{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T18:58:31Z","timestamp":1790621911696,"version":"4.1.0"},"reference-count":14,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Clin Pharmacol"],"published-print":{"date-parts":[[2026,10]]},"abstract":"Abstract<\/jats:title>\n \n Aim<\/jats:title>\n \n To evaluate the relative bioavailability of sublingual\n vs<\/jats:italic>\n . oral levothyroxine (L\u2010T4) in post\u2010thyroidectomy patients, aiming to overcome gastrointestinal absorption variability.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This open\u2010label, randomized, parallel\u2010group pilot study enrolled 15 de novo hypothyroid patients following total thyroidectomy (oral:\n n<\/jats:italic>\n \u2009=\u20097, sublingual:\n n<\/jats:italic>\n \u2009=\u20098). Participants received a single 700\u2010\u03bcg L\u2010T4 dose under fasting conditions. Pharmacokinetic parameters, including baseline\u2010corrected AUC, Cmax and Tmax, were determined via noncompartmental analysis.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Sublingual administration resulted in a Geometric Mean Ratio (GMR) of 1.283 (90% CI: 0.849\u20131.938) for total systemic exposure (AUC\n 0\u2013\u221e<\/jats:sub>\n ) and 1.123 (90% CI: 0.815\u20131.547) for early exposure (AUC\n 0\u201348<\/jats:sub>\n ) compared to the oral route. Due to the small sample size and inter\u2010subject variability, these differences did not reach statistical significance. Elimination kinetics (\n T<\/jats:italic>\n 1\/2<\/jats:sub>\n , MRT) were route\u2010independent, while sublingual delivery showed lower apparent clearance (CL\/\n F<\/jats:italic>\n ), supporting improved bioavailability.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Sublingual L\u2010T4 achieved numerically higher systemic exposure with comparable elimination kinetics to the oral route. These findings suggest sublingual delivery is a promising, practical alternative that mitigates fasting constraints. Large\u2010scale crossover studies are needed to definitively establish bioequivalence and long\u2010term efficacy.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/bcp.70661","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T04:35:33Z","timestamp":1782189333000},"page":"3527-3533","source":"Crossref","is-referenced-by-count":0,"title":["Comparative bioavailability of sublingual\n vs<\/i>\n . oral levothyroxine in patients with post\u2010thyroidectomy hypothyroidism: A single\u2010dose pilot study"],"prefix":"10.1002","volume":"92","author":[{"given":"Osama","family":"Shoaip","sequence":"first","affiliation":[{"name":"General Surgery Department Mansoura University Hospitals Mansoura Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7690-8029","authenticated-orcid":false,"given":"Mahmoud","family":"Bassiony","sequence":"additional","affiliation":[{"name":"Alexandria University Alexandria Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1782-0278","authenticated-orcid":false,"given":"Rana","family":"Elbayar","sequence":"additional","affiliation":[{"name":"Mansoura University Hospitals Mansoura Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohanned","family":"Mohsen","sequence":"additional","affiliation":[{"name":"Mansoura University Hospitals Mansoura Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hagar","family":"Elhammady","sequence":"additional","affiliation":[{"name":"Mansoura University Hospitals Mansoura Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rawda","family":"Elsaadany","sequence":"additional","affiliation":[{"name":"Mansoura University Hospitals Mansoura Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nehal M.","family":"Ramadan","sequence":"additional","affiliation":[{"name":"Clinical Pharmacology Department, Faculty of Medicine Mansoura University Mansoura Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,22]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcae070.328"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.5041\/RMMJ.10229"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.endinu.2023.11.001"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2020.0515"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12020\u2010015\u20100836\u2010y"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2017.01.005"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/pharmaceutics17081073"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1210\/er.2018\u201000168"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.2147\/RMHP.S500557"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/cts.70244"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12325\u2010022\u201002352\u20106"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/FTD.0b013e318217b69f"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcte.2019.100204"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1159\/000508216"}],"container-title":["British Journal of Clinical Pharmacology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/bpspubs.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/bcp.70661","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/bpspubs.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/bcp.70661","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/bpspubs.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/bcp.70661","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T17:56:31Z","timestamp":1790618191000},"score":1,"resource":{"primary":{"URL":"https:\/\/bpspubs.onlinelibrary.wiley.com\/doi\/10.1002\/bcp.70661"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,22]]},"references-count":14,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1002\/bcp.70661"],"URL":"https:\/\/doi.org\/10.1002\/bcp.70661","archive":["Portico"],"relation":{},"ISSN":["0306-5251","1365-2125"],"issn-type":[{"value":"0306-5251","type":"print"},{"value":"1365-2125","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,22]]}}}