Anaesthesia and refridgeration

1/ Does thyroxine require refridgeration all the time.
How liong can it remain out of refridgeration in air condition environment without losing effect.
2/ if on SSRI should i cease or wean prior to surgery.
what if i have to avoid doses post op will rapid weaning effect me
can I take narcotics and SSRI

[Burton Dunaway, PharmD]

Thyroxine commonly known as levothyroxine does not need to be kept cold. Unless, the medication was compounded, or if it is some other special formulation of levothyroxine. It is usually not necessary to stop antidepressants prior to surgery. Antidepressants should be tapered over a period of several weeks. Stopping them abruptly can cause withdrawal symptoms. Consult your physician before stopping the SSRI.
Narcotics can be taken with SSRIs. They do not interact with each other, but side effects such as drowsiness may be increased.