Raloxifene Causing Malabsorption of Levothyroxine
Abstract
To our knowledge, raloxifene hydrochloride, a selective estrogen receptor modulator, has never been reported to interfere with absorption of levothyroxine. We describe a 79-year-old woman with chronic, treated primary hypothyroidism, presenting with increasing levothyroxine requirement while taking raloxifene at the same time as levothyroxine. For two 6- to 8-week periods, we separated the ingestion of raloxifene and levothyroxine by about 12 hours. In addition, we tested the absorption of 1.0 mg of levothyroxine sodium with and without the coadministration of 60 mg of raloxifene hydrochloride on 2 separate occasions by collecting serial blood samples for 6 hours. Hypothyroidism occurred in a reproducible fashion whenever levothyroxine and raloxifene were administered together and improved whenever they were taken separately. Combined administration of levothyroxine and raloxifene resulted in lower levels of serum thyroxine compared with administration of levothyroxine alone. By a yet unknown mechanism, raloxifene caused malabsorption of levothyroxine in our patient when coadministered.
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Effects of several additional medications on LT4 absorption have been documented in individual case reports.
“Effects of several additional medications have been documented in individual cases reports (148-151).”
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- Authors
- Siraj, E. S., Gupta, M. K., & Reddy, S. S. K.
- Affiliations
- Cleveland Clinic (US)
- Venue
- Archives of Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2003-06-09
- Volume
- 163
- Issue
- 11
- Pages
- 1367
- ISSN
- 0003-9926 (ISSN-L)
- OpenAlex
- W1975298909
- Cited by
- 76
- References
- 23
- Citations by year
- 2025: 1 · 2023: 2 · 2022: 2 · 2021: 2 · 2019: 2 · 2018: 3 · 2017: 3 · 2016: 3 · 2015: 7 · 2014: 5 · 2013: 3 · 2012: 3
- FWCI
- 2.85
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacogenetics and Drug Metabolism
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Estrogen and related hormone effects
- Keywords
- raloxifene, levothyroxine, drug-drug interactions, malabsorption, selective estrogen receptor modulators, primary hypothyroidism, thyroid hormone absorption
- MeSH terms
- Absorption, Aged, Drug Interactions, Female, Humans, Hypothyroidism, Thyroxine, Selective Estrogen Receptor Modulators, Raloxifene Hydrochloride
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