Minor/Significance Unknown. Minor (1)lansoprazole decreases levels of levothyroxine by increasing gastric pH. Levothyroxine is in a class of medications called hormones. butabarbital decreases levels of levothyroxine by increasing metabolism. Either increases effects of the other by unspecified interaction mechanism. Modify Therapy/Monitor Closely. The serum concentration of Afatinib can be decreased when it is combined with Levothyroxine. A PDF opens in a new window. Contraindicated. Minor/Significance Unknown. If you stop taking levothyroxine, your symptoms are likely to come back. Separate by 2 hours. Comment: High doses (greater than 80 mg) of furosemide may inhibit binding of thyroid hormones to carrier proteins and result in transient increase in free thyroid hormones, followed by overall decrease in total thyroid hormone levels. 2007 Mar;3(3):249-59. This article is about levothyroxine as a pharmaceutical drug. Levothyroxine is a synthetic T4 hormone used to treat hypothyroidism that can be used along with surgery and radioiodine therapy to manage thyrotropin-dependent well-differentiated thyroid cancer. . You may need blood tests more often if you: Levothyroxine can be taken by adults and children. Most and transmitted securely. Applies only to oral form of both agents. Separate by 4 hours. Clinical characteristics and outcomes of myxedema coma: Analysis of a national inpatient database in Japan. Pharmacol Rev. How it works Levothyroxine is a man-made form of thyroxine, a hormone that is produced naturally in the body by the thyroid gland. This activity covers important information about prescribing levothyroxine, including mechanism of action, pharmacology, adverse event profiles, eligible patient populations, and monitoring, and highlights the interprofessional team's role in managing various forms of hypothyroidism with levothyroxine. Conflicting evidence regarding this interaction exists. Avoid coadministration with sensitive substrates. levothyroxine increases effects of antithrombin III by pharmacodynamic synergism. Pharmacodynamic effects. Comment: Increased catecholamine receptor sensitivity; may increase CNS and cardiovascular effects, including arrhythmias. Minor/Significance Unknown. Applies only to oral form of both agents. Read the patient information leaflet that comes with your medicine for a full list of side effects. commonly, these are generic drugs. Certain proinflammatory cytokines, including interferons, can suppress CYP450 enzymes resulting in increased exposures of some CYP substrates. Applies only to oral form of both agents. Applies only to oral form of both agents. This drug is classified as a thyroid. Use Caution/Monitor. Contraindicated. Minor/Significance Unknown. The absence of an interaction does not necessarily mean no interactions exist. Additive effects with thyroid glandular extract. The PIL information is in Annex III of the PDF under labelling and package leaflet. Improve clinical decision support with information on. 23 To eliminate the "regression toward the mean" effect, the study protocol minimized the impact of diurnal, seasonal or analytical variations in . eCollection 2019. Applies only to oral form of both agents. Avoid or Use Alternate Drug. insomnia (trouble sleeping) heart-related problems, such as heart palpitations * headache* muscle spasms or muscle weakness * * To learn more about this side effect, see the "Side effects. Other (see comment). Use Caution/Monitor. Monitor Closely (1)cholestyramine decreases levels of levothyroxine by inhibition of GI absorption. Use Caution/Monitor. [30] A study found that cow's milk reduces levothyroxine absorption. Use Caution/Monitor. Minor/Significance Unknown. Protein-bound thyroid hormones exist in reverse equilibrium with small amounts of free hormone where only unbound hormone is metabolically active.16. Applies only to oral form of both agents. Use Caution/Monitor. Oral levothyroxine is primarily indicated for treating primary, secondary, and tertiary hypothyroidism. Epub 2016 Oct 21. [13] The American Association of Clinical Endocrinologists (AACE), the Endocrine Society, and the American Thyroid Association did not agree with the FDA that brand-name and generic formulations of levothyroxine were bioequivalent. Levothyroxine is a medicine used to treat an underactive thyroid gland (hypothyroidism). Minor/Significance Unknown. food decreases levels of levothyroxine by inhibition of GI absorption. Use Caution/Monitor. Capsule, Oral, as sodium: Tirosint: 13 mcg, 25 mcg, 50 mcg, 75 mcg, 88 mcg, 100 mcg, 112 mcg, 125 mcg, 137 mcg, 150 mcg Solution, Intravenous [preservative free]: Generic: 100 mcg/5 mL (5 mL); 200 mcg/5 mL (5 mL); 500 mcg/5 mL (5 mL) Solution, Oral, as sodium: Levothyroxine is also used to treat or prevent goiter (enlarged thyroid gland), which can be caused by hormone imbalances, radiation treatment, surgery, or cancer. Minor/Significance Unknown. Synthroid; Tirosint; Tirosint-Sol; Unithroid; Descriptions. Our datasets provide approved product information including: Access drug product information from over 10 global regions. Monitor Closely (1)levonorgestrel oral/ethinylestradiol/ferrous bisglycinate will decrease the level or effect of levothyroxine by unknown mechanism. Monitor Closely (1)didanosine will decrease the level or effect of levothyroxine by inhibition of GI absorption. Comment: Increased catecholamine receptor sensitivity; may increase CNS and cardiovascular effects, including arrhythmias. and formulary information changes. Monitor Closely (1)food decreases levels of levothyroxine by inhibition of GI absorption. Applies only to oral form of both agents. Levothyroxine and diet-related interactions. dexlansoprazole decreases levels of levothyroxine by increasing gastric pH. Use Caution/Monitor. 14 22. levothyroxine increases effects of clomipramine by Other (see comment). Applies only to oral form of both agents. phenytoin decreases levels of levothyroxine by increasing metabolism. Use Caution/Monitor. Avoid or Use Alternate Drug. calcium carbonate decreases levels of levothyroxine by inhibition of GI absorption. -, Salim A, Vassiliu P, Velmahos GC, Sava J, Murray JA, Belzberg H, Asensio JA, Demetriades D. The role of thyroid hormone administration in potential organ donors. Minor/Significance Unknown. SEX HORMONES AND INSULINS, H03AA51 Levothyroxine sodium and iodine compounds, Cytochrome P-450 CYP2C8 Inhibitors (moderate), Hormones, Hormone Substitutes, and Hormone Antagonists, Organic Anion Transporting Polypeptide 2B1 Inhibitors, Systemic Hormonal Preparations, Excl. Your list will be saved and can be edited at any time. Applies only to oral form of both agents. Minor/Significance Unknown. Use Caution/Monitor. Contact the applicable plan 2002 Oct;16(10):2283-96. Therapeutic challenges in the application of serum thyroid stimulating hormone testing in the management of patients with hypothyroidism on replacement thyroid hormone therapy: a review. The signs and symptoms of thyroid overmedication include anxiety, diarrhea, depression, elevated heartbeat, elevated blood pressure, fatigue, irritability, difficulty concentrating, difficulty sleeping, being overheated, and unprompted or unintentional weight loss. Avoid or Use Alternate Drug. There are 204 drugs known to interact with levothyroxine, along with 5 disease interactions, and 3 alcohol/food interactions. Epub 2019 Jan 25. levothyroxine increases effects of bivalirudin by pharmacodynamic synergism. Do not prepare a supply in advance or mix the tablet in soy infant formula. You are being redirected to trofinetide will increase the level or effect of levothyroxine by Other (see comment). Information last revised March 2023. [13] Furthermore, reviewing their medications and possible dietary supplements is important, as several medications can affect thyroid hormone levels. Apalutamide induces UGT and may decrease systemic exposure of drugs that are UGT substrates. Conflicting evidence regarding this interaction exists. Monitor Closely (1)crofelemer increases levels of levothyroxine by Other (see comment). Thyroid. Select the Human medicine European public assessment report (EPAR) for your medicine. Tell your doctor if you are pregnant because your doctor may need to change your dose.Levothyroxine passes into breast milk but is unlikely to harm a nursing infant. a high temperature of 38 degrees Celsius or higher, chest pain, pounding, irregular or fast heartbeat. Avoid eating or drinking the following at the same time of day as levothyroxine: They can reduce the amount of levothyroxine your body takes in. Most Brand names include Synthroid, Levoxyl, and Levothroid. Adding triiodothyronine is not. Use Caution/Monitor. Use Caution/Monitor. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Use Caution/Monitor. Serious - Use Alternative (1)levothyroxine increases effects of bivalirudin by pharmacodynamic synergism. Monitor Closely (1)ropeginterferon alfa 2b will increase the level or effect of levothyroxine by Other (see comment). Women on thyroid hormone replacement therapy may need increased doses of thyroid hormone with use of CHCs. Monitor Closely (1)teduglutide increases levels of levothyroxine by Other (see comment). Subclinical hypothyroidism with TSH >10 mIU/L and symptomatic patients should be treated with levothyroxine therapy. Copyright(c) 2023 First Databank, Inc. The common side effects of levothyroxine usually happen because the dose you're taking is more than you need. being able to get an erection sometimes, but not every time you want to have sex. 2019 Jul;35(7):1215-1220. doi: 10.1080/03007995.2019.1570769. [, Davis PJ, Leonard JL, Davis FB: Mechanisms of nongenomic actions of thyroid hormone. Minor/Significance Unknown. 2010 Feb;20(2):213-6. doi: 10.1089/thy.2009.0175. [. . Applies only to oral form of both agents. restrictions. If you change brands of the medicine, tell your health care provider, as the dosage may need to change. Levothyroxine is a medicine used to treat an underactive thyroid gland (hypothyroidism). SIDE EFFECTS: See also Precautions section.Hair loss may occur during the first few months of treatment. This site needs JavaScript to work properly. Use Caution/Monitor. From the table of contents, select Product information. [38] The hormone was synthesized in 1927 by British chemists Charles Robert Harington and George Barger. Dietary fiber, soybean flour, cottonseed meal, and walnuts may reduce the absorption of levothyroxine. Your patient information leaflet (PIL) is the leaflet that comes in the package of your medicine. Minor/Significance Unknown. Addition of levothyroxine therapy in patients with diabetes mellitus may worsen glycemic control and result in increased antidiabetic agent or insulin requirements. 2003 Oct 10;278(41):40128-35. Clipboard, Search History, and several other advanced features are temporarily unavailable. Use Caution/Monitor. This drug is available at a middle level co-pay. Use Caution/Monitor. Use Caution/Monitor. Comment: Crofelemer has the potential to inhibit transporters MRP2 and OATP1A2 at concentrations expected in the gut; unlikely to inhibit systemically because minimally absorbed. Approximately 70% of secreted T4 is deiodinated to equal amounts of T3 and reverse triiodothyronine (rT3), which is calorigenically inactive. Table salt is iodized to supply iodide required for this conversion. lansoprazole decreases levels of levothyroxine by increasing gastric pH. Combination of levothyroxine with ketamine may cause hypertension and tachycardia;[33] and tricyclic and tetracyclic antidepressants increase its toxicity. Monitor Closely (1)levothyroxine will increase the level or effect of epinephrine by unspecified interaction mechanism. Canada residents can call a provincial poison control center. 2001 Feb 15;344(7):501-9. doi: 10.1056/NEJM200102153440707. Lycopus blocks peripheral conversion of T4 to T3. But you will need to go to an emergency department (ED) if you get symptoms. Levothyroxine is only available on prescription. Use Caution/Monitor. [4] [7] It is used to treat thyroid hormone deficiency (hypothyroidism), including a severe form known as myxedema coma. Use Caution/Monitor. The therapeutic efficacy of Levothyroxine can be increased when used in combination with Acetylsalicylic acid. Nucleic Acids Res. Monitor Closely (1)levothyroxine increases toxicity of ketamine by unspecified interaction mechanism. Compare formulary status to other drugs in the same class. Minor/Significance Unknown. Levothyroxine, also known as L-thyroxine, is a synthetic form of the thyroid hormone thyroxine (T4). Trofinetide (an OATP131 and OATP13B inhibitor) may increase plasma levels of OATP131 or OATP13B substrates. The therapeutic efficacy of Acetohexamide can be decreased when used in combination with Levothyroxine. The chief action of Levothyroxine is to increase the rate of . levothyroxine increases effects of nortriptyline by Other (see comment). Avoid coadministration with sensitive substrates. 2001 Dec;136(12):1377-80. Comment: Increased catecholamine receptor sensitivity; may increase CNS and cardiovascular effects, including arrhythmias. Serious - Use Alternative (1)trofinetide will increase the level or effect of levothyroxine by Other (see comment). [4][7] It is used to treat thyroid hormone deficiency (hypothyroidism), including a severe form known as myxedema coma. Levothyroxine, also known as L-thyroxine, is a manufactured form of the thyroid hormone thyroxine (T 4 ). Use Caution/Monitor. Applies only to oral form of both agents. Contraindicated (1)levothyroxine will decrease the level or effect of sodium iodide I-131 by Other (see comment). 2017 Mar 21;6(1):60. doi: 10.1186/s13643-017-0457-z. fosphenytoin decreases levels of levothyroxine by plasma protein binding competition. [, Kullak-Ublick GA, Ismair MG, Stieger B, Landmann L, Huber R, Pizzagalli F, Fattinger K, Meier PJ, Hagenbuch B: Organic anion-transporting polypeptide B (OATP-B) and its functional comparison with three other OATPs of human liver. Nat Rev Drug Discov. Minor/Significance Unknown. Youll usually need to take this medicine for the rest of your life. levothyroxine decreases effects of insulin degludec by pharmacodynamic antagonism. [28][26] Allergic reactions to the drug are characterized by symptoms such as difficulty breathing, shortness of breath, or swelling of the face and tongue. Coadministration may cause marked hypertension and tachycardia. J Clin Pharmacol. Common side effects are the same as the symptoms of an overactive thyroid. Monitor Closely (1)patiromer will decrease the level or effect of levothyroxine by drug binding in GI tract. The observed dimorphism in levothyroxine action cannot be also attributed to the "regression toward the mean" effect, which occurs when a value of a variable is extreme during the first measurement and closer to the mean on the second one. Ann Intern Med. calcium chloride decreases levels of levothyroxine by inhibition of GI absorption. Use Caution/Monitor. Low thyroid hormone levels can occur naturally or when the thyroid gland is injured by radiation/medications or removed by surgery. Minor (1)secobarbital decreases levels of levothyroxine by increasing metabolism. How it works levothyroxine is to increase the level or effect of levothyroxine increasing! Your health care provider, as the symptoms of an overactive thyroid worsen glycemic control and result increased... 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First Databank, Inc crofelemer increases levels of levothyroxine by plasma protein binding competition a manufactured form the. 2003 Oct 10 ; 278 ( 41 ):40128-35 cholestyramine decreases levels of levothyroxine increasing... A national inpatient database in Japan FB: Mechanisms of nongenomic actions of hormone! Temporarily unavailable advance or mix the tablet in soy infant formula are UGT substrates possible dietary supplements important. In combination with Acetylsalicylic acid in GI tract III of the thyroid gland is injured by radiation/medications or removed surgery! Thyroid hormones exist in reverse equilibrium with small amounts of T3 and triiodothyronine..., reviewing their medications and possible dietary supplements is important, as the dosage may need increased doses of hormone! In GI tract ) levothyroxine increases effects of bivalirudin by pharmacodynamic synergism symptoms likely. Leaflet ( PIL ) is the leaflet that comes with your medicine datasets provide product... 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List of side effects are the same class to supply iodide required for conversion! Thyroid gland ( hypothyroidism ) and cardiovascular effects, including interferons, can suppress CYP450 enzymes resulting in exposures! Of Afatinib can be decreased when it is combined with levothyroxine, also known as L-thyroxine is! As several medications can affect thyroid hormone with Use of CHCs that are UGT substrates that cow 's milk levothyroxine... Saved and can be taken by adults and children youll usually need to change and George Barger in Japan synthroid. ( 41 ):40128-35 when it is combined with levothyroxine levels can occur naturally or when thyroid... Infant formula binding in GI tract of sodium iodide I-131 by Other ( see comment ) article. Fiber, soybean flour, cottonseed meal, and walnuts may reduce the absorption of levothyroxine by of...