Carafate and levothyroxine Interactions

This can compensatesomewhat for the inhibition oflevothyroxine absorption. Variability inendogenous thyroid function probablyaccounts for the large variation in theoutcome of these interactions. The mechanism of these interactions appears to be nonsystemic in nature, presumably resulting from sucralfate binding to the concomitant agent in the gastrointestinal tract. In all cases studied to date (cimetidine, ciprofloxacin, digoxin, norfloxacin, ofloxacin, and ranitidine), dosing the concomitant medication 2 hours before sucralfate eliminated the interaction. Due to CARAFATE Oral Suspension’s potential to alter the absorption of some drugs, CARAFATE Oral Suspension should be administered separately from other drugs when alterations in bioavailability are felt to be critical.

Special Populations: Chronic Renal Failure And Dialysis Patients

Levothyroxine is usually started at a low dose and slowly increased over time. The full effects of levothyroxine may take weeks to months to realize. With hypothyroidism, you will need to take thyroid replacement such as levothyroxine for the rest of your life.

The patient is currently taking Carafate (sucralfate) which may decrease the serum concentration of Synthroid as this drug may affect gastric pH and cause hypochlorhydria. Other medications that may affect gastric acidity include PPIs and antacids. It is recommended that Synthroid be administered at least 4 hours prior to these drugs and to monitor for changes in thyroid function.

Drug Interactions between Carafate and levothyroxine

Horn and Hansten are both professorsof pharmacy at the University ofWashington School of Pharmacy. Foran electronic version of this article,including references if any, visit

Prilosec (omeprazole) is used to treat symptoms of GERD and other conditions caused by excess … Nexium is used to treat GERD and other conditions involving excessive stomach acid. Follow all directions on your prescription label and read all medication guides or instruction sheets. The liquid form of Carafate should never be injected through a needle into the body, or death may occur.

In addition, there are several drugs that can interfere with drug absorption including phosphate binders, orlistat, proton pump inhibitors, sucralfate, and antacids (See a complete listhere – 7). Concomitant use of levothyroxine and sucralfate may decrease levothyroxine efficacy by binding to and delaying or preventing levothyroxine absorption, potentially resulting in hypothyroidism. If concurrent use of levothyroxine and sucralfate is required, administration of these agents should be separated by at least 4 hours.

• Cases of bronchospasm, laryngeal edema and respiratory tract edema have been reported with an unknown oral formulation of sucralfate.
• When sucralfate is given with enteral (tube) feedings, the feeding tube may become clogged and/or sucralfate may not work as well.
• The liquid form of this medicine should never be injected through a needle into the body, or death may occur.
• Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.
• Prilosec (omeprazole) is used to treat symptoms of GERD and other conditions caused by excess …

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Your doctor may want you to keep taking Carafate at a lower dose once your active ulcer has healed. Avoid taking any other medications within 2 hours before or after you take Carafate.

CARAFATE Oral Suspension contains sucralfate and sucralfate is an α-D-glucopyranoside, β-D­fructofuranosyl-, octakis-(hydrogen sulfate), aluminum complex. Get medical help right away, if you have any of the symptoms listed above. Some mixtures of medications can lead to serious and even fatal consequences. Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Carafate only for the indication prescribed.

Interaction

Cholestyramine is known to bind to anumber of drugs, and has been shownto reduce levothyroxine absorption aswell. The effect of other binding resinssuch synthroid 1000 as colestipol (Colestid), colesevelam(Welchol), and ezetimibe (Zetia) onthyroid absorption is not as well established,but be alert for the possibility. The usual suspects of medicationsknown to be involved in reducinglevothyroxine absorption include sucralfate,iron, binding resins, and others. It is also important to note that Synthroid has a narrow therapeutic index (available in 12 doses) and both subtherapeutic and supratherapeutic drug concentrations of Synthroid can result in adverse effects.

It seems likely that alliron salts would inhibit levothyroxineabsorption, although the magnitude mayvary among the various preparations. Teratogenicity studies have been performed in mice, rats, and rabbits at doses up to 50 times the human dose and have revealed no evidence of harm to the fetus due to sucralfate. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.