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Introduction: The combination of levothyroxine and ciprofloxacin has been reported to cause hypothyroidism
.
When both classes of drugs are included in the prescription, patients should be informed to use
them at least 6 hours apart.
On November 2, 2022, the Drug Evaluation Center of the National Medical Products Administration and the National Adverse Drug Reaction Monitoring Center released the 10th issue of "Pharmacovigilance Alert", covering 4 aspects of information
, including "New Zealand Drug and Medical Device Safety Administration suggests potential interaction between levothyroxine and ciprofloxacin".
1
.
Japan warns of the risk of severe gastritis with nivolumab and pembrolizumab.
2.
The New Zealand Medicines and Medical Device Safety Administration suggests the potential interaction
of levothyroxine with ciprofloxacin.
3.
Canada suggests the potential risk
of serious heart-related problems, blood clots, cancer and death from JAK inhibitors (tofacitinib, baricitinib, upatinib).
4.
The European Medicines Agency (EMA) recommends measures to reduce the risk of
respiratory failure and sepsis when terlipressin-containing drugs are treated with hepatorenal syndrome.
The New Zealand Medicines and Medical Device Safety Administration has suggested potential interactions with levothyroxine with ciprofloxacin
In June 2022, the New Zealand Medicines and Medical Device Safety Administration (Medsafe) announced that it was updating product information for levothyroxine and ciprofloxacin to include information
on the risk of hypothyroidism due to drug interactions between levothyroxine and ciprofloxacin.
Levothyroxine is used to treat hypothyroidism
.
Ciprofloxacin is a fluoroquinolone antibiotic indicated for adult infections
caused by ciprofloxacin-sensitive pathogens.
The Adverse Effects Monitoring Centre (CARM) in New Zealand received a report of
symptoms of hypothyroidism in patients treated with levothyroxine plus ciprofloxacin.
Symptoms improved
after discontinuation of ciprofloxacin and temporary escalation of levothyroxine.
In addition, one case report identified in the literature search suggested this interaction
.
Combination of two drugs should be at least 6 hours apart: It is recommended that medical personnel instruct patients to use at least 6 hours between
doses when the two drugs are combined.
Patients should be informed of this potential interaction, of signs and symptoms of concern (e.
g.
, fatigue, lethargy, or feeling cold), and of any changes
in thyroid function.
Information source:
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