Drug General Information (ID: DDIA15SOWD)
Drug Name			Levothyroxine		Drug Info		Amoxapine		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antithyroid Agents				Antidepressants
Structure

Mechanism of Levothyroxine-Amoxapine Interaction (Severity Level: Moderate)
Potentiated the pharmacological effects (Unspecific) Click to Show/Hide Mechanism Graph
Drug Name		Levothyroxine				Amoxapine
Mechanism 1		Potentiate the effects of tricyclic antidepressant by increasing the sensitivity of receptors to catecholamines				Tricyclic antidepressants
Key Mechanism Factor 1
		Factor Name		Pharmacodynamics
		Factor Description		Enhanced pharmacological effects leading to increased adverse reactions.
Mechanism Description		Potentiate the pharmacologic effects by the combination of Levothyroxine and Amoxapine
Mechanism 2		Potentiate the effects of tricyclic antidepressant by increasing the sensitivity of receptors to catecholamines				Tricyclic antidepressant
Key Mechanism Factor 2
		Factor Name		Pharmacodynamics
		Factor Description		Enhanced pharmacological effects leading to increased adverse reactions.
Mechanism Description		Potentiate the pharmacologic effects by the combination of Levothyroxine and Amoxapine

Recommended Action
Management		Patients receiving concomitant thyroid hormone replacement therapy and tricyclic antidepressant therapy should be closely monitored for cardiac arrhythmias and CNS stimulation. Advise patients to contact their doctor if they experience toxicity symptoms such as: anxiety, agitation, insomnia, shortness of breath, irregular or fast heartbeat, and lightheadedness or dizziness.

References
1	Product Information. Synthroid (levothyroxine). Abbott Pharmaceutical, Abbott Park, IL.
2	Product Information. Triostat (liothyronine). JHP Pharmaceuticals, Saddle River, NJ.
3	Goodwin FK, Prange AJ Jr, Post RM, Muscettola G, Lipton MA "Potentiation of antidepressant effects by L-triiodothyronine in tricyclic nonresponders." Am J Psychiatry 139 (1982): 34-8