Can I take other medications with levothyroxine?
Ranjitha Arulmozhi contributed in study design, data gathering, data analysis and preparing first draft of the manuscript. If you are unsure whether one of your medicines interacts with levothyroxine, talk to your doctor or pharmacist. Make sure to always give all of your healthcare providers a full list of your medications (prescription and nonprescription) and any supplements you take.
Can I take other medications with levothyroxine?
Regarding the quality assessment, six out of seven studies were considered at low risk of bias,25–28,31,38 while one37 was considered at moderate risk because of measurement of outcomes. A detailed assessment of the systematic error risk of all included studies is presented in Supplementary Tables S2 and S3, and Supplementary Figures S1 and S2. The GRADE quality of evidence suggested that there was moderate quality of evidence in the included studies (Supplementary Table S4). The effectiveness of levothyroxine therapy is measured by monitoring your symptoms and by checking the amount of two main thyroid-related hormones—thyroid stimulating hormone and T4—in the blood. Levothyroxine is usually started at a low dose and slowly increased over time.
You should avoid or limit the use of alcohol while being treated with levETIRAcetam. Do not use more than the recommended dose of levETIRAcetam, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns. The concomitant use of LT4 and PPI showed a significant increase in TSH concentration.
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Interactions between antiepileptic drugs and hormones
Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum. The study was supported by the Indian Council of Medical Research, New Delhi, India. There is 1 alcohol/food interaction with Keppra (levetiracetam). Some mixtures of medications can lead to serious and even fatal consequences. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Therefore, levothyroxine should be taken on a consistent schedule with regard to time of day and relation to meals to avoid large fluctuations in blood levels, which may alter its effects. In addition, absorption of levothyroxine may be decreased and/or delayed by foods such as soybean flour, cotton seed meal, walnuts, dietary fiber, calcium, calcium fortified juices and grapefruit or grapefruit juice. These foods should be avoided within several hours of dosing if possible. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
The full effects of levothyroxine may take weeks to months to realize. With hypothyroidism, you will need to take thyroid replacement such as levothyroxine for the rest of your life. Likewise, one coauthor of this paper (RV)38 evaluated the efficacy of a liquid formulation of LT4 in correcting tablet LT4 malabsorption by PPI in 24 patients, switching from the LT4 tablet formulation to the oral solution while maintaining the same dose. Indeed, serum TSH levels were lower under the oral solution compared with the tablet both in the replacement group (1.7mU/l ± 1.0 vs. 5.4 mU/l ± 4.3) and in the TSH-suppressive group (0.1 mU/l ± 0.3 vs. 2.1 mU/l ± 2.7). One factor that probably contributes to the variability of levothyroxine drug—drug interactions is that some individuals are completely dependent on exogenous levothyroxine (eg, following total thyroidectomy) while others have varying degrees of residual thyroid function. Those with some thyroid function may also have varying degrees of feedback stimulation of endogenous thyroid release via thyroidreleasing hormone and TSH.
Associated Data
Study quality was assessed with the Newcastle–Ottawa quality assessment scale for observational studies and the Risk Of Bias In Non-randomized Studies – of Interventions (ROBINS-I) tool was used. Anti-seizure drugs have long been known to affect thyroid hormone levels in epilepsy patients. The current study is a network meta-analysis designed to produce a systematic review and comprehensive evaluation of thyroid hormone changes to inform future research and clinical treatment. Antiepileptic drugs (AEDs) are known to have endocrine side effects in both men and women. These can affect fertility, sexuality, thyroid function, and bone health, all functions of major importance for well-being and quality of life. The liver enzyme inducing antiepileptic drugs (EIAEDs), like phenobarbital, phenytoin, and carbamazepine, and also valproate (VPA), a non-EIAED, are most likely to cause such side effects.
AUTHORS’ CONTRIBUTION
A recent study assessed thyroidstimulating hormone and levothyroxine dosage in 5426 outpatients who had been prescribed levothyroxine, along with drugs that can impair levothyroxine absorption or affect levothyroxine metabolism. The results were supplemented by a manual search of the bibliographies of the shortlisted review and original study articles. In addition, a number of field experts were approached in order to identify additional viable studies from the gray literature. Two independent investigators (YGP and OS) separately screened the titles and abstracts for eligible studies published up to September 1, 2019. For drug interactions that result in binding of the levothyroxine and therefore decreased absorption of the drug from the intestine, it is very important to avoid taking the interacting medicine at the same time as levothyroxine.
- Two independent investigators (YGP and OS) separately screened the titles and abstracts for eligible studies published up to September 1, 2019.
- Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
- There is 1 alcohol/food interaction with Keppra (levetiracetam).
- It is given to people who do not produce enough of their own thyroid hormone (hypothyroidism).
These findings are consistent with drug—drug interactions that reduce levothyroxine serum concentrations, leading to a compensatory increase in TSH level and the need to increase levothyroxine dosage. This study has the advantage of a large sample size, and it certainly suggests that these interacting drugs may have a clinically important effect on levothyroxine serum concentrations. Nonetheless, the effect of individual drugs on levothyroxine cannot be determined because so many different drugs were studied and the results were lumped together. probiotics synthroid Epilepsy is a chronic disease and its treatment is lifelong in one-third of patients. Data from cross-sectional and prospective studies have reviewed the influence of antiepileptic drugs (AEDs) on thyroid hormones.
