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Levothyroxine administration — GPhC CRA MCQ

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ModerateEndocrine TherapeuticsLevothyroxine administrationGPhC CRA

A 39-year-old woman collecting levothyroxine sodium says she takes it with ferrous sulfate and breakfast because she has a busy morning. Her TSH remains raised despite adherence. What monitoring is required?

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Correct answer: E — Take levothyroxine on an empty stomach and separate it from iron

Iron salts can reduce levothyroxine absorption, and food can also impair absorption in some patients. Levothyroxine is usually taken on an empty stomach with separation from iron, calcium and some antacids. Persistently raised TSH should prompt review of adherence, timing and interacting medicines.

Reference: BNF; NICE CKS