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Colesevelam hydrochloride and lanthanum carbonate interfere with the absorption of levothyroxine.

Several oral medications have been shown to inhibit the intestinal absorption of levothyroxine sodium when taken simultaneously with thyroid hormone; these include bile acid-binding resins (1), iron salts (2), calcium carbonate (3), sucralfate (4), aluminum-containing antacids (5), raloxifene (6), chromium picolinate (7), and sevelamer hydrochloride (HCl) (7). In most of these cases, it is believed that the malabsorption of thyroxine is due to the binding of the hormone to the other medications, forming an insoluble or nonabsorbable complex (1,2,5,8,9). Based on their physicochemical properties or sim-ilarities to previously studied agents, we proposed that two other medications, colesevelam HCl and lanthanum carbonate, may also decrease thyroxine absorption when co-ad-ministered with levothyroxine.