T44

3,5,3',5'-TETRAIODO-L-THYRONINE

Find entries where: T44

is present as a standalone ligand in 22 entries

as a non-polymer is covalently linked to polymer or other heterogen groups 5 entries

is present in a polymer sequence 2 entries

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Chemical Component Summary
Name	3,5,3',5'-TETRAIODO-L-THYRONINE
Identifiers	(2S)-2-amino-3-[4-(4-hydroxy-3,5-diiodo-phenoxy)-3,5-diiodo-phenyl]propanoic acid
Formula	C₁₅ H₁₁ I₄ N O₄
Molecular Weight	776.87
Type	NON-POLYMER
Isomeric SMILES	c1c(cc(c(c1I)Oc2cc(c(c(c2)I)O)I)I)C[C@@H](C(=O)O)N
InChI	InChI=1S/C15H11I4NO4/c16-8-4-7(5-9(17)13(8)21)24-14-10(18)1-6(2-11(14)19)3-12(20)15(22)23/h1-2,4-5,12,21H,3,20H2,(H,22,23)/t12-/m0/s1
InChIKey	XUIIKFGFIJCVMT-LBPRGKRZSA-N

Chemical Details
Formal Charge	0
Atom Count	35
Chiral Atom Count	1
Bond Count	36
Aromatic Bond Count	12

Drug Info: DrugBank

DrugBank ID	DB00451
Name	Levothyroxine
Groups	approved
Description	Levothyroxine is a synthetically produced form of thyroxine, a major endogenous hormone secreted by the thyroid gland.[F4633] Also known as L-thyroxine or the brand name product Synthroid, levothyroxine is used primarily to treat hypothyroidism, a condition where the thyroid gland is no longer able to produce sufficient quantities of the thyroid hormones T<sub>4</sub> (tetraiodothyronine or thyroxine) and T<sub>3</sub> (triiodothyronine or [DB00279]), resulting in diminished down-stream effects of these hormones. Without sufficient quantities of circulating thyroid hormones, symptoms of hypothyroidism begin to develop such as fatigue, increased heart rate, depression[A179620], dry skin and hair, muscle cramps, constipation, weight gain, memory impairment, and poor tolerance to cold temperatures.[F4636,A35722] In response to Thyroid Stimulating Hormone (TSH) release by the pituitary gland, a normally functioning thyroid gland will produce and secrete T<sub>4</sub>, which is then converted through deiodination (by type I or type II 5′-deiodinases)[A179941] into its active metabolite T<sub>3</sub>. While T<sub>4</sub> is the major product secreted by the thyroid gland, T<sub>3</sub> exerts the majority of the physiological effects of the thyroid hormones; T<sub>4</sub> and T<sub>3</sub> have a relative potency of ~1:4 (T4:T3).[F4633] T<sub>4</sub> and T<sub>3</sub> act on nearly every cell of the body, but have a particularly strong effect on the cardiac system.[A179935] As a result, many cardiac functions including heart rate, cardiac output, and systemic vascular resistance are closely linked to thyroid status.[A179938] Prior to the development of levothyroxine, [DB09100] or desiccated thyroid, used to be the mainstay of treatment for hypothyroidism. However, this is no longer recommended for the majority of patients due to several clinical concerns including limited controlled trials supporting its use. Desiccated thyroid products contain a ratio of T4 to T3 of 4.2:1, which is significantly lower than the 14:1 ratio of secretion by the human thyroid gland. This higher proportion of T3 in desiccated thyroid products can lead to supraphysiologic levels of T3 which may put patients at risk of thyrotoxicosis if thyroid extract therapy is not adjusted according to the serum TSH.[A35722, F4636]
Synonyms	4-(4-Hydroxy-3,5-diiodophenoxy)-3,5-diiodo-L-phenylalanine 3,3',5,5'-Tetraiodo-L-thyronine L-Thyroxine O-(4-Hydroxy-3,5-diiodophenyl)-3,5-diiodo-L-tyrosine O-(4-Hydroxy-3,5-diidophenyl)-3,5-diiodo-L-tyrosine Levothyroxine sodium pentahydrate Levothyroxine sodium L-T4 Levothyroxin 3,5,3',5'-Tetraiodo-L-thyronine Thyroxine LT4 T4 Levothyroxine
Brand Names	Levo-T 75mcg - Tab Synthroid Tab 300mcg Tab Eltroxin Tab 300mcg Levotec 25mcg Tablets USP Eltroxin Tab 200mcg Synthroid Tab 75mcg USP Adthyza thyroid Apo-levothyroxine Synthroid Tab 125mcg USP Levotec 150mcg Tablets USP PMS-levothyroxine Sodium Tab 300mcg Levotec 100mcg Tablets USP PMS-levothyroxine Sodium Tab 125mcg Levo-T 200mcg - Tab NP Thyroid 90 Synthroid Tab 100mcg USP Synthroid Tab 88mcg USP NP Thyroid 120 Levo-T 100mcg - Tab Adthyza Thyroid Thyquidity Tirosint SOL Unithroid Levothyroxine Levothyroxine Sodium Injection Levotec 50mcg Tablets USP PMS-levothyroxine Sodium Tab 200mcg PMS-levothyroxine Sodium Tab 100mcg PMS-levothyroxine Sodium Tab 75mcg Thyroid Levo-T 50mcg - Tab Synthroid Tab 150mcg USP Levothroxine Sodium Levothyroxine and Liothyronine Thyroid Levotec 125mcg Tablets USP Levothyroxine Sodium for Injection Euthyrox Synthroid Tab 175mcg USP Levotec 112mcg Tablets USP Levoxyl Np Thyroid 60 Tirocap Ermeza Levotec 300mcg Tablets USP Levo-T 125mcg - Tab PMS-levothyroxine Sodium Tab 25mcg Synthroid Tab 112mcg USP Levo-T 150mcg - Tab Levotec 75mcg Tablets USP Np Thyroid 30 NP Thyroid 15 Levo-T 25mcg - Tab Synthroid Tab 25mcg USP Levo-T 300mcg - Tab Levothyroxine sodium Np Thyroid 90 Synthroid Liq Inj 500mcg/vial USP Thyrolar Np Thyroid Synthroid Tab 200mcg USP PMS-levothyroxine Sodium Tab 50mcg Eltroxin 150 Tab Tirosint Levo-T Levotec 200mcg Tablets USP Eltroxin Tab 50mcg Levothroid PMS-levothyroxine Sodium Tab 150mcg Levothyroxine Sodium NP Thyroid 30 Eltroxin Novothyrox NP Thyroid 60 Eltroxin Tab 100mcg Synthroid Levotec 175mcg Tablets USP Synthroid Tab 50mcg USP
Indication	Levothyroxine is indicated as replacement therapy in primary (thyroidal), secondary (pituitary) and tertiary (hypothalamic) congenital or acquired hypothyroidism. It is also indicated as an adjunct to surgery and radioiodine therapy in the management of thyrotropin-dependent well-differentiated thyroid cancer.
Categories	Agents used to treat hypothyroidism Amino Acids Amino Acids, Aromatic Amino Acids, Cyclic Amino Acids, Peptides, and Proteins Cytochrome P-450 CYP2C8 Inhibitors Cytochrome P-450 CYP2C8 Inhibitors (moderate) Cytochrome P-450 Enzyme Inhibitors Hormones Hormones, Hormone Substitutes, and Hormone Antagonists Narrow Therapeutic Index Drugs OATP1B1/SLCO1B1 Inhibitors OATP1B3 inhibitors Organic Anion Transporting Polypeptide 2B1 Inhibitors P-glycoprotein inducers Systemic Hormonal Preparations, Excl. Sex Hormones and Insulins Thyroid Products Thyroxine-binding globulin substrates UGT1A1 Substrates UGT1A1 Substrates with a Narrow Therapeutic Index
ATC-Code	H03AA01 H03AA51
CAS number	51-48-9

Drug Targets

Name	Target Sequence	Pharmacological Action	Actions
Integrin alpha-V	MAFPPRRRLRLGPRGLPLLLSGLLLPLCRAFNLDVDSPAEYSGPEGSYFG...	unknown
Integrin beta-3	MRARPRPRPLWATVLALGALAGVGVGGPNICTTRGVSSCQQCLAVSPMCA...	unknown
Thyroid hormone receptor alpha	MEQKPSKVECGSDPEENSARSPDGKRKRKNGQCSLKTSMSGYIPSYLDKD...	unknown	agonist
Thyroid hormone receptor beta	MTPNSMTENGLTAWDKPKHCPDREHDWKLVGMSEACLHRKSHSERRSTLK...	unknown	agonist
UDP-glucuronosyltransferase 1-1	MAVESQGGRPLVLGLLLCVLGPVVSHAGKILLIPVDGSHWLSMLGAIQQL...	unknown	substrate
P-glycoprotein 1	MDLEGDRNGGAKKKNFFKLNNKSEKDKKEKKPTVSVFSMFRYSNWLDKLY...	unknown	inducer
Cytochrome P450 2C8	MEPFVVLVLCLSFMLLFSLWRQSCRRRKLPPGPTPLPIIGNMLQIDVKDI...	unknown	inhibitor
Transthyretin	MASHRLLLLCLAGLVFVSEAGPTGTGESKCPLMVKVLDAVRGSPAINVAV...	unknown
Thyroxine-binding globulin	MSPFLYLVLLVLGLHATIHCASPEGKVTACHSSQPNATLYKMSSINADFA...	unknown	substrate
Serum albumin	MKWVTFISLLFLFSSAYSRGVFRRDAHKSEVAHRFKDLGEENFKALVLIA...	unknown
Solute carrier organic anion transporter family member 1C1	MDTSSKENIQLFCKTSVQPVGRPSFKTEYPSSEEKQPCCGELKVFLCALS...	unknown	substrate
Monocarboxylate transporter 8	MALQSQASEEAKGPWQEADQEQQEPVGSPEPESEPEPEPEPEPVPVPPPE...	unknown	inhibitor
P-glycoprotein 1	MDLEGDRNGGAKKKNFFKLNNKSEKDKKEKKPTVSVFSMFRYSNWLDKLY...	unknown	inducer
Solute carrier organic anion transporter family member 1A2	MGETEKRIETHRIRCLSKLKMFLLAITCAFVSKTLSGSYMNSMLTQIERQ...	unknown	substrate
Solute carrier organic anion transporter family member 1B1	MDQNQHLNKTAEAQPSENKKTRYCNGLKMFLAALSLSFIAKTLGAIIMKS...	unknown	inhibitor
Solute carrier organic anion transporter family member 1B3	MDQHQHLNKTAESASSEKKKTRRCNGFKMFLAALSFSYIAKALGGIIMKI...	unknown	inhibitor
Solute carrier organic anion transporter family member 4A1	MPLHQLGDKPLTFPSPNSAMENGLDHTPPSRRASPGTPLSPGSLRSAAHS...	unknown	substrate
Large neutral amino acids transporter small subunit 1	MAGAGPKRRALAAPAAEEKEEAREKMLAAKSADGSAPAGEGEGVTLQRNI...	unknown
Solute carrier organic anion transporter family member 2B1	MGPRIGPAGEVPQVPDKETKATMGTENTPGGKASPDPQDVRPSVFHNIKL...	unknown	inhibitor
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Drug Info/Drug Targets: DrugBank 3.0: a comprehensive resource for 'omics' research on drugs. Knox C, Law V, Jewison T, Liu P, Ly S, Frolkis A, Pon A, Banco K, Mak C, Neveu V, Djoumbou Y, Eisner R, Guo AC, Wishart DS. Nucleic Acids Res. 2011 Jan; 39 (Database issue):D1035-41. | PMID:21059682