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Pancreatin timing — GPhC CRA MCQ

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HardGastro-intestinal TherapeuticsPancreatin timingGPhC CRA

A patient takes levothyroxine on waking and is starting colestyramine twice daily with breakfast and the evening meal. Which separation is specified in the colestyramine SmPC?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Take levothyroxine one hour before or four-to-six hours after colestyramine

Explanation lettering: D = shown as A · E = shown as B · B = shown as C · C = shown as D · A = shown as E

A is correct: colestyramine can bind other medicines in the gut, so they should be taken at least one hour before or four to six hours after it. B places levothyroxine inside the binding window. C is wrong because the interaction is not limited to fat-soluble medicines. D invents a symmetric two-hour interval and understates the required post-dose separation. E provides essentially no separation and therefore does not prevent adsorption.

Reference: Colestyramine 4 g powder SmPC. https://www.medicines.org.uk/emc/product/15799/smpc