Levothyroxine with Sucralfate Interaction Details

Patients on hemodialysis may needtreatment with drugs that can bindphosphate in the gut, thus reducing theirphosphate load. The phosphate bindersevelamer (Renagel) has been shown toincrease thyrotropin concentrations inpatients on levothyroxine; hypothyroidsymptoms have been reported. Calciumcarbonate also can be used as a phosphatebinder and it also interacts withlevothyroxine, but limited clinical evidencesuggests that calcium acetate maynot affect levothyroxine absorption. Other drugs that have been reportedto reduce levothyroxine absorptioninclude ciprofloxacin (Cipro), raloxifene(Evista), and caffeine in coffee. Morestudy is needed to establish whetherthese interactions are likely to be clinicallyimportant. 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.

Drug Interactions between Carafate and levothyroxine

The timing of meals relative to your oral levothyroxine dose can affect the absorption of the medication. 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.

Check with your physician for additional information about side effects. Create a MyAccess profile and follow our contributors to stay informed via email updates. The prescribing information for each drug, as published on DailyMED, is also used.

CARAFATE Oral Suspension is contraindicated for patients with known hypersensitivity reactions to the active substance or to any of the excipients. Because many drugs are excreted in human milk, caution should be exercised when sucralfate is administered to a nursing woman. Our Carafate Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.

How long after taking levothyroxine can you drink milk?

Taking it on an empty stomach results in the best absorption of the drug from the intestine. Other drugs may interact with sucralfate, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using. The liquid form of this medicine should never be injected through a needle into the body, or death may occur.

You should separate the administration of levothyroxine and multivitamin with minerals by at least 4 hours.
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In a multicenter, double-blind, placebo-controlled study of CARAFATE Oral Suspension, a dosage regimen of 1 gram (10 mL) four times daily was demonstrated to be superior to placebo in ulcer healing.
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When sucralfate is administered orally, small amounts of aluminum are absorbed from the gastrointestinal tract. Concomitant use of sucralfate with other products that contain aluminum, such as aluminum-containing antacids, may increase the total body burden of aluminum. Patients with normal renal function receiving the recommended doses of sucralfate and aluminumcontaining products adequately excrete aluminum in the urine. Patients with chronic renal failure or those receiving dialysis have impaired excretion of absorbed aluminum. In addition, aluminum does not cross dialysis membranes because it is bound to albumin and transferrin plasma proteins.

Sometimes drug interactions cannot be avoided because both medicines may be very important to your treatment. In the case of levothyroxine, you may need more frequent testing of thyroid stimulating hormone and T4 levels when other medications are added or removed from your treatment regimen. After another drug has been added to or removed from your regimen, you should report worsening of any disease symptoms or medication side effects to your doctor.

Consider monitoring TSH levels and/or other measures of thyroid function when sucralfate is initiated or discontinued during levothyroxine treatment. In fact, it is recommended to separate the administration of these medicines from levothyroxine by 4 hours. Clinical studies of CARAFATE Oral Suspension did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported synthroid soir clinical experience has not identified differences in responses between the elderly and younger patients.

Aluminum accumulation and toxicity (aluminum osteodystrophy, osteomalacia, encephalopathy) have been described in patients with renal impairment. Sucralfate should be used with caution in patients with chronic renal failure. Concomitant use of levothyroxine and sucralfate may result in reduced levothyroxine efficacy, which may result in hypothyroidism. If concurrent use is necessary, separate administration of these agents by at least 4 hours.