Armour

Food Interaction

[Moderate] ADJUST DOSING INTERVAL: Consumption of certain foods as well as the timing of meals relative to dosing may affect the absorption of T4 thyroid hormone (i.e., levothyroxine).

T4 absorption is increased by fasting and decreased by foods such as soybean flour (e.g., infant formula), cotton seed meal, walnuts, dietary fiber, calcium, and calcium fortified juices.

MANAGEMENT: Preparations containing T4 thyroid hormone should be administered on a consistent schedule with regard to time of day and relation to meals so as to avoid large fluctuations in serum levels.

Foods that may affect T4 absorption should be avoided within several hours of dosing if possible.

When administered to patients receiving continuous enteral nutrition for more than 7 days, some experts recommend that the tube feeding should be interrupted for at least 1 hour before and 1 hour after the dose of levothyroxine is given and to monitor patients' thyroid function.

Armour Hypertension interaction

[Major] Armour hormones cause increases in myocardial contractility and heart rate as a result of increased metabolic demands and oxygen consumption.

Therapy with thyroid hormones should be administered cautiously and initiated at reduced dosages in patients with cardiovascular disorders such as angina, coronary artery disease, and hypertension.

Clinical monitoring of cardiovascular function is recommended.

If chest pain or exacerbation of cardiovascular disease occurs, the dosage of thyroid hormone should be reduced, even at the expense of achieving euthyroid state.

Armour hormones should not be administered to patients with an acute myocardial infarction that is not complicated by hypothyroidism.

Armour multivitamins interaction

[Moderate] 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

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.

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.

Armour Disease Interaction

Major: adrenal insufficiency, cardiovascular disease, thyrotoxicosisModerate: diabetes, seizures

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