Levothyroxine sodium can be taken once a day, but the timing of taking the medicine is more particular. The human body secretes the most thyroid hormone in the early morning, so it is generally recommended to take it when you wake up early, which can simulate the normal thyroid hormone secretion of the human body.
In addition, food will affect the absorption of levothyroxine, so you must take the medicine on an empty stomach and eat 30 to 60 minutes after taking the medicine.
Beans and dairy foods have the most serious impact on drug absorption, so it is best to take the medicine more than 4 hours apart from eating beans and dairy foods;
Metal ions will also affect the absorption of this drug, so it should be taken more than 2 hours apart from foods with high calcium and iron content.
For those who need to eat breakfast in a hurry after getting up early, they cannot guarantee a fasting time of 30 minutes after taking the medicine, so they can also take the medicine before going to bed instead. However, taking the medicine before going to bed will cause a slight increase in thyroid hormone, which will put the body in a state of mild hyperthyroidism and may reduce the quality of sleep. In this case, it is recommended to go to bed half an hour earlier at night and get up half an hour earlier in the morning to take the medicine.
In addition to the influence of food, when taking levothyroxine sodium, you should also pay attention to the interaction between drugs:
1. Cholesterol-lowering drugs, such as cholestyramine and colestipol, will inhibit the absorption of levothyroxine sodium, so levothyroxine sodium should be taken 4 to 5 hours before taking cholestyramine and colestipol.
2. Drugs containing metal ions, such as drugs containing metal ions such as aluminum, iron, and calcium, will reduce the effect of levothyroxine sodium. Therefore, if taken with drugs containing metal ions such as aluminum sulfate, ferrous oxide, and calcium carbonate, an interval of at least 2 hours is required.
3. Drugs that inhibit gastric acid, such as H2 receptor blockers (cimetidine, ranitidine, etc.) and proton pump inhibitors (omeprazole, pantoprazole, rabeprazole, etc.), will cause a decrease in gastric acid secretion, resulting in a decrease in the absorption of levothyroxine sodium, and the dosage needs to be increased.
4. Liver enzyme induction drugs, such as carbamazepine, phenytoin sodium, barbiturates in anti-epileptic drugs, and rifampicin in anti-tuberculosis drugs. These drugs have liver enzyme induction effects, which will accelerate the metabolism of levothyroxine sodium, shorten the duration of action in the body, and reduce the blood concentration of drugs. When taking these drugs together, the dose of levothyroxine sodium needs to be increased.
5. Estrogen, such as women taking estradiol-containing contraceptives and hormone replacement therapy during menopause, have an increased demand for thyroid hormone, and the dose of levothyroxine sodium can be appropriately increased.
6. Salicylates (such as aspirin), dicoumarol, large doses of furosemide, phenytoin, etc. will replace levothyroxine from plasma proteins, increase the free levothyroxine, and increase the latter's effect. The dose of levothyroxine sodium can be appropriately reduced under the guidance of a doctor.
7. Hypoglycemic drugs, levothyroxine sodium will reduce the effect of hypoglycemic drugs. When diabetic patients need to take levothyroxine sodium, they should pay attention to monitoring blood sugar levels. If there are any changes, the dose of hypoglycemic drugs needs to be adjusted.
8. Anticoagulants. Levothyroxine sodium will increase the effect of dicoumarol anticoagulants (such as warfarin). Therefore, when used in combination with anticoagulants, coagulation indicators should be monitored regularly and the dose of anticoagulants should be adjusted if necessary.
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