The client is at risk for decreased absorption due to medication interactions. Rationale Esomeprazole works by reducing the production of stomach acid, thereby raising the pH level in the stomach. Levothyroxine, like many other medications, is absorbed primarily in the upper part of the small intestine where a more acidic environment is optimal for absorption. When stomach acid production is reduced by esomeprazole, the pH of the stomach increases, which can decrease the dissolution and absorption of levothyroxine.