Advancing drug safety and mitigating health concerns:High-resolution mass spectrometry in the levothyroxine case study  

作　　者：Hana Chmelařová Maria Carmen Catapano Jean-Christophe Garrigues FrantišekŠvec Lucie Nováková 

机构地区：[1]Department of Analytical Chemistry,Faculty of Pharmacy in Hradec Králové,Charles University,Akademika Heyrovského 1203,50005,Hradec Králové,Czech Republic [2]Laboratoire SOFTMAT(IMRCP),Universitéde Toulouse,CNRS UMR 5623,UniversitéPaul Sabatier,118 route de Narbonne,31062 Toulouse Cedex 9,France

出　　处：《Journal of Pharmaceutical Analysis》2024年第9期1361-1371,共11页药物分析学报（英文版）

基　　金：supported by the project EFSA-CDN(Project No.:CZ.02.01/0.0/0.0/16_019/0000841)co-funded by ERDF.

摘　　要：Levothyroxine is a drug with a narrow therapeutic index.Changing the drug formulation composition or switching between pharmaceutical brands can alter the bioavailability,which can result in major health problems.However,the increased adverse drug reactions have not been fully explained scientifically yet and a thorough investigation of the formulations is needed.In this study,we used a non-targeted analytical approach to examine the various levothyroxine formulations in detail and to reveal possible chemical changes.Ultra-high-performance liquid chromatography coupled with a data-independent acquisition high-resolution mass spectrometry(UHPLC-DIA-HRMS)was employed.UHPLC-DIA-HRMS allowed not only the detection of levothyroxine degradation products,but also the presence of non-expected components in the formulations.Among these,we identified compounds resulting from reactions between mannitol and other excipients,such as citric acid,stearate,and palmitate,or from reactions between an excipient and an active pharmaceutical ingredient,such as levothyroxine-lactose adduct.In addition to these compounds,undeclared phospholipids were also found in three formulations.This non-targeted approach is not common in pharmaceutical quality control analysis.Revealing the presence of unexpected compounds in drug formulations proved that the current control mechanisms do not have to cover the full complexity of pharmaceutical formulations necessarily.

关 键 词：LEVOTHYROXINE EXCIPIENTS IMPURITIES UHPLC-DIA-HRMS Drug safety 

分 类 号：R96[医药卫生—药理学]