Simethicone and Levothyroxine: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Levothyroxine
Simethicone
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Decreased levothyroxine efficacy
Interaction Deep Dive
Concomitant use of levothyroxine and simethicone may decrease levothyroxine efficacy by binding to and delaying or preventing levothyroxine absorption, potentially resulting in hypothyroidism2. Avoid concomitant use if possible 1. If concurrent use is required, separate administration by at least 4 hours 2.
Why it happens (mechanism)
Decreased absorption of levothyroxine
Common questions
Can I take Simethicone and Levothyroxine together?
Decreased levothyroxine efficacy Always confirm with your pharmacist or prescriber before making any change.
How serious is the Simethicone and Levothyroxine interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Simethicone or Levothyroxine need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (2)
- Centanni M, Duntas L, Feldt-Rasmussen U, et al: ETA guidelines for the use of levothyroxine sodium preparations in monotherapy to optimize the treatment of hypothyroidism. Eur Thyroid J 2025; 14(4):e250123. PubMed
- Product Information: SYNTHROID(R) oral tablets, levothyroxine sodium oral tablets. Abbott Laboratories (per DailyMed), North Chicago, IL, 2011. DailyMed
Keep reading about Levothyroxine
Keep reading about Simethicone
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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