Can I take Anastrozole and Levothyroxine together?
Drug interaction guide
Originally published 25 Jan 2026
Meets Patient’s editorial guidelines
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There is no known direct interaction between anastrozole and levothyroxine. Taking these two medicines together is generally considered safe and should not change how well either drug works.
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Why this happens
Anastrozole (used for breast cancer) and levothyroxine (used for an underactive thyroid) are processed by different pathways in the body. They do not interfere with each other's absorption, metabolism, or excretion, nor do they have opposing or overlapping effects on the body's systems.
What you should do
Back to contentsYou can continue to take both medications as prescribed by your doctor. It is usually best to take levothyroxine on an empty stomach, first thing in the morning, at least 30 to 60 minutes before breakfast or taking other medications like anastrozole, to ensure it is absorbed properly. Always inform your doctor if you notice any new symptoms or changes in your health.
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Important precautions
Back to contentsPregnancy and Breastfeeding
You must not take anastrozole if you are pregnant or breastfeeding, as it can cause serious harm to the developing baby. If you are pre-menopausal, you must use effective non-hormonal contraception (such as condoms) during treatment.
Heart conditions (e.g. angina, heart failure)
If you have a heart condition, your dose must be started very low and increased slowly. Contact your doctor immediately if you experience chest pain or palpitations, as levothyroxine increases the workload on your heart.
Calcium or Iron Supplementation
Do not take calcium supplements, iron tablets, or multivitamins at the same time as levothyroxine. You must leave a gap of at least 4 hours between taking these supplements and your levothyroxine dose.
Diabetes
Levothyroxine can raise blood sugar levels. If you have diabetes, you must monitor your blood glucose more closely when starting or changing your dose, as your diabetes medication may need to be increased.
Food and drink warnings
Back to contentsFood (General)
Levothyroxine should be taken on an empty stomach, at least 30 to 60 minutes before breakfast or any caffeinated drinks. Food can significantly interfere with how much medicine your body absorbs.
Caffeine (Coffee/Tea)
Coffee and tea can reduce the absorption of levothyroxine. You should wait at least 60 minutes after taking your tablet before drinking coffee or tea.
Dairy products (Milk/Yoghurt)
Calcium found in dairy products can bind to levothyroxine and prevent it from being absorbed properly. Avoid consuming dairy within 4 hours of taking your dose.
Soya
Soya can interfere with the absorption of levothyroxine. If you eat a lot of soya, your doctor may need to monitor your hormone levels more closely and adjust your dose.
Dietary Fibre
A very high-fibre diet can reduce the absorption of levothyroxine. If you significantly change your fibre intake, inform your doctor as your dose may need adjusting.
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Using other medicines
Back to contentsTaking 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.
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Article history
The information on this page is written and peer reviewed by qualified clinicians.
25 Jan 2026 | Originally published

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