Is it necessary to increase the dose of levothyroxine in patients with hypothyroidism who use omeprazole?

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).

Literature Search

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 synthroid identification 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.

Automatically receive FDA alerts, drug interaction warnings, plus data on food, allergy & condition interactions. Before combining Levothyroxine and Prilosec, it is crucial to consult your healthcare provider for personalized advice. They can assess your individual situation and recommend the best way to manage your medications to ensure optimal treatment 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 contradictory findings mentioned may result from the limited size of the cohorts analyzed as well as differences in subjects enrolled (patients vs. healthy volunteers). Following assessment and application of eligibility criteria, seven studies were included.

Drug and food interactions

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.

• However, this finding should be interpreted with caution due to the limited number of studies with relatively short follow-up period and lack of robust statistical evidence.
• The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
• In addition, a number of field experts were approached in order to identify additional viable studies from the gray literature.
• Levothyroxine is a synthetic thyroid hormone used to treat hypothyroidism, while Prilosec is a proton pump inhibitor used to reduce stomach acid.

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 will not avoid the interaction. Add your drug list to My Med List to view medical information in a simple, easy-to-read, personalized format.

• If you need to be on a course of omeprazole while taking levothyroxine, your doctor may order more frequent laboratory testing to confirm you are absorbing enough levothyroxine.
• This can result in symptoms of hypothyroidism such as fatigue, weight gain, and depression.
• A. There is a strong likelihood that the PPI (proton pump inhibitor) you are taking for acid reflux is interfering with absorption of your thyroid medicine (Clinical Drug Investigation, March 2015).
• Learn more about the advantages of combining levothyroxine and Prilosec to optimize your health regimen.
• This interaction could result in very serious and potentially life-threatening consequences.

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.

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 regard to over the counter use, it is usually safe to take for a week or two, but oftentimes, people take it every day, and for longer periods of time. Some mixtures of medications can lead to serious and even fatal consequences. Prilosec plays a crucial role in managing digestive health and improving the well-being of individuals suffering from various gastrointestinal disorders. Learn more about the advantages of combining levothyroxine and Prilosec to optimize your health regimen.

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.