
• Prescript Pharmaceuticals
• Qualitest
• Rebel Distributors Corp.
• Remedy Repack
• Resource Optimization and Innovation LLC
• Rite Aid Corp.
• Sandhills Packaging Inc.
• Sandoz
• Simildiet SL
• Southwood Pharmaceuticals
• Stat Scripts LLC
• Teva Pharmaceutical Industries Ltd.
• UDL Laboratories
• Va Cmop Dallas
• Watson Pharmaceuticals

Dosage Forms

Form	Route	Strength
Tablet		100 UG
Tablet		125 UG
Tablet		150 UG
Tablet		50 UG
Tablet		75 UG
Tablet		100 MIKROGRAMM
Tablet		112 MIKROGRAMM
Tablet		125 MIKROGRAMM
Tablet		137 MIKROGRAMM
Tablet		150 MIKROGRAMM
Tablet		175 MIKROGRAMM
Tablet		200 MIKROGRAMM
Tablet		25 MIKROGRAMM
Tablet		50 MIKROGRAMM
Tablet		75 MIKROGRAMM
Tablet		88 MIKROGRAMM
Tablet		25 UG
Tablet		175 UG
Tablet		200 UG
Tablet		112 UG
Tablet		88 UG
Tablet		137 UG
Injection	Intravenous	100 ug/5mL
Injection	Intravenous	500 ug/5mL
Injection, powder, lyophilized, for solution	Intravenous	100 ug/1
Injection, powder, lyophilized, for solution	Intravenous	100 ug/5mL
Injection, powder, lyophilized, for solution	Intravenous	200 ug/5mL
Injection, powder, lyophilized, for solution	Intravenous	500 ug/5mL
Injection, powder, lyophilized, for solution	Intravenous	500 ug/1
Injection, solution	Intravenous	100 ug/1mL
Injection, solution	Intravenous	20 ug/1mL
Injection, solution	Intravenous	40 ug/1mL
Tablet	Not applicable	100 ug/1
Tablet	Not applicable	112 ug/1
Tablet	Not applicable	125 ug/1
Tablet	Not applicable	137 ug/1
Tablet	Not applicable	150 ug/1
Tablet	Not applicable	175 ug/1
Tablet	Not applicable	200 ug/1
Tablet	Not applicable	25 ug/1
Tablet	Not applicable	50 ug/1
Tablet	Not applicable	75 ug/1
Tablet	Not applicable	88 ug/1
Tablet	Oral	.025 mg/1
Tablet	Oral	.05 mg/1
Tablet	Oral	.075 mg/1
Tablet	Oral	.088 mg/1
Tablet	Oral	.1 mg/1
Tablet	Oral	.112 mg/1
Tablet	Oral	.125 mg/1
Tablet	Oral	.137 mg/1
Tablet	Oral	.15 mg/1
Tablet	Oral	.150 mg/1
Tablet	Oral	0.025 mg/1
Tablet	Oral	0.05 mg/1
Tablet	Oral	0.050 mg/1
Tablet	Oral	0.075 mg/1
Tablet	Oral	0.088 mg/1
Tablet	Oral	0.1 mg/1
Tablet	Oral	0.100 mg/1
Tablet	Oral	0.112 mg/1
Tablet	Oral	0.125 mg/1
Tablet	Oral	0.137 mg/1
Tablet	Oral	0.15 mg/1
Tablet	Oral	0.150 mg/1
Tablet	Oral	0.175 mg/1
Tablet	Oral	0.2 mg/1
Tablet	Oral	0.200 mg/1
Tablet	Oral	0.3 mg/1
Tablet	Oral	0.300 mg/1
Tablet	Oral	100 ug/1
Tablet	Oral	112 ug/1
Tablet	Oral	125 ug/1
Tablet	Oral	137 ug/1
Tablet	Oral	150 ug/1
Tablet	Oral	175 ug/1
Tablet	Oral	200 ug/1
Tablet	Oral	25 ug/1
Tablet	Oral	300 ug/1
Tablet	Oral	50 ug/1
Tablet	Oral	75 ug/1
Tablet	Oral	88 ug/1
Powder, for solution	Intramuscular; Intravenous
Solution	Intramuscular; Intravenous
Tablet	Topical
Tablet	Oral	100 mcg
Tablet	Oral	112 mcg
Tablet	Oral	125 mcg
Tablet	Oral	137 mcg
Tablet	Oral	150 mcg
Tablet	Oral	175 mcg
Tablet	Oral	200 mcg
Tablet	Oral	25 mcg
Tablet	Oral	300 mcg
Tablet	Oral	50 mcg
Tablet	Oral	75 mcg
Tablet	Oral	88 mcg
Liquid	Intravenous
Tablet	Oral
Tablet	Oral
Capsule	Oral	100 ug/1
Capsule	Oral	112 ug/1
Capsule	Oral	125 ug/1
Capsule	Oral	13 ug/1
Capsule	Oral	137 ug/1
Capsule	Oral	150 ug/1
Capsule	Oral	175 ug/1
Capsule	Oral	200 ug/1
Capsule	Oral	25 ug/1
Capsule	Oral	50 ug/1
Capsule	Oral	75 ug/1
Capsule	Oral	88 ug/1
Solution	Oral	100 ug/1mL
Solution	Oral	112 ug/1mL
Solution	Oral	125 ug/1mL
Solution	Oral	13 ug/1mL
Solution	Oral	137 ug/1mL
Solution	Oral	150 ug/1mL
Solution	Oral	175 ug/1mL
Solution	Oral	200 ug/1mL
Solution	Oral	25 ug/1mL
Solution	Oral	50 ug/1mL
Solution	Oral	75 ug/1mL
Solution	Oral	88 ug/1mL

Prices

Unit description	Cost	Unit
Levothyroxine sodium powder	159.12USD	g
Levothyroxine 200 mcg vial	24.0USD	vial
Levothyroxine 500 mcg vial	24.0USD	vial
Levoxyl 300 mcg tablet	2.34USD	tablet
Synthroid 300 mcg tablet	1.29USD	tablet
Synthroid 175 mcg tablet	1.07USD	tablet
Synthroid 200 mcg tablet	0.99USD	tablet
Synthroid 137 mcg tablet	0.87USD	tablet
Synthroid 112 mcg tablet	0.84USD	tablet
Synthroid 125 mcg tablet	0.84USD	tablet
Synthroid 150 mcg tablet	0.83USD	tablet
Levothyroxine Sodium 300 mcg tablet	0.77USD	tablet
Synthroid 100 mcg tablet	0.73USD	tablet
Synthroid 75 mcg tablet	0.72USD	tablet
Synthroid 88 mcg tablet	0.71USD	tablet
Levoxyl 200 mcg tablet	0.7USD	tablet
Levoxyl 175 mcg tablet	0.69USD	tablet
Unithroid 300 mcg tablet	0.69USD	tablet
Synthroid 50 mcg tablet	0.65USD	tablet
Levoxyl 137 mcg tablet	0.62USD	tablet
Unithroid 200 mcg tablet	0.62USD	tablet
Levoxyl 112 mcg tablet	0.61USD	tablet
Synthroid 25 mcg tablet	0.61USD	tablet
Unithroid 175 mcg tablet	0.61USD	tablet
Levoxyl 150 mcg tablet	0.59USD	tablet
Levoxyl 125 mcg tablet	0.58USD	tablet
Levothyroxine Sodium 175 mcg tablet	0.57USD	tablet
Levothyroxine Sodium 200 mcg tablet	0.57USD	tablet
Levothyroxine 175 mcg tablet	0.55USD	tablet
Unithroid 150 mcg tablet	0.55USD	tablet
Levoxyl 88 mcg tablet	0.54USD	tablet
Unithroid 112 mcg tablet	0.53USD	tablet
Unithroid 125 mcg tablet	0.53USD	tablet
Levoxyl 75 mcg tablet	0.52USD	tablet
Levothroid 300 mcg tablet	0.51USD	tablet
Levoxyl 100 mcg tablet	0.51USD	tablet
Levothyroxine Sodium 100 mcg tablet	0.5USD	tablet
Levothyroxine Sodium 150 mcg tablet	0.5USD	tablet
Levothyroxine Sodium 88 mcg tablet	0.5USD	tablet
Levoxyl 50 mcg tablet	0.49USD	tablet
Unithroid 88 mcg tablet	0.49USD	tablet
Unithroid 100 mcg tablet	0.47USD	tablet
Unithroid 75 mcg tablet	0.47USD	tablet
Levothyroxine Sodium 125 mcg tablet	0.47USD	tablet
Levothyroxine Sodium 137 mcg tablet	0.47USD	tablet
Levothyroxine Sodium 50 mcg tablet	0.47USD	tablet
Levothyroxine Sodium 75 mcg tablet	0.47USD	tablet
Levothyroxine Sodium 112 mcg tablet	0.46USD	tablet
Levothyroxine 137 mcg tablet	0.45USD	tablet
Levoxyl 25 mcg tablet	0.45USD	tablet
Levothyroxine 112 mcg tablet	0.44USD	tablet
Levothyroxine Sodium 25 mcg tablet	0.43USD	tablet
Unithroid 50 mcg tablet	0.43USD	tablet
Unithroid 25 mcg tablet	0.42USD	tablet
Unithroid direct 100 mcg tablet	0.42USD	tablet
Unithroid direct 112 mcg tablet	0.42USD	tablet
Unithroid direct 125 mcg tablet	0.42USD	tablet
Unithroid direct 150 mcg tablet	0.42USD	tablet
Unithroid direct 175 mcg tablet	0.42USD	tablet
Unithroid direct 200 mcg tablet	0.42USD	tablet
Unithroid direct 25 mcg tablet	0.42USD	tablet
Unithroid direct 300 mcg tablet	0.42USD	tablet
Unithroid direct 50 mcg tablet	0.42USD	tablet
Unithroid direct 75 mcg tablet	0.42USD	tablet
Unithroid direct 88 mcg tablet	0.42USD	tablet
Levothroid 200 mcg tablet	0.4USD	tablet
Levothroid 175 mcg tablet	0.38USD	tablet
Levothyroxine 88 mcg tablet	0.38USD	tablet
Levothroid 125 mcg tablet	0.36USD	tablet
Levothroid 150 mcg tablet	0.36USD	tablet
Levothroid 100 mcg tablet	0.35USD	tablet
Levothroid 137 mcg tablet	0.35USD	tablet
Levothroid 112 mcg tablet	0.34USD	tablet
Levothroid 75 mcg tablet	0.33USD	tablet
Levothroid 88 mcg tablet	0.33USD	tablet
Levothyroxine 300 mcg tablet	0.32USD	tablet
Levothroid 25 mcg tablet	0.31USD	tablet
Unithroid 137 mcg tablet	0.31USD	tablet
Levothroid 50 mcg tablet	0.3USD	tablet
Levothyroxine 200 mcg tablet	0.29USD	tablet
Levothyroxine 150 mcg tablet	0.24USD	tablet
Levothyroxine 125 mcg tablet	0.22USD	tablet
Levothyroxine 100 mcg tablet	0.2USD	tablet
Levothyroxine 75 mcg tablet	0.2USD	tablet
Levothyroxine 50 mcg tablet	0.18USD	tablet
Synthroid 0.137 mg Tablet	0.18USD	tablet
Levothyroxine 25 mcg tablet	0.17USD	tablet
Synthroid 0.3 mg Tablet	0.12USD	tablet
Synthroid 0.175 mg Tablet	0.11USD	tablet
Synthroid 0.075 mg Tablet	0.1USD	tablet
Synthroid 0.088 mg Tablet	0.1USD	tablet
Synthroid 0.112 mg Tablet	0.1USD	tablet
Synthroid 0.125 mg Tablet	0.1USD	tablet
Synthroid 0.025 mg Tablet	0.09USD	tablet
Synthroid 0.2 mg Tablet	0.09USD	tablet
Synthroid 0.1 mg Tablet	0.08USD	tablet
Synthroid 0.15 mg Tablet	0.08USD	tablet
Eltroxin 0.3 mg Tablet	0.07USD	tablet
Synthroid 0.05 mg Tablet	0.06USD	tablet
Eltroxin 0.2 mg Tablet	0.05USD	tablet
Eltroxin 0.1 mg Tablet	0.04USD	tablet
Eltroxin 0.15 mg Tablet	0.04USD	tablet
Eltroxin 0.05 mg Tablet	0.03USD	tablet

DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.

Patents

Patent Number	Pediatric Extension	Approved	Expires (estimated)	Region
Unlock Additional Data
US7723390	No	2010-05-25	2024-03-14
US7101569	No	2006-09-05	2023-10-02
US7067148	No	2006-06-27	2022-02-15
US6555581	No	2003-04-29	2022-02-15
US6399101	No	2002-06-04	2020-03-30
US9168239	No	2015-10-27	2032-08-29
US9168238	No	2015-10-27	2032-08-29
US9006289	No	2015-04-14	2032-10-03
US7691411	No	2010-04-06	2024-03-14
US9782376	No	2017-10-10	2036-12-01
US10398669	No	2019-09-03	2036-12-01
US10537538	No	2017-02-28	2037-02-28

Additional Data Available

Filed On
Filed On
The date on which a patent was filed with the relevant government.
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Properties

State

Solid

Experimental Properties

Property	Value	Source
melting point (°C)	235.5 °C	PhysProp
water solubility	0.105 mg/mL	Not Available
logP	4	Not Available

Predicted Properties

Property	Value	Source
Water Solubility	0.00898 mg/mL	ALOGPS
logP	1.15	ALOGPS
logP	3.73	ChemAxon
logS	-4.9	ALOGPS
pKa (Strongest Acidic)	0.27	ChemAxon
pKa (Strongest Basic)	9.43	ChemAxon
Physiological Charge	0	ChemAxon
Hydrogen Acceptor Count	4	ChemAxon
Hydrogen Donor Count	3	ChemAxon
Polar Surface Area	92.78 Å2	ChemAxon
Rotatable Bond Count	5	ChemAxon
Refractivity	126.79 m3·mol-1	ChemAxon
Polarizability	49.4 Å3	ChemAxon
Number of Rings	2	ChemAxon
Bioavailability	1	ChemAxon
Rule of Five	No	ChemAxon
Ghose Filter	No	ChemAxon
Veber's Rule	No	ChemAxon
MDDR-like Rule	No	ChemAxon

Predicted ADMET Features

Property	Value	Probability
Human Intestinal Absorption	+	0.7212
Blood Brain Barrier	-	0.6886
Caco-2 permeable	-	0.653
P-glycoprotein substrate	Non-substrate	0.5321
P-glycoprotein inhibitor I	Non-inhibitor	0.9175
P-glycoprotein inhibitor II	Non-inhibitor	0.9709
Renal organic cation transporter	Non-inhibitor	0.8891
CYP450 2C9 substrate	Non-substrate	0.8309
CYP450 2D6 substrate	Non-substrate	0.9116
CYP450 3A4 substrate	Non-substrate	0.6847
CYP450 1A2 substrate	Non-inhibitor	0.5924
CYP450 2C9 inhibitor	Non-inhibitor	0.7037
CYP450 2D6 inhibitor	Non-inhibitor	0.923
CYP450 2C19 inhibitor	Non-inhibitor	0.9025
CYP450 3A4 inhibitor	Non-inhibitor	0.831
CYP450 inhibitory promiscuity	Low CYP Inhibitory Promiscuity	0.8459
Ames test	Non AMES toxic	0.7591
Carcinogenicity	Non-carcinogens	0.9148
Biodegradation	Not ready biodegradable	0.9693
Rat acute toxicity	2.7082 LD50, mol/kg	Not applicable
hERG inhibition (predictor I)	Weak inhibitor	0.9697
hERG inhibition (predictor II)	Non-inhibitor	0.8508

ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397)

Spectra

Mass Spec (NIST)

Not Available

Spectra

Spectrum	Spectrum Type	Splash Key
Predicted GC-MS Spectrum - GC-MS	Predicted GC-MS	Not Available
MS/MS Spectrum - Quattro_QQQ 10V, Positive	LC-MS/MS	splash10-0ac9-0591664310-c9b7aec3184ebb20a2da
MS/MS Spectrum - Quattro_QQQ 25V, Positive	LC-MS/MS	splash10-014i-2566449540-35bb942c7bcbcfe41af7
MS/MS Spectrum - Quattro_QQQ 40V, Positive	LC-MS/MS	splash10-00xr-3375497520-9dee3cb0c153e6c6df9e
Predicted MS/MS Spectrum - 10V, Positive (Annotated)	Predicted LC-MS/MS	Not Available
Predicted MS/MS Spectrum - 20V, Positive (Annotated)	Predicted LC-MS/MS	Not Available
Predicted MS/MS Spectrum - 40V, Positive (Annotated)	Predicted LC-MS/MS	Not Available
Predicted MS/MS Spectrum - 10V, Negative (Annotated)	Predicted LC-MS/MS	Not Available
Predicted MS/MS Spectrum - 20V, Negative (Annotated)	Predicted LC-MS/MS	Not Available
Predicted MS/MS Spectrum - 40V, Negative (Annotated)	Predicted LC-MS/MS	Not Available
MS/MS Spectrum - , positive	LC-MS/MS	splash10-0059-0001001900-83ff4aafed0b73c6c7b7
1H NMR Spectrum	1D NMR	Not Applicable
[1H,13C] 2D NMR Spectrum	2D NMR	Not Applicable

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Drug created on June 13, 2005 07:24 / Updated on August 05, 2020 23:35