Comparative Pharmacology
Head-to-head clinical analysis: LEVOTHYROXINE versus RECORLEV.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LEVOTHYROXINE versus RECORLEV.
Levothyroxine vs RECORLEV
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Levothyroxine is a synthetic form of thyroxine (T4) that is converted to triiodothyronine (T3) in peripheral tissues. T3 binds to thyroid hormone receptors in the nucleus, regulating gene transcription and increasing metabolic rate, protein synthesis, and oxygen consumption.
RECORLEV (levoketoconazole) is an orally administered corticosteroid biosynthesis inhibitor that suppresses cortisol production by inhibiting adrenal and gonadal steroidogenic enzymes, particularly CYP17A1 (17α-hydroxylase and 17,20-lyase) and CYP11B1 (11β-hydroxylase). It also weakly inhibits CYP3A4 and other CYP enzymes.
1.6 mcg/kg orally once daily, adjusted based on TSH levels; typical adult dose 50-200 mcg/day.
150 mg orally twice daily with a high-fat meal.
None Documented
None Documented
Clinical Note
moderateLevothyroxine + Sulfisoxazole
"The metabolism of Sulfisoxazole can be decreased when combined with Levothyroxine."
Clinical Note
moderateLevothyroxine + Erythromycin
"The metabolism of Erythromycin can be decreased when combined with Levothyroxine."
Clinical Note
moderateLevothyroxine + Cyclosporine
"The metabolism of Cyclosporine can be decreased when combined with Levothyroxine."
Clinical Note
moderateLevothyroxine + Fluconazole
7 days (euthyroid); prolonged in hyperthyroidism (3-4 days) and shortened in hypothyroidism (9-10 days); clinical effects persist for weeks after discontinuation due to slow elimination.
18 hours; prolonged in renal impairment (up to 45 hours in CrCl <30 mL/min)
Primarily renal (approximately 50% as unchanged drug and metabolites, mainly glucuronide and sulfate conjugates); minor biliary/fecal excretion (<20%).
Renal: 85% as unchanged drug; Fecal: 10% as metabolites
Category A/B
Category C
Thyroid Hormone
Thyroid Hormone
"The metabolism of Fluconazole can be decreased when combined with Levothyroxine."