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Cytomel and Vital-D Rx

Determining the interaction of Cytomel and Vital-D Rx and the possibility of their joint administration.

Check result:

Cytomel <> Vital-D Rx

Relevance: 04.11.2023 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Using multivitamin with minerals together with liothyronine may decrease the effects of liothyronine. You should separate the administration of liothyronine and multivitamin with minerals by at least 4 hours. If your doctor does prescribe these medications together, you may need a dose adjustment or special test to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

ADJUST DOSING INTERVAL: Concurrent administration of calcium-containing products may decrease the oral bioavailability of levothyroxine by one-third in some patients. Pharmacologic effects of levothyroxine may be reduced. The exact mechanism of interaction is unknown but may involve nonspecific adsorption of levothyroxine to calcium at acidic pH levels, resulting in an insoluble complex that is poorly absorbed from the gastrointestinal tract. In one study, 20 patients with hypothyroidism who were taking a stable long-term regimen of levothyroxine demonstrated modest but significant decreases in mean free and total thyroxine (T4) levels as well as a corresponding increase in mean thyrotropin (thyroid-stimulating hormone, or TSH) level following the addition of calcium carbonate (1200 mg/day of elemental calcium) for 3 months. Four patients had serum TSH levels that were higher than the normal range. Both T4 and TSH levels returned to near-baseline 2 months after discontinuation of calcium, which further supported the likelihood of an interaction. In addition, there have been case reports suggesting decreased efficacy of levothyroxine during calcium coadministration. It is not known whether this interaction occurs with other thyroid hormone preparations.

MANAGEMENT: Some experts recommend separating the times of administration of levothyroxine and calcium-containing preparations by at least 4 hours. Monitoring of serum TSH levels is recommended. Patients with gastrointestinal or malabsorption disorders may be at a greater risk of developing clinical or subclinical hypothyroidism due to this interaction.

References

Singh N, Singh PN, Hershman JM "Effect of calcium carbonate on the absorption of levothyroxine." JAMA 283 (2000): 2822-5
Neafsey PJ "Levothyroxine and calcium interaction: timing is everything." Home Healthc Nurse 22 (2004): 338-9
Csako G, McGriff NJ, Rotman-Pikielny P, Sarlis NJ, Pucino F "Exaggerated levothyroxine malabsorption due to calcium carbonate supplementation in gastrointestinal disorders." Ann Pharmacother 35 (2001): 1578-83
Schneyer CR "Calcium carbonate and reduction of levothyroxine efficacy." JAMA 279 (1998): 750

Cytomel

Generic Name: liothyronine

Brand name: Cytomel, Triostat

Synonyms: n.a.

What is Cytomel?

Vital-D Rx

Generic Name: multivitamin with minerals

Brand name: Berocca Plus, Vicon Forte, Prosteon, TheraCal D200, TheraCal D400, Ocuvite PreserVision, Protegra Softgel, Centavite, Daily Multi-Vitamins with Minerals, Strovite Advance, I-Sense OccuShield, Tab-A-Vite Maximum, Occuplex, ICaps AREDS, Siderol, Uni-Fac ZX, MagneBind 400 RX, Folgard OS, Dialyvite with Zinc Rx, Dialyvite 800 with Zinc, Dialyvite 800 with Zinc 15, CF Vite, Resource Optisource, High Potency, Tab-A-Vite Womens Formula, Tab-A-Vite WeightSlim, Dialyvite 3000, Udamin, Udamin SP, Vita Zx, CalciFol, Femtabs, Diatx Zn, Complete A-Z, Thera-Vite M, Ellis Tonic Sherry, Renax 55, O-CAL FA, ICaps MV, Viactiv Multi-Vitamin, Os-Cal Ultra, Opti-Gen, Encora, Disney Winnie the Pooh Complete, Disney Winnie the Pooh with Extra C, Disney Winnie the Pooh Gummies, Mag-SR with Calcium, Folpace Rx, Calafol Rx, Corvite, NIC 750, Tandem Plus, Multi-Day Plus Minerals, ABC Plus Senior, Certa-Vite Senior Plus Lutein, I-Vite Protect, CalciFolic-D, Ostiva, Daily-Vite Weight Control, One-A-Day WeightSmart, RenaPlex, Centrum Kids Complete Dora the Explorer, Centrum Kids Complete SpongeBob SquarePants, Centrum Kids Complete Variety, Caltrate 600 Plus, Ecee Plus, Viactiv Multi-Vitamin Flavor Glides, Viactiv Calcium Flavor Glides, Biotin Forte with Zinc, AquADEKs Pediatric, AquADEKs, Antioxidant Ultra Formula, Clusimar, Multi-betic, elon Matrix 5000 Complete, One-A-Day Women 50 Plus, One-A-Day Men 50 Plus, SourceCF Multivitamins with A, B, D, E & K plus Zinc, Vitamax, Corvite Free, Corvite 150, RE Fac-X, Vital-D, SourceCF Softgels, SourceCF Chewables, SourceCF Pediatric Drops, Magonate Tablets, Hemocyte Plus, Reocyte Plus, Re Dualvit F, Re Dualvit Plus, Folbee Plus CZ, Centrum Cardio, Renatabs with Iron, CertaVite with Lutein, Strovite Advance+D, Thera-M Enhanced, Ferrocite Plus, Risanoid Plus, Dialyvite 5000, Nicotinamide ZCF, Leg-Gesic, PreserVision, Children's Complete, Daily Multiple for Women, Spectravite Cardio Health, Daily Multiple for Women 50+, Daily Multiple for Men 50+, Eye Health Formula, elppa Daily, MaxiVision Eye Formula, MaxiVision Ocular Formula, MaxiVision Eye & Body Formula, MaxiVision Whole Body Formula, Nutiifac ZX, Recal Fol D, Centrum Women's, Centrum Silver Women's, Centrum Men's, Centrum Silver Men's, Strovite One, Vitatab MV, Megavite Rx, Nutravance, Super Theravite-M, Vitatrum, Advanced AM/PM, ProBarimin QT, One-A-Day Men Pro Edge, One-A-Day Vitacraves, Corvita, Centrum Kids, TL G-Fol OS, Corvita 150, Century Senior, Dialyvite 800 Ultra D, CertaVite with Antioxidants, NicAzel, Centratex, Spectravite Senior, Centrum Ultra Women's, Centrum Silver Ultra Women's, Centrum Ultra Men's, Centrum Silver Ultra Men's, Tozal, ICaps Lutein & Omega-3, Apetigen-Plus, Lysiplex Plus, Bladder 22, Essentia, 50 + Companion, Companion Multi, Prostate 24, TheraLith XR, ConceptionXR MSF, ConceptionXR RHF, Centrum Special Energy, Centrum Special Heart, TheraCal D2000, TheraCal D4000, TheraCal Rapid Repletion, Prosteon, Centrum Specialist Vision, PureVit DualFe Plus, PureFe Plus, Centamin, AKEDamins, Dialyvite Supreme D, VP-ZEL, Macular Vitamin Benefit, ProRenal Vital, ProRenal QD, Nutricap, Nutrivit, Lipoflavovit, Macular Health, Daily Multi, Centrum Flavor Burst, Centrum Special Immune, Folgard, Caltrate 600+D Plus Minerals, CertaVite Senior, Solo, NanoVM 1-3 Years, NanoVM 4-8 Years, Calcium 600+D Plus Minerals, Prosight with Lutein, Advanced Eye Health, PreserVision AREDS 2, ChoiceFul, Complete Formulation Softgels, Abatron, Corvite Fe, NicAzel Forte, Nicadan, DermaNIC, Active FE, Companion, CalMag Thins, ProCerv HP, Conception XR, Nature's Bounty Men's Hair Formula, Men's Hair Formula, Stress with Zinc, Somnicin, MaxFe, Puralor Ci with DHA, Star Wars Hero Gummies, Star Wars Villain Gummies, Star Wars Yoda Gummies, Citracal Plus Bone Density Builder, Star Wars, Centrum Adults, Caltrate 600+D Plus Minerals Minis, One-A-Day Mens 50+ Healthy Advantage, Emergen-C, Vitamin C plus Zinc, RenaPlex-D, Vol-Plus, Multigenics, Supervite EC, Supervite, Thyrosol, Se-Tan Plus, Centrum Silver Plus Vision, Complete Formulation, Ocuvite Eye + Multi, Complete Formulation Softgels D3000, Complete Formulation D5000, Complete Formulation D3000, Complete Formulation Pediatric Drops, Airborne Everyday, Airborne Dual Action, Airborne, Airborne Kids Gummies, Airborne Everyday Gummies, Airborne Gummies, Airborne Plus Energy, Celebrate Multivitamin, Celebrate Calcium Plus 500, Nicadan ZX, DEKAs Plus, Nicaprin, Astamed MYO, L'il Critters Gummy Vites, Theratrum Complete with Lutein and Lycopene, Theratrum Complete 50 Plus Lutein & Lycopene, Centravites 50 Plus, Macular Health Formula, Dry Eye Formula, MultiVitamin Plus Zinc, ABDEK Pediatric, ABDEK, Centravites Adults, Optisource Post Bariatric Surgery, Healthy Eyes with Lutein, Centrum MultiGummies Women, Centrum Vitamints, Genicin Vita-Q, Genicin Vita-S, Complete Formulation Minis, Theratrum Complete 50 Plus, DEKAs Bariatric, Emergen-C Energy Plus Orange Zest, Bariatric Multivitamins with 45 mg Iron, Folite, Geritol Tonic, SSS. Tonic, Vitalize, Fovex

Synonyms: Multivitamins and minerals, Calcium-Folic Acid Plus D

What is Vital-D Rx?

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In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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