Liel Y, Sperber A D, Shany S
Department of Medicine, Soroka Medical Center of Kupat Holim, Beer-Sheva, Israel.
Am J Med. 1994 Oct;97(4):363-5. doi: 10.1016/0002-9343(94)90303-4.
To evaluate the adverse effect of aluminum hydroxide on levothyroxine pharmacokinetics in hypothyroid patients and study the mechanism of this effect.
An in vivo open study supplemented by in vitro experiments.
A university hospital-based outpatient service.
Administration for 2 to 4 weeks of an aluminum hydroxide-containing preparation to patients balanced on replacement thyroxine therapy.
Serum thyrotropin (TSH).
A significant increase in serum TSH was observed during seven periods of aluminum hydroxide administration (7.19 +/- 1.3 versus 2.62 +/- 0.8 mU/L; P = 0.012). In vitro studies indicated a considerable nonspecific adsorptive capacity of aluminum hydroxide for thyroxine.
The results indicate an adverse effect of aluminum hydroxide on levothyroxine bioavailability through a mechanism involving nonspecific adsorption, or complexing, of levothyroxine to aluminum hydroxide. We recommend close monitoring of serum TSH levels in patients receiving oral thyroid hormone replacement therapy who concurrently take aluminum hydroxide-containing medications. Adjustment of the levothyroxine dose, or cessation of the antacid, may be necessary.
评估氢氧化铝对甲状腺功能减退患者左甲状腺素药代动力学的不良影响，并研究其作用机制。
一项体内开放性研究，并辅以体外实验。
一家大学医院的门诊服务部。
对接受甲状腺素替代治疗且病情稳定的患者给予含氢氧化铝制剂2至4周。
血清促甲状腺激素（TSH）。
在七个氢氧化铝给药期内观察到血清TSH显著升高（7.19±1.3对2.62±0.8 mU/L；P = 0.012）。体外研究表明氢氧化铝对甲状腺素有相当大的非特异性吸附能力。
结果表明氢氧化铝通过左甲状腺素与氢氧化铝的非特异性吸附或络合机制对左甲状腺素生物利用度产生不良影响。我们建议对同时服用含氢氧化铝药物的口服甲状腺激素替代治疗患者密切监测血清TSH水平。可能需要调整左甲状腺素剂量或停用抗酸剂。
