How soon after taking levothyroxine can I take omeprazole?

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.

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• Prilosec works by reducing the production of stomach acid, which helps alleviate symptoms like heartburn, acid reflux, and indigestion.
• Well-designed large studies are needed in order to further better clarify the interfering role of PPI on LT4 intestinal absorption.
• Therefore, the results of this systematic review were summarized qualitatively.
• The timing of meals relative to your oral levothyroxine dose can affect the absorption of the medication.

In this study, the authors wanted to find out if PPIs affect the absorption of liquid levothyroxine (Tirosint- SOL). It’s commonly prescribed to treat gastroesophageal reflux disease or a host of other stomach conditions. Proton pump inhibitors alter the acidity of the stomach, something which studies have shown can decrease the absorption of thyroid hormone prescription products. There is a potential interaction between any proton pump inhibitor (e.g. Prilosec (omeprazole)) and most medications used to treat hypothyroidism (such as Cytomel (liothyronine) and Nature-Throid). In our latest question and answer, the pharmacist discusses the interaction between proton pump inhibitors, like omeprazole, and thyroid medication. The relevance of a particular drug interaction to a specific individual is difficult to determine.

The Interaction

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 synthroid suspension 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.

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). Proton pump inhibitors, when taken consistently, have a long duration of action. They can alter the stomach acid for well over 24 hours after dosing (which is why they are generally dosed on daily). So, unfortunately, taking, say, omeprazole in the morning and your thyroid medications in the evening, won’t do much good.

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).

• It’s important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances.
• This decreases the acidity of your stomach contents (which is why it can interact with thyroid prescription products).
• Continuous use can lead to a lot of long term complications, such as vitamin and mineral deficiencies and an increased risk of infection.
• In animal models, decreased postpartum offspring growth rates were observed when this drug was administered during late gestation and throughout lactation at oral doses of at least 138 mg/kg/day and IV doses of 3.2 mg/kg/day.
• Serum levels of TSH were lower under the oral solution compared with the tablet both in the replacement group (1.63 ± 0.66 mU/l vs. 2.77 ± 2.05 mU/l) and in the suppressive group (0.12 ± 0.12 mU/l vs.1.15 ± 1.85 mU/l).

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).

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 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.

Evidence

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.

levothyroxine food

Embryofetal and postnatal developmental toxicities were observed in offspring of parents given at least 3.4 times an oral human dose of 40 mg. Using multivitamin with minerals together with levothyroxine may decrease the effects of levothyroxine. You should separate the administration of levothyroxine and multivitamin with minerals by at least 4 hours. If your doctor does prescribe these medications together, you may need a dose adjustment or special test to safely use both medications. With hypothyroidism, you do not produce enough thyroid hormone and must replace it. The effectiveness of levothyroxine therapy is measured by monitoring your symptoms and by checking the amount of two key thyroid-related hormones, thyroid stimulating hormone and T4, in the blood.