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Levothyroxine administration — GPhC CRA MCQ

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ModerateEndocrine TherapeuticsLevothyroxine administrationGPhC CRA

A 56-year-old woman with hypothyroidism has persistent symptoms despite levothyroxine 125micrograms daily. She takes it with breakfast, ferrous sulfate and omeprazole every morning. TSH remains raised. What is the most appropriate action?

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Correct answer: E — Advise taking levothyroxine separately from iron and consistently before food

Iron salts reduce levothyroxine absorption, and taking levothyroxine with food can also reduce and vary absorption. Administration should be consistent, usually before breakfast and separated from iron by several hours. Dose changes may be considered by the prescriber after administration issues are addressed. Stopping therapy would worsen hypothyroidism.

Reference: BNF; NICE CKS Hypothyroidism