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There are many drugs that have the potential to induce hypothyroidism. Drug- induced hypothyroidism is an underactive thyroid gland due to a reaction to a medication. If your hypothyroid symptoms began after starting a medication, you may be suffering from drug-induced hypothyroidism. Here is a list of some medications known to cause hypothyroidism. For a detailed explanation of the mechanisms by which these drugs exert their influence on thyroid hormone, read: Drugs That Suppress TSH or Cause Central Hypothyroidism, Best Pract Res Clin Endocrinol Metab. 2009 Dec; 23(6) 793-800.

Drugs impact thyroid function at many different levels; from the hypothalamus to pituitary, synthesis and secretion by the thyroid gland, metabolism, binding of thyroid to its major binding protein, altering thyroid receptor function, and absorption of medication from the GI tract.

Drugs that affect thyroid function in normal patients:

Inhibition of T4/T3 synthesis

Propylthiouracil

Methimazole

 

Inhibition of T4/T3 secretion

Lithium

Iodide

Amiodarone

Aminoglutethimide

 

Thyroiditis

Interferon

Interleukin-2

Amiodarone

Sunitinib

 

Jod-Basedow Hyperthyroidism

Iodide

Amiodarone

 

TSH suppression

Glucocorticoids

Dopamine agonists

Somatostatin analogs

Rexinoids Carbemazepine/Oxcarbemazepine

Metformin

 

TSH elevation

Metyrapone

 

Displacement from thyroxine binding globulin (laboratory artifact)

Furosemide

Phenytoin

Probenecid

Heparin

Nonsteroidal anti-inflammatory medications

 

Drugs affecting patients taking levothyroxine:

Inhibition of levothyroxine absorption

Antacids (Tums, Rolaids, etc)

Antibiotics (Cipro, Maxaquin, Levaquin, Avelox, Norox-in, Floxin)

Aluminum hydroxide

Calcium

Colestyramine (Questran)

Colestipol

Iron and Iron Supplements

Sucralfate (Carafate)

Raloxifene (Evista)

Sevelamer (Renagel, Renvela)

Increased hepatic metabolism

Carbemazepine (Tegretol)

Phenobarbitol (Luminal, Solfoton)

Oxycarbazepine (Trileptal)

Phenytoin (Dilantin)

Primidone (Mysoline)

Rifampin TKI (Imatinib, axitinib, motesanib, vandetanib)

Rexinoids

St. John’s Wort

 

Decrease hepatic metabolism

Metformin

Inhibition of 5’ deiodinase

Propylthiouracil

Methimazole

Propranolol

Glucocorticoids

Iodide

 

Increased thyroxine binding globulin levels

Estrogen

Raloxifene

Tamoxifen

Methadone

Mitotane

Fluorouracil

 

Decreased thyroxine binding globulin levels

Androgens

Glucocorticoids

Nicotinic acid

 

Interactions with other drugs

Warfarin (Coumadin)- both low and high thyroid function can alter the blood-thinning response of Coumadin

Drugs toxic to the thyroid- Drugs containing bromide or fluoride can be toxic to the thyroid or can displace iodine as the central molecule in thyroid hormone

Advair (fluticasone)

Alphagen (brimonidine)

bromide Atrovent (Ipratropium)

bromide Avelox (moxifloxacin)

Adovart (dulasteride)

Celebrex (celecoxib)

Celexa (citalopram) both fluoride and bromide

Cipro (ciprofloxacin)

Clinoril (sulindac)

Combivent (from the ipratropium)bromide

Crestor (rosuvastatin)

Diflucan (fluconazole)

DuoNeb (nebulized Combivent)

Enablex (darifenacin)

bromide Flonase (fluticasone)

Flovent (fluticasone)

Guaifenex DM (dextromethorphan) bromide

Lescol (fluvastatin)

Levaquin (levofloxacin)

Lexapro (escitalopram)

Lipitor (atorvastatin)

Lotrisone topical cream Paxil (paroxetine)

Prevacid (lansoprazole)

Protonix (pantoprazole)

Prozac (fluoxetine)

Pulmicort (budesonide)

Razadyne (galantamine) bromide

Risperdal (risperidone)

Spiriva (tiotropium) bromide

Tobra Dex (from dexamethasone)

Travatan (travoprost)

Triamcinolone Vigamox (moxifloxacin)

Vytorin (from eztimibe)

Zetia (eztimibe)

 

Learn more about thyroid function and hypothyroidism on our website.