Drug General Information (ID: DDIAUYCJXO)
Drug Name			Levothyroxine		Drug Info		Sevelamer		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antithyroid Agents				Phosphate Binders
Structure

Mechanism of Levothyroxine-Sevelamer Interaction (Severity Level: Moderate)
Complex formation Click to Show/Hide Mechanism Graph
Drug Name		Levothyroxine				Sevelamer
Mechanism		Binds to anion exchange resin/polymer				Anion exchange resin/polymer
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 Sevelamer due to formation of complexes caused by Levothyroxine

Recommended Action
Management		Levothyroxine should be administered at least 4 hours apart from phosphate binders. It is recommended that TSH levels be monitored more closely during concomitant use.

References
1	Cerner Multum, Inc. "UK Summary of Product Characteristics.".
2	Product Information. Renagel (sevelamer). Genzyme Corporation, Cambridge, MA.