Drug General Information (ID: DDISHYQ7GI)
Drug Name			Sorafenib		Drug Info		Levothyroxine		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antineoplastics				Antithyroid Agents
Structure

Mechanism of Sorafenib-Levothyroxine Interaction (Severity Level: Moderate)
Attenuated pharmacological effects (Unspecific) Click to Show/Hide Mechanism Graph
Drug Name		Sorafenib				Levothyroxine
Mechanism		Decrease the suppression effect of exogenous thyroid hormone on differentiated thyroid carcinoma				Thyroid hormone
Key Mechanism Factor 1
		Factor Name		Pharmacodynamics
		Factor Description		Reduced pharmacological effects leading to insufficient efficacy and/or treatment failure.
Mechanism Description		Attenuated pharmacological effects of  Sorafenib when combined with Levothyroxine

Recommended Action
Management		TSH levels should be monitored monthly during sorafenib treatment for differentiated thyroid carcinoma, and the dosage of thyroid replacement medication adjusted as necessary.

References
1	Product Information. Armour thyroid (thyroid desiccated). Forest Pharmaceuticals, St. Louis, MO.
2	Product Information. Nexavar (sorafenib). Bayer Pharmaceutical Inc, West Haven, CT.
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]