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Can I take Levothyroxine and Paracetamol together?

Drug interaction guide

There is no known interaction between levothyroxine and paracetamol. It is generally considered safe to take these two medicines together.

You can take levothyroxine and paracetamol together as there are no known interactions between them.

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.

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How to take levothyroxine and paracetamol safely

  • You can take paracetamol while you are taking levothyroxine.

  • Take levothyroxine on an empty stomach.

  • Take levothyroxine 30 to 60 minutes before breakfast to ensure proper absorption.

  • Paracetamol can be taken with or without food.

  • Paracetamol can be taken at any time of day.

Liver disease or heavy alcohol use

You are at a much higher risk of severe liver damage from paracetamol. Do not exceed the recommended dose, and ensure you do not take any other products containing paracetamol (such as cold and flu remedies) at the same time.

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.

Interaction with supplements (Calcium/Iron)

Do not take calcium tablets, iron supplements, or multivitamins at the same time as levothyroxine. You must leave a gap of at least 4 hours between these supplements and your levothyroxine to ensure the medicine works.

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.

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Alcohol

It is best to avoid or strictly limit alcohol when taking paracetamol. Combining alcohol and paracetamol increases the risk of serious liver damage.

It is best to avoid or strictly limit alcohol while taking levothyroxine. While there is no direct chemical reaction, alcohol can affect thyroid function and may worsen symptoms like tiredness or mood changes.

Timing of dose and food/drink

Take your levothyroxine on an empty stomach, at least 30 to 60 minutes before breakfast or any caffeine. Food, milk, and coffee prevent the medicine from being absorbed properly.

Caffeine (Coffee/Tea)

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

Dairy products (Milk, Yoghurt, Cheese)

Avoid consuming dairy products at the same time as your levothyroxine. Calcium found in dairy can interfere with how your body absorbs the medicine, making it less effective. It is best to wait at least 4 hours between taking levothyroxine and consuming dairy.

Soya products

Soya can interfere with the absorption of levothyroxine. If you regularly eat or drink soya products, your doctor may need to monitor your thyroid levels more closely. Avoid consuming soya at the same time as your dose.

Kelp and Seaweed

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

High-fibre foods

A diet very high in fibre can reduce the absorption of levothyroxine. If you significantly change your fibre intake, inform your doctor as your dose may need adjusting.

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.

Article history

The information on this page is written and peer reviewed by qualified clinicians.

  • 25 Jan 2026 | Originally published
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