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Drug interactions between Dilantin and Synthroid

Results for the following 2 drugs:
Dilantin (phenytoin)
Synthroid (levothyroxine)

Interactions between your drugs

Moderate

phenytoin ↔ levothyroxine

Applies to:Dilantin (phenytoin) and Synthroid (levothyroxine)

Using phenytoin together with levothyroxine can decrease the effects of levothyroxine. This can cause fatigue, weight gain, constipation, and low blood pressure. Talk with your doctor before using phenytoin while you are using levothyroxine. You may need a dose adjustment and may need to check your thyroid levels more often. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Drug and food interactions

Moderate

phenytoin food

Applies to: Dilantin (phenytoin)

Phenytoin levels may decrease when the suspension is given with enteral feedings. This could lead to a loss of seizure control. You could interrupt the feeding for 2 hours before and after the phenytoin dose. Alternatively, you may give the phenytoin suspension diluted in water and flush the tube with water after administration. These would make it easier for your body to absorb the medication. However, this still may not entirely avoid the interaction and may not always be feasible. You should have your phenytoin levels checked upon starting and stopping of enteral feedings. In addition, using phenytoin together with food may alter the effects of phenytoin. Contact your doctor if you experience worsening of seizure control or symptoms of toxicity, including twitching eye movements, slurred speech, loss of balance, tremor, muscle stiffness or weakness, nausea, vomiting, feeling light-headed, fainting, and slow or shallow breathing. If your doctor does prescribe these medications together, you may need a dose adjustment or special test to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Ask your doctor before making any changes to your therapy.

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Moderate

levothyroxine food

Applies to: Synthroid (levothyroxine)

The timing of meals relative to your levothyroxine dose can affect 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 by foods such as soybean flour, cotton seed meal, walnuts, dietary fiber, calcium, and calcium fortified juices. These foods should be avoided within several hours of dosing if possible. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor. When levothyroxine is given during continuous enteral nutrition (tube feedings) for more than 7 days, the tube feeding should be interrupted for at least one hour before and one hour after the dose of levothyroxine. You may need more frequent blood tests to monitor levothyroxine levels.

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Therapeutic duplication warnings

No therapeutic duplications were found for your selected drugs.

Drug Interaction Classification

The classifications below are a guideline only. The relevance of a particular drug interaction to a specific patient is difficult to determine using this tool alone given the large number of variables that may apply.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No information available.

Do not stop taking any medications without consulting your healthcare provider.

Disclaimer: Every effort has been made to ensure that the information provided by Multum is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. Multum's information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill, knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2018 Multum Information Services, Inc. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist.

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