Drug General Information (ID: DDI8BTAWZV)
Drug Name			Thyroid, porcine		Drug Info		Iron protein succinylate		Drug Info
Drug Type		Hormones				Small molecule
Therapeutic Class		Thyroid Drugs				Iron Supplement

Mechanism of Thyroid, porcine-Iron protein succinylate Interaction (Severity Level: Moderate)
Complex formation Click to Show/Hide Mechanism Graph
Drug Name		Thyroid, porcine				Iron protein succinylate
Mechanism		Binds to polyvalent cations				Polyvalent cations
Key Mechanism Factor 1
		Factor Name		Chelation
		Factor Description		Chelation is a direct drug interaction that usually involves the formation of dimers or trimers, resulting in larger complexes and poorer absorption.
Mechanism Description		Decreased absorption of Iron protein succinylate due to formation of complexes caused by Thyroid, porcine

Recommended Action
Management		Some experts recommend separating the times of administration of levothyroxine and iron-containing preparations by at least 2 to 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
1	Campbell NR, Hasinoff BB, Stalts H, Rao B, Wong NC "Ferrous sulfate reduces thyroxine efficacy in patients with hypothyroidism." Ann Intern Med 117 (1992): 1010-3. [PMID: 1443969]
2	Product Information. Armour thyroid (thyroid desiccated). Forest Pharmaceuticals, St. Louis, MO.
3	Wohlt PD, Zheng L, Gunderson S, Balzar SA, Johnson BD, Fish JT "Recommendations for the use of medications with continuous enteral nutrition." Am J Health Syst Pharm 66 (2009): 1438-67. [PMID: 19667002]