Thyroid & Mood

When the thyroid is imbalanced, men
often experience mood disorders

Thyroid imbalance and mood disorders in men

Summary:

  • The thyroid is a small butterfly-shaped gland at the front of your neck.
  • It produces two hormones, thyroxine (T4) and triiodothyronine (T3).
  • These hormones are required for all the cells in your body to work efficiently, regulating your metabolism, heartbeat, energy levels, temperature, digestion, even affecting how you think and feel.
  • If the thyroid produces too many (hyperthyroidism) or too few (hypothyroidism) hormones, people often experience mood disorders, which can be relieved by thyroid medications.
  • For years, psychiatrists and doctors have used thyroid medication to treat mood disorders. Queen Victoria’s court physician, Sir William Withey Gull, is the first to be attributed with the connection [1] between thyroid and mood back in 1867.
Wondering if you may be suffering from low thyroid levels? Take a free hormone assessment to see if hormone replacement therapy can help.

What are mood disorders?

  • Depression: Losing interest in daily activities along with feelings of sadness and a loss of hope. If these feelings last for two weeks or longer, this could indicate the onset of depression.
  • Dysthymia: This is a low-grade depressed state or irritable mood that lasts for two years at least.
  • Bipolar disorder: People living with bipolar disorder usually have periods of highs and lows. They often exhibit phases of depression and then extreme highs typified by signs of mania.
  • Mood disorders associated with illness: Cancer, injury, arthritis, infections, and many chronic diseases can often cause depression.
  • Substance-induced mood disorder: Medicines, toxins, illegal drugs, and alcohol can all cause symptoms of depression.
  • Mood disorders related to significant events: Significant life events can cause depression, such as PTSD (post-traumatic stress disorder), divorce, career setbacks, or witnessing tragic events.

What causes thyroid problems?

There are several causes of thyroid problems, but usually, it is due to an autoimmune response – this is when your body’s immune system goes into self-destruct mode, attacking the thyroid, thinking it is a foreign body. This attack causes the thyroid to slow the production of thyroid hormones, and symptoms may develop. It is common for thyroid problems to be hereditary, so if a family member suffers from hypothyroidism or hyperthyroidism, there is a chance you will too. Notably, the most common disorder is an underactive thyroid which is often easy to correct using medications.

Grave’s disease and chronic thyroiditis (Hashimoto’s thyroiditis) are autoimmune diseases of the thyroid gland. The cause of grave’s disease is when TSH receptors located on the thyroid gland react to an antibody known as TSH receptor antibody (TRAb). This antibody causes an increase in the thyroid hormone T4 and T4. Hashimoto’s thyroiditis is the exact opposite. Thyroid function slows due to a TSH stimulation-blocking antibody (TSBAb) which blocks the action of TSH hormone and subsequently damages and causes shrinkage to the thyroid gland.

Can low thyroid cause depression?

When the thyroid isn’t working efficiently, people often develop mental health problems such as depression, anxiety, and bipolar disorder. These types of mood disorders are common for those with either an underactive or overactive thyroid.

Hypothyroidism, in particular, can affect your ability to ‘think straight,’ affecting your mood and often causing depression. Reduced thyroid hormones cause reduced cognitive reasoning, and mental processing slows down. Over time this constant reduction in hormones can cause depression and even symptoms of dementia. Studies show [2] that psychiatric symptoms and disorders frequently occur in patients with thyroid dysfunction.

Studies [3] support theories that dysfunction in the hypothalamus-pituitary thyroid axis (HPT) can lead to depression. This neuroendocrine system is triggered by a chain reaction of events starting in the hypothalamus. The hypothalamus’s primary role is to link the nervous system to the endocrine system via the pituitary gland.

The hypothalamus releases thyrotropin-releasing hormone (TRH), signaling the pituitary gland to produce thyroid-stimulating hormones, which then tells the thyroid to release T3, T4, and calcitonin. The thyroid hormones are then taken around the body in the blood to do their work. However, problems can occur anywhere along this pathway, ultimately decreasing thyroid hormone production and causing symptoms of depression.

Thyroid hormone production

Even slight changes in thyroid hormone levels can also negatively impact the area of the brain called the hippocampus. The hippocampus is involved in your ability to learn and to maintain memory function. The hippocampus is rich in thyroid hormone receptors involved in learning and memory. Evidence shows [4] this area of the brain even shrinks if thyroid hormones are lacking.

Any chemical change caused by a hormone imbalance can cause mood disorder symptoms, including:

  • Changes in behavior
  • Depression
  • Elevated anxiety
  • Memory issues
  • Learning problems
  • Speech problems
 

Thyroid problems and anxiety

People usually associate hyperthyroidism with anxiety, nervous tendencies, and erratic behavior. Many don’t realize that anxiety is also a common symptom of hypothyroidism. Studies [5] show that people are twice as likely to suffer from anxiety if they have hypothyroidism than those without the condition and that thyroid disorders cause nearly a third of all anxiety disorders.

If you have an overactive thyroid (hyperthyroidism), common mood-related symptoms include:

  • Excessive nervousness
  • Restlessness and irritability
  • Anxiety

 

If you have an underactive thyroid (hypothyroidism), mood-related symptoms can include:

  • Mild to severe fatigue
  • Depression
  • Anxiety

Antidepressants and thyroid

Common antidepressant drugs such as many SSRIs (Selective Serotonin Reuptake Inhibitor) reduce [6] thyroid hormone production. Other drugs such as lithium, a common medication for those with bipolar, significantly reduce levels, preventing the production of T3 and T4. Those taking lithium are far more likely to develop hypothyroidism. Interestingly, studies also show that 28% of those with bipolar disorder already have hypothyroidism, showing the close link between the thyroid and depression.

With most antidepressant medications once stopped, thyroid function usually returns to normal unless the patient has clinical hypothyroidism.

Thyroid medication and testosterone

It’s common for men to suffer from low thyroid and low testosterone in tandem. The symptoms are very similar, and here at Male Excel, we test thyroid hormones and testosterone levels to make sure we can offer the most effective treatment possible.

Much the same as testosterone, thyroid levels naturally decline with age, so the older you become, the less ‘protection’ you get from your hormones. Your mood can suffer, and depression can follow. The best form of defense is to optimize your hormone levels to avoid any decline in the first place. If you already have low thyroid and testosterone, it’s still possible to optimize levels to restore the balance. The benefits of thyroid treatment, along with bioidentical hormone replacement therapy (BHRT), can give you that boost in mood you may desperately need.

Benefits of thyroid treatment include but are not limited to:

  • Improved energy and sleep
  • Faster metabolism
  • Increased muscle mass
  • Weight loss
  • Better mood
  • More focus and motivation
  • Improved libido

 

How to test for imbalanced thyroid

Our at-home test kit is the best way to check if thyroid medication and BHRT could help optimize your hormone levels. We check free T3, which is the best indicator of thyroid health, testosterone, DHEA’s, estradiol, and PSA (prostate-specific androgen), all the most essential hormones for overall optimal health.

Internal and external factors can cause mood disorders. By optimizing your hormones and leading an active, healthy lifestyle, you will fuel your body. You will give yourself all it needs to rejuvenate your mental state of mind and your physical appearance.

It’s time to replenish your hormone levels and start living a happier, healthier life.

Wondering if you may be suffering from low thyroid levels? Take a free hormone assessment to see if hormone replacement therapy can help.

Additional info on thyroid

Frequently asked questions

HRT stands for hormone replacement therapy. Hormone levels are tested and medications are administered to help hormones such as testosterone and thyroid reach their optimum levels.

TRT stands for testosterone replacement therapy. Testosterone is given to combat decreasing levels in men. This is to fight the usual signs and symptoms of aging such as fatigue, weight gain, loss of libido, and muscle loss.

We offer a daily injectable Testosterone Cypionate or a twice-daily Lipoderm cream. Both are bioidentical. We also prescribe Triclozene (Clomiphene Citrate) for men, which can help improve several aspects of male health, including low testosterone levels, hormone ratios and sperm production.

The benefits of HRT are extensive but include the following: healthy heart and blood, less fat, more muscle, stronger bones, improved libido, better sleep, improved memory, spatial ability and mental reasoning, improved mood, and better sex.

You can start your HRT journey by filling out our simple online hormone assessment here.

On average it takes approximately 7 business days from ordering your test kit to receiving your results. This is obviously dependent on how quickly you complete and return the test via free return postage. Once we have received your results, a dedicated medical provider will review this along with your online assessment to create your personalized treatment plan.

This is a very difficult question because there is no definitive answer. Everybody is biologically different and responds to the treatment differently. For detailed information, click here.

The test indicates whether you will benefit from this treatment and what your current hormone levels are. We can then know the proper medication to get your testosterone and thyroid to their optimum levels.

Our blood spot test measures 5 key hormone levels. It offers distinct advantages over traditional testing methods because it eliminates the need for a blood draw – saving patients time and money. Our blood spot test is a simple to use test that is done in the comfort of your own home. It involves a finger prick and 12 drops of blood dropped onto a card. We include free return postage with your test for your convenience.

Yes. HRT is safe when monitored by a licensed medical provider. This is why we require yearly testing and symptoms questionnaires every 2 months.

The treatment is effective for as long as you take it. Once you stop taking HRT your levels will return to the levels they were previously.

You will be charged $99 for the hormone test kit upon your order. Once approved for treatment, you will be charged every other month for your medication. You also will be charged a Medical Membership per month, which allows you to schedule unlimited consultations with your Male Excel medical provider.

What people say

Don't just take our word for it

Mark TRT PATIENT “Since starting HRT, I have lost 25 lbs., lost 4" in my waist,my energy level has increased and my metabolism has really increased. In short, I feel at least 20 years younger!”
John TRT PATIENT “The process was easy. I had some questions but the doctor was excellent and was able to answer them all. The product has worked as advertised, I feel literally a hundred times better! Would recommend Male Excel!”
Jared TRT PATIENT “You guys are awesome, you are helping people get their physical and emotional life back. Always on time with medicine and up to date with follow up. I can't thank your team enough for that!! Keep up the positive work.”
Jeff TRT PATIENT “I was on low T treatment for about a week when I noticed the difference. I have new-found energy, mental clarity and the desire to go out and do things. Over the next few months it has gotten better and better."
Thomas TRT PATIENT “Male Excel has been great to work with and the medications have made a huge difference in my life. Energy levels, sleep, weight loss and sexual stamina. Thank you Male Excel!”
Chris TRT PATIENT “It has only been a couple of weeks but I'm already starting to feel a ton better. Renewed energy and mental clarity has me back to my old self or at least seeing that I can get there. I wouldn't hesitate to recommend Male Excel.”

Studies and References:

[1] Pearce JM. Myxoedema and Sir William Withey Gull (1816-1890). J Neurol Neurosurg Psychiatry. 2006 May;77(5):639. doi: 10.1136/jnnp.2005.082198. PMID: 16614024; PMCID: PMC2117466.

[2] Bathla M, Singh M, Relan P. Prevalence of anxiety and depressive symptoms among patients with hypothyroidism. Indian J Endocrinol Metab. 2016 Jul-Aug;20(4):468-74. doi: 10.4103/2230-8210.183476. PMID: 27366712; PMCID: PMC4911835.

[3] Fischer S, Ehlert U. Hypothalamic-pituitary-thyroid (HPT) axis functioning in anxiety disorders. A systematic review. Depress Anxiety. 2018 Jan;35(1):98-110. doi: 10.1002/da.22692. Epub 2017 Oct 24. PMID: 29064607.

[4] Cooke GE, Mullally S, Correia N, O’Mara SM, Gibney J. Hippocampal volume is decreased in adults with hypothyroidism. Thyroid. 2014 Mar;24(3):433-40. doi: 10.1089/thy.2013.0058. Epub 2014 Feb 24. PMID: 24205791.

[5] Siegmann EM, Müller HHO, Luecke C, Philipsen A, Kornhuber J, Grömer TW. Association of Depression and Anxiety Disorders With Autoimmune Thyroiditis: A Systematic Review and Meta-analysis. JAMA Psychiatry. 2018 Jun 1;75(6):577-584. doi: 10.1001/jamapsychiatry.2018.0190. Erratum in: JAMA Psychiatry. 2019 Jun 19;: PMID: 29800939; PMCID: PMC6137529.

[6] Kupka RW, Nolen WA, Post RM, McElroy SL, Altshuler LL, Denicoff KD, Frye MA, Keck PE Jr, Leverich GS, Rush AJ, Suppes T, Pollio C, Drexhage HA. High rate of autoimmune thyroiditis in bipolar disorder: lack of association with lithium exposure. Biol Psychiatry. 2002 Feb 15;51(4):305-11. doi: 10.1016/s0006-3223(01)01217-3. PMID: 11958781.

Lai J, Xu D, Peterson BS, Xu Y, Wei N, Zhang M, Hu S. Reversible Fluoxetine-Induced Hyperthyroidism: A Case Report. Clin Neuropharmacol. 2016 Jan-Feb;39(1):60-1. doi: 10.1097/WNF.0000000000000116. PMID: 26626429; PMCID: PMC4714632.

Joffe RT. Hormone treatment of depression. Dialogues Clin Neurosci. 2011;13(1):127-38. doi: 10.31887/DCNS.2011.13.1/rjoffe. PMID: 21485752; PMCID: PMC3181966.

ADDITIONAL IMPORTANT SAFETY INFORMATION

WARNING: SECONDARY EXPOSURE TO TESTOSTERONE

· See full prescribing information for complete boxed warning
· Virilization has been reported in children with secondary exposure to topical testosterone products
· Children should avoid contact with unwashed or unclothed application sites in men using topical testosterone products
· Healthcare providers should advise patients to strictly adhere to recommended instructions for use

Disclaimer: The information provided on this page is not a substitute for professional medical advice, diagnosis, or treatment. If you have any questions or concerns about your health, please talk to a doctor.

Warnings and Precautions:

· Possible increased risk of heart attack or stroke.
· Male Excel’s testosterone products are not meant for use by women.
· It is not known if Male Excel’s testosterone products are safe or effective in children younger than 18 years old. Improper use of testosterone in children may affect bone growth.
· Testosterone can be abused when taken at higher than prescribed doses and when used with other anabolic androgenic steroids. Male Excel’s Testosterone Lipoderm Cream is a controlled substance (CIII) because it contains testosterone that can be a target for people who abuse prescription medicines. Anabolic androgenic steroid abuse can lead to serious cardiovascular and psychiatric adverse reactions. Your doctor will check you for signs of abuse before and during treatment.
· Keep your Male Excel products in a safe place to protect them.
· Never give your Male Excel products to anyone else, even if they have the same symptoms you have.
· Selling or giving away this medicine may harm others and is against the law.

These are not all the possible side effects. See the Full Prescribing Information for more.

What Should You Know Before Taking Male Excel’s Testosterone Lipoderm Cream?

It is not known if Male Excel’s Testosterone Lipoderm Cream is safe or effective in treating men who have low testosterone due to aging.

It is not known if Male Excel’s Testosterone Lipoderm Cream is safe or effective in children younger than 18 years old.

Male Excel l’s Testosterone Lipoderm Cream is a controlled substance (CIII) because it contains testosterone that can be a target for people who abuse prescription medicines. Keep it in a safe place to protect it, and never give it to anyone else. Selling or giving away this medicine may harm others and is against the law.

Male Excel’s Testosterone Lipoderm Cream is not meant for use in women.

Male Excel’s Testosterone Lipoderm Cream can transfer from your body to others, including children and women. Transference can happen if other people come into contact with the area where Male Excel’s Testosterone Lipoderm Cream is applied. Children and women should avoid contact with the unwashed or uncovered (unclothed) areas where Male Excel’s Testosterone Lipoderm Cream has been applied to your skin.

Early signs and symptoms of puberty have occurred in young children who have come in direct contact with testosterone by touching areas where men have used Male Excel’s Testosterone Lipoderm Cream.

Signs and symptoms of early puberty in a child who has come in direct contact with Male Excel’s Testosterone Lipoderm Cream may include:

· Abnormal sexual changes.
· Enlarged penis or clitoris.
· Early hair growth near the vagina or around the penis (pubic hair).
· Erections or acting out sexual urges (sex drive).
· Behavior problems, including acting aggressively or behaving angrily or violently.

Signs and symptoms in a woman who has come in direct contact with Male Excel’s Testosterone Lipoderm Cream may include:

· Changes in body hair.
· An abnormal increase in pimples (acne).

To lower the risk of transfer of Male Excel’s Testosterone Lipoderm Cream from your body to others, you should follow these important instructions:

· Apply Male Excel’s Testosterone Lipoderm Cream only to areas of your shoulders, upper arms, or stomach area (abdomen) that a short-sleeve t-shirt will cover.
· Wash your hands right away with soap and water after applying testosterone cream
· After the gel has dried, cover the application area with clothing. Keep the area covered until you have washed or showered the application area well.
· If you expect skin-to-skin contact with another person, wash the application area well with soap and water.
· If a child or woman touches the area where you have applied testosterone cream, that area on the child or woman should be washed thoroughly with soap and water immediately.

Stop using Male Excel’s Testosterone Lipoderm Cream and call your healthcare provider immediately if you see any signs and symptoms of puberty in a child or changes in body hair. The same applies if you notice increased acne in a woman that may have happened through accidental touching of the area where you have applied Male Excel’s Testosterone Lipoderm Cream.

Do not use Male Excel’s Testosterone Lipoderm Cream if you:

· Have breast cancer or have or might have prostate cancer.
· Are pregnant. Male Excel’s Testosterone Lipoderm Cream may harm your unborn baby. Pregnant women should avoid contact with the area of skin where Male Excel’s Testosterone Lipoderm Cream has been applied.

Before using Male Excel’s Testosterone Lipoderm Cream, inform your healthcare provider about all of your medical conditions, including if you have breast cancer, prostate cancer, urinary problems due to an enlarged prostate, heart, kidney, or liver problems, or problems breathing while you sleep (sleep apnea).

Inform your healthcare provider of all medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Especially tell your healthcare provider if you take insulin, medicines that decrease blood clotting (blood thinners), or corticosteroids.

Male Excel’s Testosterone Lipoderm Cream can cause serious side effects, including:

· If you already have an enlarged prostate gland, your signs and symptoms can worsen while using Male Excel’s Testosterone Lipoderm Cream (including changes in urination).
· Possible increased risk of prostate cancer.]
· Blood clots in the legs or lungs. Signs and symptoms of a blood clot in your leg can include leg pain, swelling, or redness. Signs and symptoms of a blood clot in your lungs can include difficulty breathing or chest pain.
· Possible increased risk of heart attack or stroke.[sw4]
· In large doses, Male Excel’s Testosterone Lipoderm Cream may lower your sperm count.
· Swelling in your ankles, feet, or body, with or without heart failure. This may cause serious problems for people with heart, kidney, or liver disease.
· Enlarged or painful breasts.
· Having problems breathing while you sleep (sleep apnea).

The most common side effects of Male Excel’s Testosterone Lipoderm Cream include increased prostate-specific antigen (a test used to screen for prostate cancer), mood swings, high blood pressure, increased red blood cell count, acne, and skin irritation where the gel is applied.

This is the most important information to know about Male Excel’s Testosterone Lipoderm Cream. For further information, talk with your healthcare provider.

Tell your healthcare provider if you have any side effect that bothers you or does not go away.

These are not all the possible side effects of Male Excel’s Testosterone Lipoderm Cream. For more information, ask your healthcare provider or pharmacist.

Please click here to see full prescribing information, Medication Guide, and complete boxed warnings for the product.

You are encouraged to report any adverse side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

ADDITIONAL IMPORTANT SAFETY INFORMATION AND BLACK BOX WARNING

WARNING: Drugs with thyroid hormone activity, alone or together with other therapeutic agents, have been used for the treatment of obesity. In euthyroid patients, doses within the range of daily hormonal requirements are ineffective for weight reduction. Larger doses may produce serious or even life-threatening manifestations of toxicity, particularly when given in association with sympathomimetic amines such as those used for their anorectic effects.

What Should You Know Before Taking Male Excel’s desiccated thyroid [tetraiodothyronine sodium (T4 levothyroxine) and triiodothyronine sodium (T3 liothyronine)]?

PLEASE NOTE: The information provided on this page is not a substitute for professional medical advice, diagnosis, or treatment. If you have any questions or concerns about your health, please talk to a doctor.

This is not an Orange Book product and has not been subjected to FDA therapeutic equivalency or other equivalency testing. No representation is made as to generic status or bioequivalency. Each person recommending a prescription substitution using this product shall make such recommendations based on each such person’s professional opinion and knowledge upon evaluating the active ingredients, excipients, inactive ingredients and chemical information provided herein. All prescription substitutions and/or recommendations using this product shall be made subject to state and federal statutes as applicable.

What is Male Excel’s desiccated thyroid?

· Male Excel’s desiccated thyroid is a prescription medicine used to treat a condition called hypothyroidism from any cause, except for cases of temporary hypothyroidism, which is usually associated with an inflammation of the thyroid (thyroiditis). It is meant to replace or supplement a hormone that is usually made by your thyroid gland.

When should I not take Male Excel’s desiccated thyroid?

· Male Excel’s desiccated thyroid should not be used for weight loss. Do not use Male Excel’s desiccated thyroid if you have hyperthyroidism, overactive thyroid, uncorrected adrenal problems, or are allergic to any of its ingredients.

What warnings should I know about Male Excel’s desiccated thyroid?

· Large doses of Male Excel’s desiccated thyroid may cause serious or life-threatening side effects, including chest pain, increased pulse rate, rapid, strong, irregular heartbeat, and excessive sweating.
· Male Excel’s desiccated thyroid should be used with caution in people with heart disease, on diabetes medication, or on blood thinning medication.
· Children may experience partial hair loss in the first few months of thyroid therapy, but this will usually go away on its own.

What should I tell my healthcare provider?

· Tell your doctor immediately if you experience chest pain, increased pulse rate, rapid, strong, irregular heartbeat, excessive sweating, or any other unusual event.
· Tell your doctor about any other medical conditions you may have, especially heart disease, diabetes, blood clotting problems, and adrenal or pituitary gland problems. The dose of other drugs you may be taking to control these conditions may have to be changed while you are taking Male Excel’s desiccated thyroid.
· If you have diabetes, check your blood sugar levels and/or the glucose in your urine, as ordered by your doctor and immediately tell your doctor if there are any changes.
· Tell your doctor if you are allergic to any foods or drugs, are pregnant or plan to become pregnant, are breastfeeding or are taking any other drugs, as well as prescription and over-the-counter products.

What are the side effects of Male Excel’s desiccated thyroid?

· Side effects may include chest pain, increased pulse rate, rapid, strong, irregular heartbeat, or excessive sweating. If you experience these side effects, immediately contact your doctor.

What other medications might interact with Male Excel’s desiccated thyroid?

· Male Excel’s desiccated thyroid can interact with some medications, such as oral anticoagulants, which are medicines used to thin the blood, insulin or oral medications used to treat diabetes, certain medications used to treat high cholesterol levels, and estrogen-containing birth control pills.

IMPORTANT RISK INFORMATION

Thyroid hormones, including Male Excel’s desiccated thyroid, should not be used alone or in combination with other drugs to treat obesity or weight loss. In patients with normal thyroid levels, doses of Male Excel’s desiccated thyroid used daily for hormone replacement are not helpful for weight loss. Larger doses may result in serious or even life-threatening events, especially when combined with certain other drugs used to reduce appetite.

· Male Excel’s desiccated thyroid is contraindicated in patients with uncorrected adrenal insufficiency, untreated thyrotoxicosis, and hypersensitivity to any component of the product.
· In the elderly and patients with cardiovascular disease, Male Excel’s desiccated thyroid should be used with greater caution than younger patients or those without cardiovascular disease.
· Use of Male Excel’s desiccated thyroid in patients with diabetes mellitus or adrenal cortical insufficiency may worsen the intensity of their symptoms.
· The therapy of myxedema coma requires simultaneous administration of glucocorticoids.
· Concomitant use of Male Excel’s desiccated thyroid with oral anticoagulants alters the sensitivity of oral anticoagulants. Prothrombin time should be closely monitored in thyroid-treated patients on oral anticoagulants.
· In infants, excessive doses of Male Excel’s desiccated thyroid may produce craniosynostosis.
· Partial loss of hair may be experienced by children in the first few months of therapy but is usually transient.
· Adverse reactions associated with Male Excel’s desiccated thyroid therapy are primarily those of hyperthyroidism due to therapeutic overdosage.
· Many drugs and some laboratory tests may alter the therapeutic response to Male Excel’s desiccated thyroid. In addition, thyroid hormones and thyroid status have varied effects on the pharmacokinetics and actions of other drugs. Administer at least 4 hours before or after drugs that are known to interfere with absorption. Evaluate the need for dose adjustments when regularly administering within one hour of certain foods that may affect absorption.

Please click here to see full prescribing information, including BOXED WARNING and important safety information.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088