Sodium alendronate, levothyroxine and proton pump inhibitors: is there an interaction between them?

• Autor(a) principal: Sousa, Camila Tavares de
• Data de Publicação: 2021
• Outros Autores: Gomes, Gabrielle Kéfrem Alves, Pichitelli, Janaina de Sousa Dias, Tinoco, Marlon Silva, Pereira, Leonardo Régis Leira, Pereira, Mariana Linhares, Baldoni, André de Oliveira
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Revista Brasileira de Medicina de Família e Comunidade (Online)
• Texto Completo: https://www.rbmfc.org.br/rbmfc/article/view/2486
• topic: Alendronato; Tiroxina; Inibidores da Bomba de Prótons; Desenvolvimento de Medicamentos.; Alendronate; Thyroxine; Proton Pump Inhibitors; Drug Development.; Alendronato; Tiroxina; Inhibidores de la Bomba de Protones; Desarrollo de Medicamentos.

Introduction: Drug interactions can alter safety and/or effectiveness in the treatment of diseases. Some medications need to be used on an empty stomach and the literature presents divergent information about the real clinical impact of using them at the same time. Objectives: To analyze the evidence on the clinical relevance of potential interactions between proton pump inhibitors, levothyroxine and sodium alendronate. Methods: A narrative review of articles available in the PubMed database was carried out, in addition to consulting potential drug interactions in sources of information on drugs available on the World Wide Web. Results: In only three of the 17 information sources consulted, a report was reported possible reduction in plasma levels and the effectiveness of levothyroxine, when administered concomitantly with omeprazole or another in the class. Only one source reports a slight reduction in plasma sodium alendronate levels due to interaction with levothyroxine, and only two sources show a possible reduction in the therapeutic effect of sodium alendronate through interaction with PPIs. Only two studies report significant results related to the existence of an interaction between levothyroxine or alendronate in concomitant use of PPIs. In all sources consulted, interactions are described as minor, mild, moderate or of unknown significance. All sources of information suggest the continuity of therapy to manage the interaction. Conclusion: To date, there is no robust evidence demonstrating that it is impossible to use proton pump inhibitors, levothyroxine and sodium alendronate at the same time, and it is essential to monitor clinical and laboratory parameters.