From the Research
To prepare a levothyroxine solution using Ora-Sweet or Ora-Plus, mix crushed levothyroxine tablets with a 1:1 ratio of Ora-Sweet and Ora-Plus to create a 25 mcg/mL suspension, as this method has been shown to be effective in clinical practice 1.
Preparation Steps
- Crush the required number of tablets to achieve the desired concentration, for example, ten 100 mcg tablets to make 40 mL of a 25 mcg/mL solution.
- Triturate the crushed tablets with a small amount of the vehicle to form a smooth paste, then gradually add more vehicle while mixing until you reach the final volume.
- The resulting suspension should be stored in an amber glass bottle, refrigerated, and used within 14 days, as the stability of levothyroxine sodium in oral liquid dosage forms has been studied and found to be most stable under these conditions 2.
Key Considerations
- Shake well before each use to ensure uniform distribution of the medication.
- This compounded preparation is necessary because levothyroxine is unstable in solution and commercially available liquid formulations are limited.
- The acidic nature of Ora-Sweet helps preserve the medication while Ora-Plus provides suspension stability.
- Always label the container with preparation date, expiration date, storage requirements, and dosing instructions.
- Remember that compounded preparations may have variable potency compared to commercial products, so careful monitoring of thyroid function tests is recommended when using this formulation, as supported by recent studies on the use of liquid and softgel levothyroxine formulations 3, 4, 5.