To what extent will taking fluoxetine decrease absorption of levothyroxine if both are taken at the same time? i know thyroxine should ideally be taken on an empty stomach, but sometimes i forget?

Fluoxetine ‘s effect on levothyroxine absorption is limited. The medications that do seem to cause more problems with levothyroxine include antacids, iron, sucralfate, proton pump inhibitors, carbamazepine, phenobarbital, and phenytoin. Take your levothyroxine on an empty stomach; and take your levothyroxine 2 hours before or 4 hours after the offending medication.