Jones asked
I am taking levothyroxine and lisinopril. Gastro dotorc added Prilosec for a month or two and said to ask a pharmacist on the timing of these three meds. Can you please advise?
Answer
It's important to note that there is a drug interaction between Prilosec (omeprazole) and levothyroxine. Taking the medications concurrently can affect your thyroid hormone levels in a negative way. Prilosec decreases gastric pH, which plays an important role in the absorption of levothyroxine. They should not be taken together.
Levothyroxine
Levothyroxine is a synthetic T4 hormone used in the treatment of hypothyroidism. Common side effects associated with taking levothyroxine include but are not limited to:
- Insomnia
- Weight loss
- Tremor
- Upset stomach
Levothyroxine should be taken first thing in the morning 30 to 60 minutes prior to eating breakfast. It should be taken with a full glass of water to prevent choking and or gagging on the tablet.
Note that the above is ideal and simplest form of dosing levothyroxine. If you have been taking this medication a different way or time you should continue to take it in that manner. The most important part of levothyroxine administration is taking it the exact same way and time everyday. Changing administration habits can put your thyroid hormones off and you may require a dosing adjustment.
Prilosec (Omeprazole)
Prilosec (omeprazole) is a proton pump inhibitor most commonly used for gastroesophageal reflux disease (GERD), ulcers, and other gastric hypersecretory conditions. The most common side effects associated with taking Prilosec include but are not limited to:
- Headache
- Vomiting
- Abdominal pain
- Diarrhea
Prilosec should be given on an empty stomach 60 minutes before the first meal of the day.
Lisinopril
Lisinopril is an angiotensin converting enzyme (ACE) inhibitor. It is indicated for the treatment of high blood pressure, congestive heart failure and diabetic nephropathy. The most common side effects experienced while taking lisinopril include but are not limited to:
- Cough
- Dizziness
- Diarrhea
- Fatigue
- Nausea
Lisinopril can be taken without regard to food.
Taking Levothyroxine With Prilosec And Lisinopril
Dosing Prilosec and levothyroxine can be tricky, given they should both be dosed about 30 to 60 minutes before the first meal of the day. If possible, it is generally recommended to take levothyroxine first thing in the morning, before other medications. Prilosec is then safe to take 30 to 60 minutes later. Lisinopril can be taken anytime during the day, just make sure it is consistent.
