Levothyroxine with Omeprazole Interaction Details

Both are usually taken once a day, first thing in the morning on an empty stomach. They are taken this way so that they are absorbed consistently since thyroid hormones are difficult to dose. A small change in absorption may lead to decreased thyroid levels and you beginning to feel the effects of hypothyroidism. Talk to your doctor before using oral levothyroxine together with omeprazole. Combining these medications may interfere with the absorption of oral levothyroxine and may reduce its effectiveness. It was first available only as a prescription medicine and was approved for the treatment of stomach and intestinal ulcers and for gastroesophageal reflux disease (GERD).

It was first available only as a prescription medicine and was approved for the treatment of stomach and intestinal ulcers and for gastroesophageal reflux disease (GERD).
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 our latest question and answer, the pharmacist discusses the best time of day to take levothyroxine, omeprazole and pantoprazole.

Drug and Pregnancy Interactions

It is recommended to take Levothyroxine on an empty stomach and wait at least 4 hours before taking Prilosec to minimize any interaction. Simply separating the time you take PPI (such as omeprazole) from your thyroid medications willnot avoid the interaction. Add your drug list to My Med List to view medical information in a simple, easy-to-read, personalized format.

Drug and Breastfeeding Interactions

In the preliminary search, 5012 studies were identified through the literature search, and 2004 remained after the duplicates were removed. A title and abstract review was performed on the remaining 2004 studies, with 1983 excluded at this first stage for not meeting the PICOS criteria. A PRISMA flow diagram of the screening and selection process can be found in Figure 1. The concomitant use of LT4 and PPI showed a significant increase in TSH concentration. However, given the small number of studies, further research is needed to clarify the interfering role of PPI on LT4 intestinal absorption.

Impact on Health Results

Its effects of decreasing stomach acid begin within an hour and last as long as 72 hours. After the drug is stopped, normal levels of stomach acid return in 3 to 5 days. In addition to proton pump inhibitors such as esomeprazole (Nexium), lansoprazole (Prevacid) or omeprazole (Prilosec), certain other medicines may interfere with thyroid pills. Specifically, iron, calcium and estrogen can lead to elevated TSH (Clinical Endocrinology, Jan. 2015).

Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms. Levothyroxine interacts with many other medications, but there are different kinds of drug interactions. Depending on the drug, you may need to avoid the drug, avoid taking it at certain times or be monitored by your physician. If you have an underactive thyroid gland, you know how important it is to take your thyroid pills on a regular basis.

There is a known drug interaction between levothyroxine and omeprazole, but the timing of when you take the two medicines is not relevant.
Combining these medications may interfere with the absorption of oral levothyroxine and may reduce its effectiveness.
Two independent investigators (YGP and OS) separately screened the titles and abstracts for eligible studies published up to September 1, 2019.
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.

What are the health benefits of tea?

Nevertheless, as they are all thyroid hormones, and have similar absorption properties, they are generally included with levothyroxine as far as interactions are concerned. Animal models have revealed evidence of dose-related increases in embryolethality, fetal resorptions, and pregnancy disruptions when animal models were given this drug during organogenesis. Major fetal malformations were not frequently observed in animal models.

A PRISMA flow diagram of the screening and selection process can be found in Figure 1.
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.
Concomitant use of levothyroxine and a proton pump inhibitor may cause clinically significant increases in TSH levels.
This drug should be used during pregnancy only if the benefit outweighs the risk to the fetus.

Links to NCBI Databases

If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. Overall, Prilosec offers effective and lasting relief from acid reflux and heartburn, making it a popular choice for individuals seeking relief from stomach-related issues. If you are already taking your other medications (e.g. metoprolol, Lasix, Plavix, calcium, and other multivitamins) in the morning and are adding on levothyroxine, it may be easiest to indeed take the levothyroxine at night. Overall, I would expect a few months where your TSH levels are fluctuating, but over time, things should get more consistent. Some of the published data on the matter is conflicting, but overall, it would be prudent to monitor for an altered response to your thyroid medications if you are taking a PPI. Individual drug-drug interaction detail pages contain references specific to that interaction.

Levothyroxine is commonly prescribed to treat hypothyroidism, a condition where the thyroid gland does not produce synthroid maoi enough thyroid hormone. Prilosec, on the other hand, is a medication used to treat conditions such as gastroesophageal reflux disease (GERD) and ulcers by reducing the production of stomach acid. BACKGROUNDLevothyroxine is the most commonly used medication to treat hypothyroidism.

Therefore, the results of this systematic review were summarized qualitatively. When considering the combination of Levothyroxine and Prilosec, it is important to be aware of possible interactions between the two medications. Levothyroxine is a synthetic thyroid hormone used to treat hypothyroidism, while Prilosec is a proton pump inhibitor used to reduce stomach acid. It is noteworthy that in two studies37,38 patients were switched from the tablet formulation to the liquid one while maintaining the co-ingestion of PPI and the daily dose of LT4, with a significant decrease in serum TSH levels (Table 1).

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. Omeprazole, regardless of when it is taken, reduces the amount of thyroid hormone that is absorbed and it is recommended to avoid the combination or, at the very least, be prudent in monitoring your thyroid levels if taken together. Omeprazole, or under the brand name Prilosec, is a proton pump inhibitor.