The nurse practitioner has treated a patient for hypothyroid…
The nurse practitioner has treated a patient for hypothyroidism with the same dose of levothyroxine for several years. In the past two weeks she has complained of fatigue, dry skin, and cold intolerance. She was recently admitted to the hospital for a GI bleed and prescribed several new medications – pantoprazole (Protonix), sulcralfate (Carafate), hydrocodone-acetaminophen (Vicodin), and metoclopramide (Reglan). Which medication when co-administered together with levothyroxine is known to have a drug-drug interaction and may be causing her hypothyroid symptoms today?