A 64-year-old wom an was diagnosed w ith hypothyroidism and started on levothyroxine replacem ent…

A 64-year-old wom an was diagnosed w ith hypothyroidism and started on levothyroxine replacem ent therapy. For the previous 8 m onths, she had been receiving warfarin therapy for the treatm ent of recurrent deep venous throm bosis. Her warfarin dose was adjusted to m aintain her international norm alized ratio (INR) between 2 and 3. When she started thyroxine replacem ent therapy, her physician reduced the dosage of warfarin by 50% and advised her that her INR would need to be m onitored on a weekly basis until a new appropriate dose of warfarin was determ ined. Which of the follow ing statem ents best explains w hy the warfarin dose was reduced? A. Warfarin decreases the renal clearance of levothyroxine. B. Warfarin decreases the hepatic clearance of levothyroxine. C. Levothyroxine decreases the hepatic clearance of warfarin. D. Levothyroxine increases the catabolism of clotting factors. E. Levothyroxine increases the intestinal absorption of warfarin.

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