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I Don't Know How To Take Levothyroxine Properly With Respect To Other Meds I Take.vzuxj

Updated July 19, 2012
Suzie Says:
Mon, July 9, 2012

I need to know how long after taking levothyroxine in the morning I need to wait BEFORE taking my omeprazole, caffeine, clonazepam, gabapentin, deplin and propranolol? (I know to wait one-half to one hour before taking any FOOD.)

1 Reply

1
David Says:
Thu, July 19, 2012

Hi Suzie,

This is just my theory, but I think timing just depends on which medications interact with each other and which ones don't.

Based on my research, propranolol interacts with both clonazepam and levothyroxine, and clonazepam interacts with omeprazole. So taking any of these together does present a risk factor.

The interaction between propranolol and clonazepam states the following:
"MONITOR: Many psychotherapeutic and CNS-active agents (e.g., anxiolytics, sedatives, hypnotics, antidepressants, antipsychotics, opioids, alcohol, muscle relaxants) exhibit hypotensive effects, especially during initiation of therapy and dose escalation. Coadministration with antihypertensive agents, in particular vasodilators and alpha-blockers, may result in additive effects on blood pressure and orthostasis.

MANAGEMENT: Caution is advised during coadministration of these agents. Close monitoring for development of hypotension is recommended. Patients should be advised to avoid rising abruptly from a sitting or recumbent position and to notify their physician if they experience dizziness, lightheadedness, syncope, orthostasis, or tachycardia."

The interaction between propranolol and levothyroxine states the following:
"Thyroid hormone therapy may reverse decreased hepatic blood flow associated with hypothyroidism. Increased hepatic metabolism and decreased serum levels of some beta-blockers may result. Data are available for propranolol only. No special precautions are necessary. When hypothyroidism is converted to a euthyroid state, a decrease in beta-blocking effectiveness is possible."

The interaction between clonazepam and omeprazole states the following:
"MONITOR: Omeprazole may increase the pharmacologic effects and serum levels of certain benzodiazepines via hepatic enzyme inhibition. Diazepam and triazolam are the only benzodiazepines that have been specifically studied in this regard.

MANAGEMENT: Patient should be observed for increased sedation. Reduced benzodiazepine dosage may be indicated, especially in the elderly. Benzodiazepines not metabolized via oxidation (i.e., lorazepam, oxazepam, temazepam) are not expected to interact and may be considered as alternatives."

Due to the nature of such interactions, it may be in your best interest to have your doctor or pharmacist explain in detail when and how often you should take these medications in conjunction with one another. I also mention this because doctors and pharmacists are more able to be held liable for giving such personalized advice, because of their certifications.

I hope this helps!

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