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Does Nexium negate Levoxyl (Synthroid)?
My endocrinologist told me that Nexium (the medicine for GERD) negates my thyroid medicine. I wish I had known this sooner - just wanted to share this information and hear the thoughts of others.
Female
asked Jan 27, 2010 at 11:50AM in Other
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1Votesanswered Jan 27, 2010 at 07:31PMI have NOT heard that Nexium affects Thyroid Medications.
I do know that it reduces the efficiency of Plavix(used as an anti aggregate of platelets following arterial stent implant.
The interactions that Nexium has besides Plavix are with the following:
ampicillin, diazepam, digoxin, iron salts, ketoconazole(anti fungal medications), phenytoin and warfarin. -
2Votes
answered Feb 07, 2010 at 05:26PMI have not heard that, and if it affects thyroid medication at all it would most likely not "negate" it. We often recommend that thyroid medication be taken "alone" (spaced out from other medications). For the most part, this has more to do with interfering with absorption from the gut, as thyroid medications can become stuck to calcium, iron, etc. supplements. Of course, if one were to take thyroid medication with a drug that interferes with its absorption, the result would be a change in the thyroid hormone blood test, which would prompt adjustment in the dosing (and, really should also prompt the prescribing physician to query the patient regarding how they are taking their medication), but eventually, regardless of the interfering medication the dosing of thyroid hormone would result in a normal blood level. -
0Votes
answered Dec 22 at 02:53PMIt is unlikely that Nexium (esomeprazole) affects absorption or biological action of thyroid replacement therapy.
In order to address this question we have conducted the PAROS study, a cross-over trial with healthy volunteers that received a one-time high-dose levothyroxine administration (4 µg / kg body weight) before and after (or after and before) receiving 40 mg pantoprazole, respectively. There was no difference in T4 resorption or suppression of TSH levels (PMID 16477543).
Conversely, a report of Centanni et al. assumed PPIs to influence bioavailability of thyroid hormones as they observed an increase of levothyroxine demand in patients with chronic gastritis (PMID 16641395). It may be this study that your endocrinologist has in mind. However, we believe that it is the inflammatory disease per se and not the proton-pump inhibitor therapy that caused the absorption of thyroid hormones to decrease (PMID 16971728).
The differences between esomeprazole, pantoprazole and other PPIs may be small with respect to biological effects.
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