Drug interactions
Levothyroxine + Rabeprazole
Severity: Moderate
Levothyroxine and Rabeprazole: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Rabeprazole raises gastric pH, which can reduce dissolution and absorption of oral levothyroxine tablets. In some patients this results in a rise in TSH and a need for higher levothyroxine doses, although study results are inconsistent.
What this interaction means in plain words
Levothyroxine and Rabeprazole can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Levothyroxine belongs to Endocrine; Rabeprazole belongs to Gastrointestinal Tract.
Why it happens
Reduced gastric acidity decreases dissolution and absorption of levothyroxine.
What to do
Check TSH about 6 to 8 weeks after starting, stopping or changing the dose of rabeprazole, and adjust the levothyroxine dose as needed. Keep levothyroxine administration consistent, on an empty stomach.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Rabeprazole
- Rabeprazole + Rilpivirine Contraindicated
- Acalabrutinib + Rabeprazole Major
- Atazanavir + Rabeprazole Major
- Dacomitinib + Rabeprazole Major
- Dasatinib + Rabeprazole Major
- Erlotinib + Rabeprazole Major
Other interactions of Levothyroxine
Frequently asked questions
Can I take Levothyroxine with Rabeprazole?
MediHelp rates the interaction as moderate. Levothyroxine and Rabeprazole can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Rabeprazole raises gastric pH, which can reduce dissolution and absorption of oral levothyroxine tablets. In some patients this results in a rise in TSH and a need for higher levothyroxine doses, although study results are inconsistent.
How serious is the interaction between Levothyroxine and Rabeprazole?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Check TSH about 6 to 8 weeks after starting, stopping or changing the dose of rabeprazole, and adjust the levothyroxine dose as needed. Keep levothyroxine administration consistent, on an empty stomach.
What other medicines interact with Rabeprazole?
MediHelp also lists interactions of Rabeprazole with, for example, Rilpivirine, Acalabrutinib, Atazanavir. The full list is on the Rabeprazole page.
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