Drugs that Impair Levothyroxine Absorption A number of drugs have been shown to impair the absorption of levothyroxine; these drugs include calcium carbonate, aluminum- containing antacids, sucralfate, iron supplements, cholestyramine, sevelamer, and, possibly, ciprofloxacin, raloxifene, and orlistat. It is rarely necessary to avoid binding agents in patients taking levothyroxine, so if the patient needs to receive the binding agent, the following precautions can minimize the risk of an adverse outcome note: the first 2 bullet points do not apply to proton pump inhibitors because they probably do not bind levothyroxine : Administer levothyroxine at least 2 hours before or 4 hours after the binding agent.
Keep the interval between the levothyroxine and binding agent as constant as possible. Monitor the TSH level and watch for clinical evidence of a reduced levothyroxine effect. If the binding agent is discontinued or its dosage changed, or if the interval between the levothyroxine and binding agent is changed, monitor the TSH level, and watch for an altered levothyroxine response.
Drug interactions with levothyroxine therapy in patients with hypothyroidism: observational study in general practice. Clin Drug Invest. Clin Endocrinol Oxford. Liwanpo L, Hershman JM. Conditions and drugs interfering with thyroxine absorption. Benvenga S. When thyroid hormone replacement is ineffective? Curr Opin Endocrinol Diabetes Obes. Patients who are taking an antiepileptic drug should consult a doctor before starting alli because loss or seizure control have been reported during concomitant treatment with orlistat and antiepileptic drugs such as sodium valproate and lamotrigine.
Orlistat may decrease the absorption of antiepileptic drugs, leading to loss of seizure control. During concomitant treatment, patients should be monitored for possible changes in the frequency and severity of convulsions. If this occurs, consideration could be given to administering orlistat and antiepileptic drugs at different times.
Pancreatitis has also been added as an undesirable effect of alli treatment after reports in a number of patients frequency unknown. We are aware that consumers may be at risk after reports in the USA of counterfeit alli that contained sibutramine rather than orlistat. Although the counterfeit product has not been found in the UK, it is still potentially available to UK customers via the internet.
Consumers should not buy medicines from unregulated websites. See our news centre for more information. Report suspected counterfeit medicine in confidence at counterfeit mhra. In July , there was a Europe-wide review of a possible association between orlistat and serious hepatic reactions.
The review included non-clinical, clinical trial, and post-marketing safety data provided by the licence holders and a review of suspected adverse reaction reports submitted to the MHRA. Data from the licence holders have also been submitted to the US Food and Drug Administration, which is also conducting a review.
The European review concluded that there is insufficient evidence to show that Xenical or alli are associated with more serious liver disorders than those already listed in the product information, and that no further action was recommended at this time.
The current product information for Xenical and alli contains a warning that hepatitis, cholelithiasis, and increased transaminases and alkaline phosphatase are possible side effects, and that patients who experience symptoms such as yellowing of the skin and eyes, itching, stomach pain, and liver tenderness should stop taking the capsules and tell their doctor. The MHRA, together with European regulatory authorities, will continue to monitor all adverse reactions associated with orlistat.
Suspected adverse reactions can be reported to us via the Yellow Card Scheme see www. Further information about alli is provided in the May issue of Drug Safety Update.
Check what you need to do. If you experience weight gain, lack of energy and hair loss, your body may not be producing enough hormones, according to PubMed Health.
Thyroid-regulating medications such as levothyroxine can help these symptoms, but only if you truly have problems with your thyroid. If your doctor approves, you can also combine some types of diet drugs with levothyroxine to help you lose weight more quickly. Levothyroxine, commonly marketed as Synthroid, treats hypothyroidism, according to PubMed Health. If you have hypothyroidism, your thyroid gland does not produce enough hormones and hampers your normal body functions, including your ability to lose weight.
While levothyroxine can help normalize your thyroid function, you might experience unwanted side effects such as headache, fever, stomach cramps, nausea, nervousness, insomnia and increased appetite. Orlistat is a Food and Drug Administration-approved diet medication that enables your body to not digest the fat from the food you eat, according to the National Institute of Diabetes and Digestive and Kidney Diseases.
Orlistat is marketed as over-the-counter Alli and prescription Xenical and can help you lose 3 to 7 pounds more each year than you would with just dieting and exercising.
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