Levothyroxine Administration Guidelines

Drug Interactions and Timing

• The American Gastroenterological Association recommends that bile acid sequestrants, such as cholestyramine, colestipol, and colesevelam, require 4-6 hours of separation from levothyroxine to avoid binding interactions 1
• The American Gastroenterological Association suggests that when drug interactions cannot be excluded, other medications should be taken at least 1 hour before or 4-6 hours after levothyroxine 1

Special Considerations

• The European Society for Clinical Nutrition and Metabolism notes that patients on levodopa for Parkinson's disease should take that medication 30 minutes before meals, highlighting the importance of timing for other medications 2