Thyroid UK
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Help! I currently take Carbimazole/Propranolol and I don't know when to take my Levothyroxine medication during the day?


I am a Graves' Disease sufferer seeking a bit of advice because I am a bit unsure as to when to start taking my Levothyroxine dosage each day. After a few weeks of being on Carbimazole and Propranolol, I have been given the go-ahead to start taking Levothyroxine.

At the moment I take my first dosage of Propranolol 40mg with my full daily dosage of Carbimazole 40mg just before my breakfast each day and I take my second dosage of Propranolol 40mg just before my evening meal.

I read on the Levothyroxine leaflet that it should be taken on an empty stomach with a full glass of water before breakfast. If I do this, I don't know when I should take my Propranolol/Carbimazole meds?Unfortunately, I can't ask my Endocrinologist about this because he's gone AWOL and it is my Doctor who has been prescribing my meds until I go and see my new Endo in December and he is very hard to get a hold of.

I've also read online that Levothyroxine can interact with Propranolol so I'm a little nervous about starting it and I also read somewhere about not having caffeine within half an hour of taking it? Is this correct? I have read and re-read the leaflet and it gives hardly any information to help me.

If anybody could advise me some more that would be so great! Many, many thanks! :) x

8 Replies

When I was being treated for Graves I always took my levo as soon as my alarm went off at 06.00 and then took my carb and my blood pressure pills at 08.00 when I was having breakfast. Unfortunately I have no idea about the propranolol as I couldn't take it because I have asthma. Will you continue to take propranolol once the hyper palpitations / symbols have settled down?

If no one here can help you I would speak to the pharmacist at your local pharmacy although I know there is a lot of variation in how helpful pharmacists can be. My own pharmacy is wonderful but I've asked about odd things in other pharmacies and found that they can be unhelpful and uninterested and look at me like I've crawled out from under a stone - which comes as a shock considers how helpful my local place is.


I think once my thyroid levels are balanced then I will be weaned off the Propranolol, it has been a great help though I had terrible palpitations, etc.

I think I will take the Levo first thing in the morning and then wait an hour before taking the rest of my meds (Propranolol & Carbimazole) before my breakfast. I don't know how I will last that long because I wake up and my tummy is always rumbling! :)

I have also had the same experience as you, some pharmacies just fob you off.

1 like

I have turned down B&R as the amount of drugs to take is way too dangerous. The only thing I know is you can take Carbi at any time, it doesn't matter.


May I ask what are you doing instead of B&R? I was kind of thrown in to it. :(


Nathalie is probably titrating her carbimazole down - you start on a certain amount of carbimazole - I don't know how much but I don't think it is as high as the 40mcg I was taking although I'm not medically qualified so I really don't know - and gradually reduce it until things stabilise.

When I saw the endo first he explained so the different methods of treating hyperactive thyroid sand then said they used the 'quick way' which was block and replace - considering it took the best part of a year it didn't seem all that quick to me.

Think it just depends on the method your hospital prefers to work with. Not sure one is better than the other - just different routes to hopefully the same place.

It's worth reading as much as y can - there is a handy little book called Understanding your Thyroid by Dr Anthony Toft - costs about £5 and it outlines most things about the thyroid and if you want to you can follow things up.


Simply Carbimazole, 20mg at first now 10mg but I never suffered from tachycardia. I have Graves too. I was cured a first time in 7 months but I relapsed 3 years later.

Carbimazole gives all sort of side effets including losing hair and muscle and joint pain so taking high doses is not an option for me.

My new endo wanted to do B&R too I turned it down. Moreover there is no way to see if you're getting better with B&R: you can do it for 18 months and be hyper 2 weeks after stopping the treatment. With Carbimazole, you can see your progress - or lack of.

You should use the search function of this site to see older posts about B&R and make up your mind.


Different problem I know..........I have hashimotos and have always found tolerating taking my necessary Levo virtually impossible. I therefore also have to take propranolol 4x a day. (Can't tolerate slow release propranolol)

I take Levo at bedtime, as recommended by my Endo.

Why not ask your endo what time of day they recommend you taking Levo?


Hi there,

Hmm just a wee bit worried your GP is advising you to start levo, do you know if he has taken his direction from another endo?


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