Can I take Levothyroxine and Paracetamol together?

Why this happens

Levothyroxine and paracetamol are processed by the body using different pathways. Paracetamol does not interfere with how the thyroid hormone is absorbed, used by the cells, or cleared from the system.

You may be experiencing an interaction between levothyroxine and paracetamol if:

• You notice reduced effectiveness of levothyroxine, such as persistent fatigue, weight gain, or feeling unusually cold.

• You feel unusually tired, weak, or lethargic despite taking your usual dose.

• You experience changes in heart rate, such as a slower pulse.

• You notice swelling, puffiness, or fluid retention.

• Symptoms start shortly after taking paracetamol around the same time as levothyroxine.

You can take paracetamol while you are on levothyroxine. However, always remember to take your levothyroxine on an empty stomach, usually 30 to 60 minutes before breakfast, to ensure it is absorbed properly. Paracetamol can be taken with or without food at any time of day. If you have any of the above symptoms, you should:

• Speak to your GP or pharmacist for advice on how to adjust your medication timing.

• Do not stop taking levothyroxine unless instructed by a healthcare professional.

• Take levothyroxine on an empty stomach and separate it from paracetamol or other medicines if advised.

• Monitor your symptoms and report any persistent fatigue, weight changes, or swelling.

• Attend any blood tests recommended to check thyroid hormone levels.

Liver disease or heavy alcohol consumption

You are at a significantly higher risk of life-threatening liver damage even at standard doses. Do not exceed the recommended dose and avoid alcohol while taking this medicine.

Heart disease (e.g., angina, heart failure, or recent heart attack)

This medicine increases the workload on your heart. If you experience chest pain, palpitations, or shortness of breath, you must contact your doctor immediately as your dose may need urgent adjustment.

Taking other medicines or supplements (e.g., iron, calcium, or indigestion remedies)

These products stop levothyroxine from being absorbed. You must wait at least 4 hours between taking levothyroxine and any supplements or antacids.

Coffee and Caffeine

Caffeine can significantly reduce the absorption of levothyroxine. You should wait at least 30 to 60 minutes after taking your tablet before drinking coffee or tea.

Dairy products (Milk, Yoghurt, Cheese)

Calcium found in dairy products can interfere with how your body absorbs levothyroxine. It is best to take your medicine on an empty stomach and wait at least 30 to 60 minutes before consuming dairy.

Soya products

Soya can stop levothyroxine from being absorbed properly. If you eat or drink a lot of soya, your doctor may need to monitor your hormone levels more closely.

Kelp and Seaweed

These foods are very high in iodine. Too much iodine can interfere with your thyroid treatment and make your condition worse.

Alcohol

While a small amount of alcohol is usually safe, chronic heavy drinking combined with paracetamol increases the risk of serious liver damage. Avoid regular heavy drinking while using this medication.

Taking multiple medicines? Our Medicines Interaction Checker helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.

Disclaimer

This information is for general educational purposes only and should not be relied upon as a substitute for professional medical advice. Always consult your GP, pharmacist, or another qualified healthcare professional before making decisions about your medications. Individual circumstances may vary, and only a healthcare professional who knows your medical history can provide personalised guidance.