Colesevelam hydrochloride and lanthanum carbonate interfere with the absorption of levothyroxine
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The list of medications that can alter the absorption of LT4 is extensive and includes calcium carbonate, PPIs, bile acid sequestrants (cholestyramine and colesevelam), phosphate binders, ferrous sulfate, aluminum-containing antacids, and sucralfate.
“The list of medications that can alter the absorption of LT4 is extensive and includes calcium carbonate (132-134), PPIs (135), bile acid sequestrants (cholestyramine and colesevelam) (136,137), phosphate binders (138,139), ferrous sulfate (140,141), aluminum-containing antacids (142,143), and sucralfate (144,145).”
From Guidelines for the Treatment of Hypothyroidism: Prepared by the American Thyroid Association Task Force on Thyroid Hormone Replacement (2014) · cites this paper as [137]
Bile acid sequestrants bind LT4 within the intestine.
“Two studies have implicated bile acid sequestrants as being responsible for binding LT4 within the intestine (136,137).”
From Guidelines for the Treatment of Hypothyroidism: Prepared by the American Thyroid Association Task Force on Thyroid Hormone Replacement (2014) · cites this paper as [137]
Co-administration of bile acid sequestrants and LT4 reduces LT4 absorption in healthy volunteers.
“Both of these reports incorporated pharmacokinetic studies in healthy volunteers showing reduced absorption with co-administration of the agent and LT4.”
From Guidelines for the Treatment of Hypothyroidism: Prepared by the American Thyroid Association Task Force on Thyroid Hormone Replacement (2014) · cites this paper as [137]
Direct complexation and chelation play important roles in the malabsorption of LT4 induced by the intake of many drugs, including calcium and iron supplements, aluminum-containing antacids, bile acid sequestrants, and some foods (eg, fiber-rich foods, coffee, and milk).
“It is widely acknowledged that direct complexation and chelation play important roles in the malabsorption of LT4 induced by the intake of many drugs, including calcium and iron supplements (72, 73), aluminum-containing antacids (74), bile acid sequestrants (75, 76), and some foods (eg, fiber-rich foods, coffee, and milk) (22, 77, 78).”
From Levothyroxine: conventional and novel drug delivery formulations. (2023) · cites this paper as [76]
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References 12 · Cited by 35
Research works printed but not linked: 1
- [13]Wenzel KW. Kirschsieper HE. Aspects of the absorption of oral l-thyroxine in normal man. Metabolism: Clinical & Experimental. 1977;26:1–8. doi: 10.1016/0026-0495(77)90121-4. [DOI] [PubMed] [Google Scholar] · DOI · Paper page
- Authors
- Weitzman, S. P., Ginsburg, K. C., & Carlson, H. E.
- Affiliations
- Northport VA Medical Center (US)
- Stony Brook School (US)
- Corresponding author
- Carlson, Harold E.
- ORCID
- Carlson, Harold E.
- Venue
- Thyroid
- Publisher
- SAGE Publications
- Published
- 2009-01
- Volume
- 19
- Issue
- 1
- Pages
- 77-79
- ISSN
- 1050-7256 (ISSN-L)
- 1557-9077
- PMC
- PMC2858370
- OpenAlex
- W2050996957
- Cited by
- 35
- References
- 12
- Citations by year
- 2025: 1 · 2023: 3 · 2022: 2 · 2021: 1 · 2018: 6 · 2017: 1 · 2016: 3 · 2015: 4 · 2014: 3 · 2013: 1 · 2012: 4
- FWCI
- 2.43
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Thyroid (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Center for Research Resources (M01RR010710, MO1 RR10710)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Nephrology › Parathyroid Disorders and Treatments
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Keywords
- lanthanum carbonate, levothyroxine, drug-drug interactions, drug absorption, thyroid hormone absorption, bile acid sequestrants
- MeSH terms
- Colesevelam Hydrochloride, Adult, Allylamine, Anticholesteremic Agents, Drug Interactions, Female, Humans, Lanthanum, Male, Thyrotropin, Thyroxine
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