Drug Interaction Report

Taking levothyroxine and dihydroxyaluminum sodium carbonate too close together may interfere with the absorption of levothyroxine and reduce its effectiveness. To prevent or minimize potential interaction, these medications should preferably be taken at least four hours apart. Contact your doctor if you experience signs and symptoms of reduced thyroid function such as fatigue; sluggishness; constipation; depression; hoarseness; unexplained weight gain; sensitivity to cold; pale, dry skin; muscle ache, weakness, or tenderness; joint pain, stiffness, or swelling; heavier than normal menstruation periods; or brittle fingernails and hair. 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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Citrate, or citric acid, can increase the absorption of dihydroxyaluminum sodium carbonate. This may lead to elevated blood levels of aluminum, particularly in individuals with reduced kidney function, since aluminum is primarily eliminated by the kidneys. Excess aluminum may deposit and cause problems in various tissues including bone, brain, heart, liver, muscles, and spleen. Over time, weak bones, bone pain, fractures, skeletal deformity, brain disorders, and anemia may develop. Talk to your doctor before using dihydroxyaluminum sodium carbonate if you have kidney impairment or are on hemodialysis. You should avoid or limit the consumption of citrate-containing foods and beverages (e.G., soft drinks, citrus fruits, fruit juices) during treatment with dihydroxyaluminum sodium carbonate. Be aware that some effervescent and dispersible drug formulations may also contain citrate and should be restricted as well. Even if you do not have kidney problems, it may be best to separate the dosing of dihydroxyaluminum sodium carbonate and citrate-containing products by 2 to 3 hours. Talk to a healthcare professional if you have any questions or concerns. 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 dihydroxyaluminum sodium carbonate is taken during enteral nutrition therapy (tube feeding), the tube may get clogged. Therefore, dihydroxyaluminum sodium carbonate should not be mixed with or given after high-protein tube feedings. The dose should be separated from the feeding by as much as possible, and the tube should be thoroughly flushed before administration of the dose.

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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. 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.

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Using multivitamin with minerals together with levothyroxine may decrease the effects of levothyroxine. You should separate the administration of levothyroxine and multivitamin with minerals by at least 4 hours. 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. Do not stop using any medications without first talking to your doctor.

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