Drug Interactions between levothyroxine and Naproxen Sodium DS
This report displays the potential drug interactions for the following 2 drugs:
- levothyroxine
- Naproxen Sodium DS (naproxen)
Interactions between your drugs
No interactions were found between levothyroxine and Naproxen Sodium DS. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.
levothyroxine
A total of 211 drugs are known to interact with levothyroxine.
- Levothyroxine is in the drug class thyroid drugs.
- Levothyroxine is used to treat the following conditions:
Naproxen Sodium DS
A total of 424 drugs are known to interact with Naproxen Sodium DS.
- Naproxen sodium ds is in the drug class Nonsteroidal anti-inflammatory drugs.
-
Naproxen sodium ds is used to treat the following conditions:
- Ankylosing Spondylitis
- Aseptic Necrosis (off-label)
- Back Pain
- Bursitis
- Chronic Myofascial Pain
- Costochondritis
- Diffuse Idiopathic Skeletal Hyperostosis
- Dysautonomia
- Fever
- Frozen Shoulder
- Gout, Acute
- Headache
- Muscle Pain
- Neck Pain
- Osteoarthritis
- Pain
- Period Pain
- Rheumatoid Arthritis
- Sciatica
- Spondylolisthesis
- Tendonitis
Drug and food interactions
levothyroxine food
Applies to: levothyroxine
ADJUST DOSING INTERVAL: Consumption of certain foods as well as the timing of meals relative to dosing may affect the absorption of T4 thyroid hormone (i.e., levothyroxine). T4 absorption is increased by fasting and decreased by foods such as soybean flour (e.g., infant formula), cotton seed meal, walnuts, dietary fiber, calcium, and calcium fortified juices.
MANAGEMENT: Preparations containing T4 thyroid hormone should be administered on a consistent schedule with regard to time of day and relation to meals so as to avoid large fluctuations in serum levels. Foods that may affect T4 absorption should be avoided within several hours of dosing if possible. When administered to patients receiving continuous enteral nutrition for more than 7 days, some experts recommend that the tube feeding should be interrupted for at least 1 hour before and 1 hour after the dose of levothyroxine is given and to monitor patients' thyroid function.
References
- "Product Information. Synthroid (levothyroxine)." Abbott Pharmaceutical PROD (2002):
- "Product Information. Armour Thyroid (thyroid desiccated)." Forest Pharmaceuticals (2022):
- Wohlt PD, Zheng L, Gunderson S, Balzar SA, Johnson BD, Fish JT "Recommendations for the use of medications with continuous enteral nutrition." Am J Health Syst Pharm 66 (2009): 1438-67
naproxen food
Applies to: Naproxen Sodium DS (naproxen)
GENERALLY AVOID: The concurrent use of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) and ethanol may lead to gastrointestinal (GI) blood loss. The mechanism may be due to a combined local effect as well as inhibition of prostaglandins leading to decreased integrity of the GI lining.
MANAGEMENT: Patients should be counseled on this potential interaction and advised to refrain from alcohol consumption while taking aspirin or NSAIDs.
References
- "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn PROD (2002):
levothyroxine food
Applies to: levothyroxine
ADJUST DOSING INTERVAL: Concurrent administration of calcium-containing products may decrease the oral bioavailability of levothyroxine by one-third in some patients. Pharmacologic effects of levothyroxine may be reduced. The exact mechanism of interaction is unknown but may involve nonspecific adsorption of levothyroxine to calcium at acidic pH levels, resulting in an insoluble complex that is poorly absorbed from the gastrointestinal tract. In one study, 20 patients with hypothyroidism who were taking a stable long-term regimen of levothyroxine demonstrated modest but significant decreases in mean free and total thyroxine (T4) levels as well as a corresponding increase in mean thyrotropin (thyroid-stimulating hormone, or TSH) level following the addition of calcium carbonate (1200 mg/day of elemental calcium) for 3 months. Four patients had serum TSH levels that were higher than the normal range. Both T4 and TSH levels returned to near-baseline 2 months after discontinuation of calcium, which further supported the likelihood of an interaction. In addition, there have been case reports suggesting decreased efficacy of levothyroxine during calcium coadministration. It is not known whether this interaction occurs with other thyroid hormone preparations.
MANAGEMENT: Some experts recommend separating the times of administration of levothyroxine and calcium-containing preparations by at least 4 hours. Monitoring of serum TSH levels is recommended. Patients with gastrointestinal or malabsorption disorders may be at a greater risk of developing clinical or subclinical hypothyroidism due to this interaction.
References
- Schneyer CR "Calcium carbonate and reduction of levothyroxine efficacy." JAMA 279 (1998): 750
- Singh N, Singh PN, Hershman JM "Effect of calcium carbonate on the absorption of levothyroxine." JAMA 283 (2000): 2822-5
- Csako G, McGriff NJ, Rotman-Pikielny P, Sarlis NJ, Pucino F "Exaggerated levothyroxine malabsorption due to calcium carbonate supplementation in gastrointestinal disorders." Ann Pharmacother 35 (2001): 1578-83
- Neafsey PJ "Levothyroxine and calcium interaction: timing is everything." Home Healthc Nurse 22 (2004): 338-9
Therapeutic duplication warnings
No warnings were found for your selected drugs.
Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.
See also
Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
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. | |
No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
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