Susan M. Harmon, MD; Charles F. Seifert, PharmD
Harmon SM, Seifert CF. Levothyroxine-Cholestyramine Interaction Reemphasized. Ann Intern Med. 1991;115:658-659. doi: 10.7326/0003-4819-115-8-658_2
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Published: Ann Intern Med. 1991;115(8):658-659.
To the editors: Several clinically significant interactions have been reported with bile acid sequestrants, including digoxin, warfarin, thiazide diuretics, corticosteroids, and levothyroxine (1). To date, only one case report of cholestyramine interference with levothyroxine with subsequent clinical hypothyroidism has been reported (2). We report the case of a patient who received concomitant cholestyramine and levothyroxine and developed elevations in the thyroid-stimulating hormone (TSH) level. On the same dose of levothyroxine after discontinuation of the cholestyramine, the patient's TSH level returned to normal.
A 51-year-old man with known coronary artery disease and hypothyroidism was noted on 5 July 1990 to have
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