What to do if you have accidentally taken Levothyroxine at night?
By
Dr Natalia Marceli Stephanes (PhD)
Author bio
Dr Natália Marcéli Stephanes PhD is a Pharmacist with expertise in Drugs Administration and Toxicity; Discovery of New Drugs; Cancer Treatment; Biochemical Analyzes and Hematological Analyzes. She writes and reviews content on these topics.
Dr Natália Marcéli Stephanes’ Highlights:
- Pharmacist at the Department of Health of Santa Catarina State, Brazil
- PhD with a focus on oncology treatment
- Years of experience in commercial pharmacy
- Bachelor, Master and PhD degrees in Pharmacy at the Federal University of Santa Catarina
Professional Experience:
From her undergraduate studies to her Master’s and Doctorate degrees in Pharmacy, Dr Natália Marcéli Stephanes has participated in numerous scientific studies in the field of oncology and onco-hematology at the University Hospital of the Federal University of Santa Catarina, Brazil. Her research has focused on understanding the molecular and biochemical bases of malignant neoplasms and investigating safer and more effective therapeutic alternatives.
Dr Natália Marcéli Stephanes has also served as an assistant professor of haematology for undergraduate students at the Federal University of Santa Catarina. Additionally, she held the position of professor of Hospital Pharmacy at the Qualificar Technical School in Brazil, where she developed instructional materials for use in the Pharmacy Postgraduate Program at the Leonardo Da Vinci University Center.
In addition to her academic experiences, Dr Natália Marcéli Stephanes possesses a strong expertise in commercial pharmacy, with in-depth knowledge of medications, their routes of administration, desired effects, adverse effects, and toxicity.
Currently, Dr Natália Marcéli Stephanes works as a Pharmacist at the Health Department of Santa Catarina State, where her role entails providing pharmaceutical scientific consulting services to judges.
Education:
- 2016 Bachelor in Pharmacy at the Federal University of Santa Catarina, Brazil
- 2018 Master in Pharmacy at the Federal University of Santa Catarina, Brazil
- 2023 PhD in Pharmacy at the Federal University of Santa Catarina, Brazil
The main publications of Dr Natália Marcéli Stephanes are:
Falchetti M ; Delgobo M, Zancanaro H, Almeida K, Das Neves RN, Dos Santos B, Stefanes NM, et al. Bishop Omics-based identification of an NRF2-related auranofin resistance signature in cancer: Insights into drug repurposing. Comput. Biol. Med [Internet]. 2023; 152:106347.
Feuser PM, Matos dos Santos PC, Cordeiro AP, Stefanes NM, Walter LO, Maioral MF, Santos-Silva MC, et al. Antineoplastic activity of free 4-nitrochalcone and encapsulated in poly(thioether-ester) nanoparticles obtained by thiol-ene polymerization in two human leukemia cell lines (Jurkat and K562). J Drug Deliv Sci Technol [Internet]. 2022; 67:102924.
Jacques AV, Stefanes NM, Walter LO, Perondi DM, Efe FL, Souza LFS, Sens L, et al. Synthesis of chalcones derived from 1-naphthylacetophenone and evaluation of their cytotoxic and apoptotic effects in acute leukemia cell lines. Bioorg. Chem [Internet]. 2021; 116:105315.
Duarte BF, Vieira DSC, Lisboa ML, Stefanes NM, Grando LJ, Santos-Silva MC. Características clínico-epidemiológicas de pacientes portadores de carcinoma de células escamosas de boca. Arquivos Catarinenses de Medicina. 2021; 50(2): 232–245.
Machado V, Jacques AV, Stefanes NM, Santos-Silva MC, Biavatti MW. Anti-leukemic activity of semisynthetic derivatives of Lupeol. Nat. Prod. Res. 2021; 35(22):4494-4501.
Bigolin A, Maioral MF, Stefanes NM, Mascarello A, Chiaradia-Delatorre LD, Nunes RJ, Yunes RA, et al. A novel sulfonamide derivative as a strong and selective apoptotic agent against hematological malignancies. Chem. Pap. 2020; 74:2965–2976.
Bigolin A, Maioral MF, Stefanes NM, Zatelli GA, Philippus AC, Falkenberg MB, Santos-Silva MC. Cytotoxic mechanisms of primin, a natural quinone isolated from Eugenia hiemalis, on hematological cancer cell lines. Anticancer Drugs. 2020; 31(7):709-717.
Maioral MF, Stefanes NM, Neufeldt PD, Chiaradia-Delatorre LD, Nunes RJ, Santos-Silva MC. Aldehyde biphenyl chalcones induce immunogenic apoptotic-like cell death and are promising new safe compounds against a wide range of hematologic cancers. Future Med. Chem. 2020; 12(8):673–688.
Perondi DM, Jacques AV, Stefanes NM, Maioral MF, Sens L, Pacheco LA, Cury NM, et al. A novel thiosemicarbazone as a promising effective and selective compound for acute leukemia. Anticancer Drugs. 2019; 30(8):p 828-837.
Rengifo AFC, Stefanes NM, Toigo J, Mendes C, Argenta DF, Dotto MER, Santos-Silva MC, et al. PEO-chitosan nanofibers containing carboxymethyl-hexanoyl chitosan/dodecyl sulfate nanoparticles loaded with pyrazoline for skin cancer treatment. Eur. Polym. J. 2019; 119:335-343.
Rengifo AFC, Stefanes NM, Toigo J, Mendes C, Santos-Silva MC, Nunes RJ, Parize AL, et al. A new and efficient carboxymethyl-hexanoyl chitosan/dodecyl sulfate nanocarrier for a pyrazoline with antileukemic activity. Mater. Sci. Eng. C [Internet]. 2019; 105:110051.
Maioral MF, Stefanes NM, Bigolin A, Zatelli GA, Philippus AC, Falkenberg MB, Santos-Silva MC. Miconidine acetate, a new selective and cytotoxic compound with synergic potential, induces cell cycle arrest and apoptosis in leukemia cells. Invest. New Drugs. 2019; 37:912–922.
Srefanes NM, Toigo J, Maioral MF, Jacques AV, Chiaradia-Delatorre LD, Perondi DM, Ribeiro AAB, et al. Synthesis of novel pyrazoline derivatives and the evaluation of death mechanisms involved in their antileukemic activity. Bioorg. Med. Chem. 2019; 27(2):375-382.
Maioral MF, Bodack CN, Stefanes NM, Bigolin A, Mascarello A, Chiaradia-Delatorre LD, Yunes RA, et al. Cytotoxic effect of a novel naphthylchalcone against multiple cancer cells focusing on hematologic malignancies. Biochim. 2017; 140:48-57.
You can view some of Dr Natália’s work below and links to her professional profile below.
Research Gate: https://www.researchgate.net/profile/Natalia-Stephanes
Linkedin: https://www.linkedin.com/in/nataliamarceli/
What to do if you have accidentally taken Levothyroxine at night?
If you have accidentally taken Levothyroxine at night, there are a few things you should do. These include:
- First of all, don’t panic
- Avoid double dosing
- Maintain a consistent dosing schedule
- Consult your doctor
First of all, don’t panic
It’s common for some people to react by entering a state of panic when a mishap like this one happens. According to experts, taking Levothyroxine at night once in a while is not considered harmful. However, it’s essential to try and maintain a consistent dosing schedule.
Avoid double dosing
Some people may try and take Levothyroxine again in the morning at their usual time, which can do far more damage than just mistakenly taking it at night.
Taking another Levothyroxine in the morning can result in an overdose, which can cause disturbing side effects in some individuals. This is why it’s best to avoid taking another pill unless it has been 24 hours since your last dose.
Maintain a consistent dosing schedule
It is crucial to maintain a consistent dosage schedule when it comes to drugs like Levothyroxine. It is usually administered once daily in the morning on an empty stomach.
Levothyroxine is used for the treatment of an underactive thyroid gland and proper dosing is essential in this case. This medication is available in micrograms, which means a small change in the dosage strength or frequency of administration can make a big difference in some cases.
Consult your doctor
If you have accidentally taken a double dose of Levothyroxine and you feel unusual, please reach out to your healthcare provider. Even if you feel okay, this is something you should discuss with your provider. They can provide specific guidance according to the details specific to you.
It is also important to properly follow your doctor’s directions and take Levothyroxine properly and at the exact same time each day.
What are the risks of taking Levothyroxine at night?
The following are the potential risks associated with taking Levothyroxine:
- Decreased Absorption from the Gut: Levothyroxine is absorbed properly when taken on an empty stomach.
- Disturbed Sleep: Levothyroxine has a stimulating effect on our nervous system which can result in sleep disturbance when taken at night.
- Drug-Drug interactions: If you take other medications in the evening, there is a possibility of Levothyroxine interfering with these drugs when taken at night.
- Thyroid Hormone Levels: Night-time Levothyroxine can also result in an imbalance of thyroid hormone in the body
It’s important to note that the risks associated with taking Levothyroxine at night may vary depending on individual factors, such as specific medical conditions and other medications being taken.
Side effects associated with taking Levothyroxine in the morning after accidentally taking it at night
As we have discussed earlier, taking two tablets in less than 24 hours can result in an increased concentration of Levothyroxine in your body, which may cause side effects, including (1).
- Chest pain
- Anxiety
- Irregular heartbeat
- Tremors
- Nervousness
- Irritability
- Insomnia
- Confusion
- Shortness of breath
- Excessive sweating
- Loss of consciousness
- Convulsions
Important instructions to follow when taking Levothyroxine
The instructions below should be followed when taking Levothyroxine:
- Timing: Take Levothyroxine once a day, preferably 30 minutes before breakfast in the morning.
- Consistency: Take the drug at the same time every day.
- Dosage: Make sure to take the right amount of dosage every day. Double dosing can result in harmful side effects.
- Interactions: Inform your healthcare provider about any other drugs that you take besides Levothyroxine in the morning.
- Empty Stomach: Avoid eating or drinking before taking Levothyroxine, this will result in better absorption of the drug from your gut.
- Follow-Up: Attend regular checkups with your healthcare provider.
- Storage: Store Levothyroxine in a cool and dry place, away from the reach of children.
- Consultation: If you have any questions, or concerns, or experience side effects while taking levothyroxine, consult your healthcare provider promptly for guidance and support.
Conclusion
If you have accidentally taken Levothyroxine at night, make sure to skip the dose in the morning and strictly comply with the recommended dosing schedule provided by your healthcare professional. Make sure not to repeat the same mistake again. If you feel any discomfort of any kind, immediately get in touch with your healthcare provider.
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References
1.-
MedlinePlus. Levothyroxine: MedlinePlus drug information [internete]. Bethesda (MD); National Library of Medicine (US); [updated 2019 Feb 15; cited 2023 May 15]. Available From: https://medlineplus.gov/druginfo/meds/a682461.html
