Levothyroxine

Levothyroxine is a synthetic thyroid hormone (T4) used to replace missing thyroid hormone in hypothyroidism, to help manage certain thyroid cancers, and, as an injection, to treat myxedema coma.

Brand names Levo-tLevoxylSynthroidTirosintUnithroid +8 more
Drug class ⓘ L-thyroxine
Rx/OTC Forms 4 Routes Oral · Intravenous
Dr. Brian Staiger, PharmD, BCPS
Reviewed by Last reviewed Jul 10, 2026 Content updated Oct 1, 2026

Built from the FDA-approved label, dated May 15, 2026 · How this page is built

✓No current FDA shortage listed · checked Oct 2, 2026 🚨Recall on record · 60
⭐ Levothyroxine at a glance The quick version — the full detail is in the Patient Information Guide below.
Dr. Brian Staiger, PharmD, BCPS
The Pharmacist’s Bottom LineWritten from the FDA label in plain language · reviewed by
Levothyroxine is a safe, effective way to replace thyroid hormone in hypothyroidism when taken consistently and monitored with blood tests. Take it on an empty stomach, space it from interacting products, and never use it for weight loss. Tell your prescriber about heart disease, pregnancy and any new medicines.
⚠️ FDA Boxed Warning — the FDA’s strongest safety alert ▾

Levothyroxine must not be used to lose weight. In people with normal thyroid levels, usual doses do not cause weight loss. Larger doses can cause serious or even life-threatening toxicity, especially when combined with sympathomimetic amines such as appetite suppressants. Call your doctor right away if you have a rapid heartbeat, chest pain, tremor, or severe nervousness.

Read the full warning on DailyMed →
How you get itPrescription and over the counter
Comes asTablet, Capsule, Injection +1
On the market since2000
Companies that make it88
FDA label last updatedMay 15, 2026
FDA’s strongest warning (boxed)Yes, see below

⚡ Quick answers about Levothyroxine

What is levothyroxine for?

It replaces thyroid hormone when your thyroid doesn’t make enough, a condition called hypothyroidism. Oral forms are also used with surgery and radioiodine for certain thyroid cancers.

Read the full answer →

How should I take it?

Oral forms are usually taken once a day on an empty stomach, about 15 to 60 minutes before breakfast, depending on the product. Keep calcium, iron and antacids at least 4 hours away.

Read the full answer →

How soon will I feel better?

Full effect may take 4 to 6 weeks. Your doctor will check TSH and/or T4 blood tests to adjust your dose.

See it in the FAQ →

Can I use it to lose weight?

No. It doesn’t cause weight loss at normal doses if your thyroid is normal. Larger doses can be seriously toxic.

See it in the FAQ →
🧬 Where this information comes from Click to expand

The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 287 clinical label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →

How we combine label and product data →

📖 Levothyroxine: Patient Information Guide

A plain-language walkthrough of Levothyroxine — what it treats, how it works, how it’s taken, side effects, warnings and interactions. Tap any section to expand it.

What Levothyroxine is used for

▾

Levothyroxine is used for several thyroid-related conditions, depending on the product.

  • Hypothyroidism (primary, secondary and tertiary; congenital or acquired): oral tablets, capsules and oral solutions.
  • Add-on to surgery and radioiodine therapy for thyrotropin-dependent well-differentiated thyroid cancer: oral products.
  • Myxedema coma: Levothyroxine Sodium injection (intravenous) only.
  • Not for shrinking benign thyroid nodules or nontoxic diffuse goiter in iodine-sufficient people.
  • Not for hypothyroidism during the recovery phase of subacute thyroiditis (oral products).

How Levothyroxine works

▾

Levothyroxine is a synthetic form of T4, your body’s main thyroid hormone. Thyroid hormones enter cells and bind to receptors in the nucleus, which turns on genes and protein production. About 80% of the active hormone T3 comes from T4 being converted in body tissues.

How Levothyroxine is taken (dosage)

▾

Oral levothyroxine is generally taken once daily, usually on an empty stomach, 15 minutes to an hour before breakfast. Your starting dose depends on age, weight, heart health and other medicines. Full effect may take 4 to 6 weeks.

  • Separate it by at least 4 hours from drugs that interfere with absorption.
  • Regular TSH and/or T4 blood tests guide dose changes.
  • The injection is given intravenously by a healthcare professional.

Follow your prescriber and label directions.

Dosing details from the FDA-approved label

From the Levothyroxine prescribing information (“Dosage and Administration”). Doses are set by your prescriber for your product, condition, kidney function and age — never change a dose on your own.

  • Primary Hypothyroidism in Adults and in Adolescents in Whom Growth and Puberty are Complete (otherwise healthy, non-elderly, hypothyroid for only a short time)
    • Start at the full replacement dose
    • The average full replacement dose is approximately 1.6 mcg per kg per day (for example: 100 mcg per day to 125 mcg per day for a 70 kg adult)
    • Adjust the dose by 12.5 mcg to 25 mcg increments every 4 to 6 weeks until the patient is clinically euthyroid and the serum TSH returns to normal
    • Maximum: Doses greater than 200 mcg per day are seldom required.
    • An inadequate response to daily doses of greater than 300 mcg per day is rare and may indicate poor compliance, malabsorption, drug interactions, or a combination of these factors.
  • Elderly patients or patients with underlying cardiac disease
    • Start with a dose of 12.5 mcg per day to 25 mcg per day
    • Increase the dose every 6 to 8 weeks, as needed until the patient is clinically euthyroid and the serum TSH returns to normal
    • The full replacement dose may be less than 1 mcg per kg per day in elderly patients.
  • Severe longstanding hypothyroidism
    • Start with a dose of 12.5 mcg per day to 25 mcg per day
    • Adjust the dose in 12.5 mcg to 25 mcg increments every 2 to 4 weeks until the patient is clinically euthyroid and the serum TSH level is normalized
  • Secondary or Tertiary Hypothyroidism
    • Start at the full replacement dose in otherwise healthy, non-elderly individuals
    • Start with a lower dose in elderly patients, patients with underlying cardiovascular disease or patients with severe longstanding hypothyroidism
    • Titrate until the patient is clinically euthyroid and the serum free-T4 level is restored to the upper half of the normal range
    • Serum TSH is not a reliable measure of dose adequacy; use the serum free-T4 level to monitor therapy.
  • Pediatric hypothyroidism, 0-3 months
    • 10 mcg/kg/day to 15 mcg/kg/day
    • Consider a lower starting dose in newborns at risk for cardiac failure; increase the dose every 4 to 6 weeks as needed.
  • Pediatric hypothyroidism, 3-6 months
    • 8 mcg/kg/day to 10 mcg/kg/day
  • Pediatric hypothyroidism, 6-12 months
    • 6 mcg/kg/day to 8 mcg/kg/day
  • Pediatric hypothyroidism, 1-5 years
    • 5 mcg/kg/day to 6 mcg/kg/day
  • Pediatric hypothyroidism, 6-12 years
    • 4 mcg/kg/day to 5 mcg/kg/day
  • Pediatric hypothyroidism, greater than 12 years but growth and puberty incomplete
    • 2 mcg/kg/day to 3 mcg/kg/day
    • Growth and puberty complete: 1.6 mcg/kg/day. Children at risk for hyperactivity: start at one-fourth the recommended full replacement dose and increase weekly by one-fourth until the full dose is reached.
Read the label’s full dosing text

2 DOSAGE AND ADMINISTRATION • Administer once daily, preferably on an empty stomach, one-half to one hour before breakfast with a full glass of water. (2.1) • Administer at least 4 hours before or after drugs that are known to interfere with absorption. (2.1) • Evaluate the need for dose adjustments when regularly administering within one hour of certain foods that may affect absorption. (2.1) • Advise patients to stop biotin and biotin-containing supplements at least 2 days before assessing TSH and/or T4 levels. (2.2) • Starting dose depends on a variety of factors, including age, body weight, cardiovascular status, and concomitant medications. Peak therapeutic effect may not be attained for 4 to 6 weeks. (2.2) • See full prescribing information for dosing in specific patient populations. (2.3) • Adequacy of therapy determined with periodic monitoring of TSH and/or T4 as well as clinical status. (2.4) 2.1 Important Administration Instructions Administer levothyroxine sodium tablets as a single daily dose, on an empty stomach, one-half to one hour before breakfast with a full glass of water to avoid choking or gagging [see Adverse Reactions (6) ]. Administer levothyroxine sodium tablets at least 4 hours before or after drugs known to interfere with levothyroxine sodium absorption [see Drug Interactions (7.1) ]. Evaluate the need for dosage adjustments when regularly administering within one hour of certain foods that may affect levothyroxine sodium tablets absorption [see Dosage and Administration (2.2 and 2.3) , Drug Interactions (7.9), and Clinical Pharmacology (12.3) ]. Administer levothyroxine sodium tablets to pediatric patients who cannot swallow intact tablets by crushing the tablet, suspending the freshly crushed tablet in a small amount (5 to 10 mL) of water and immediately administering the suspension by spoon or dropper. Ensure the patient ingests the full amount of the suspension. Do not store the suspension. Do not administer in foods that decrease absorption of levothyroxine sodium tablets, such as soybean-based infant formula [see Drug Interactions (7.9) ].

Excerpted — the section continues on the label. Read the full Dosage and Administration section on DailyMed →

Levothyroxine side effects in detail

▾

Common side effects

  • Headache
  • Nervousness, anxiety or irritability
  • Trouble sleeping
  • Tremors or muscle weakness
  • Fast or pounding heartbeat
  • Increased appetite or weight loss
  • Heat intolerance or excess sweating
  • Diarrhea

When to get medical help

  • Chest pain, irregular or very fast heartbeat, or shortness of breath: these can signal too much thyroid hormone.
  • Seizures, confusion or disorientation, especially after a possible overdose.
  • Swelling of the face or throat, wheezing, hives or a serious rash: these can be allergic reactions to inactive ingredients.
  • Symptoms of overdose may be delayed for several days, so call Poison Control (1-800-222-1222) right away.
  • In children: new headaches with vision changes, or hip or knee pain with limping, should be reported promptly.

Most side effects look like too much thyroid hormone, which usually means the dose needs adjusting.

  • Headache, nervousness, irritability, insomnia
  • Tremors, muscle weakness or spasm
  • Palpitations or fast heartbeat
  • Weight loss, increased appetite, diarrhea
  • Heat intolerance, sweating, hair loss, rash
  • Menstrual irregularities

Get help for chest pain, irregular heartbeat, shortness of breath, seizures, or signs of allergic reaction.

Levothyroxine warnings and precautions

▾
  • Not for weight loss: larger doses can be life-threatening.
  • Overtreatment or undertreatment can harm the heart, bones, growth and thinking.
  • Heart risk is higher in older adults and people with heart disease.
  • Oral levothyroxine should not be used for myxedema coma.
  • Starting before treating adrenal insufficiency may trigger an adrenal crisis.
  • It may worsen blood sugar control in diabetes.
  • Overtreatment can lower bone density, especially after menopause.

Levothyroxine interactions: what it interacts with

▾

Many drugs and foods change how levothyroxine is absorbed or how it works.

  • Calcium, iron, sevelamer, lanthanum: bind it; separate by 4 hours.
  • Bile acid sequestrants and Kayexalate: reduce absorption.
  • Antacids, sucralfate, proton pump inhibitors: less stomach acid lowers absorption.
  • Soy, walnuts, fiber, cottonseed meal, grapefruit juice: may reduce or delay absorption.
  • Warfarin-type blood thinners: effect may increase.
  • Digoxin-type drugs: effect may decrease.
  • Diabetes medicines: needs may change.
  • Rifampin and phenobarbital: may raise levothyroxine needs.
  • Biotin: can distort thyroid tests; stop 2 days before testing.

Interactions listed in the FDA-approved label

From the Levothyroxine prescribing information (“Drug Interactions”): what the manufacturer studied or reported to the FDA.

  • Phosphate binders (e.g., calcium carbonate, ferrous sulfate, sevelamer, lanthanum): Phosphate binders may bind to levothyroxine. Administer levothyroxine sodium tablets at least 4 hours apart from these agents.
  • Orlistat: May decrease levothyroxine absorption, potentially resulting in hypothyroidism. Monitor patients treated concomitantly for changes in thyroid function.
  • Bile acid sequestrants (e.g., colesevelam, cholestyramine, colestipol) and ion exchange resins (e.g., Kayexalate): These are known to decrease levothyroxine absorption. Administer levothyroxine sodium tablets at least 4 hours prior to these drugs or monitor TSH levels.
  • Proton pump inhibitors, sucralfate, antacids (e.g., aluminum & magnesium hydroxides, simethicone): They may cause hypochlorhydria, affect intragastric pH, and reduce levothyroxine absorption. Monitor patients appropriately.
  • Antidiabetic therapy: Adding levothyroxine in patients with diabetes mellitus may worsen glycemic control and increase antidiabetic agent or insulin requirements. Carefully monitor glycemic control, especially when thyroid therapy is started, changed, or discontinued.
  • Oral anticoagulants: Levothyroxine sodium increases the response to oral anticoagulant therapy. A decrease in anticoagulant dose may be warranted; closely monitor coagulation tests to permit appropriate and timely dosage adjustments.
  • Digitalis glycosides: Levothyroxine may reduce the therapeutic effects of digitalis glycosides; serum levels may decrease when a hypothyroid patient becomes euthyroid. An increase in the dose of digitalis glycosides may be necessary.
  • Tricyclic (e.g., amitriptyline) or tetracyclic (e.g., maprotiline) antidepressants; sertraline: Concurrent use may increase the therapeutic and toxic effects of both drugs, including increased risk of cardiac arrhythmias and CNS stimulation; sertraline may increase levothyroxine requirements.
  • Ketamine: Concurrent use may produce marked hypertension and tachycardia. Closely monitor blood pressure and heart rate.
  • Foods (soybean flour, cottonseed meal, walnuts, dietary fiber) and grapefruit juice: These may bind and decrease levothyroxine absorption; grapefruit juice may delay absorption and reduce bioavailability. Dosing adjustments may be necessary.
Read the label’s full interactions text

7 DRUG INTERACTIONS See full prescribing information for drugs that affect thyroid hormone pharmacokinetics and metabolism (e.g., absorption, synthesis, secretion, catabolism, protein binding, and target tissue response) and may alter the therapeutic response to levothyroxine sodium. (7) 7.1 Drugs Known to Affect Thyroid Hormone Pharmacokinetics Many drugs can exert effects on thyroid hormone pharmacokinetics and metabolism (e.g., absorption, synthesis, secretion, catabolism, protein binding, and target tissue response) and may alter the therapeutic response to levothyroxine sodium (Tables 5 to 8). Table 5. Drugs That May Decrease T4 Absorption (Hypothyroidism) Potential impact: Concurrent use may reduce the efficacy of levothyroxine sodium by binding and delaying or preventing absorption, potentially resulting in hypothyroidism. Drug or Drug Class Effect Phosphate Binders (e.g., calcium carbonate, ferrous sulfate, sevelamer, lanthanum) Phosphate binders may bind to levothyroxine. Administer levothyroxine sodium tablets at least 4 hours apart from these agents. Orlistat Monitor patients treated concomitantly with orlistat and levothyroxine sodium for changes in thyroid function. Bile Acid Sequestrants (e.g., colesevelam, cholestyramine, colestipol) Ion Exchange Resins (e.g., Kayexalate) Bile acid sequestrants and ion exchange resins are known to decrease levothyroxine absorption. Administer levothyroxine sodium tablets at least 4 hours prior to these drugs or monitor TSH levels. Proton Pump Inhibitors Sucralfate Antacids (e.g., aluminum & magnesium hydroxides, simethicone) Gastric acidity is an essential requirement for adequate absorption of levothyroxine. Sucralfate, antacids and proton pump inhibitors may cause hypochlorhydria, affect intragastric pH, and reduce levothyroxine absorption. Monitor patients appropriately. Table 6.

Excerpted — the section continues on the label. Read the full Drug Interactions section on DailyMed →

Not a complete list. The label covers the interactions the manufacturer studied or reported, and our own interaction database does not cover every medicine either. Bring your full medication list, including vitamins and herbal products, to your pharmacist.

Before taking Levothyroxine

▾
  • Do not use with uncorrected adrenal insufficiency.
  • Heart disease or older age: start low.
  • Diabetes: monitor blood sugar.
  • Pregnancy: doses may need to rise; do not stop it.
  • Breastfeeding: present in milk; no adverse effects reported.
  • Children: needs close monitoring.
  • Tartrazine allergy or aspirin sensitivity: some products contain tartrazine.

Levothyroxine overdose: if you take too much

▾

Overdose looks like severe hyperthyroidism, with possible confusion, seizures, shock, coma and death. Symptoms may be delayed for days. The dose may need to be reduced or paused. Call Poison Control at 1-800-222-1222.

Pharmacodynamics: what Levothyroxine does in the body

▾

Oral levothyroxine is a synthetic T4 that acts like your own T4. It maintains normal T4 levels when you are deficient.

Pharmacokinetics: how your body processes Levothyroxine

▾

About 40% to 80% of an oral dose is absorbed, mostly in the small intestine. Fasting increases absorption. Soy, fiber, malabsorption and age can decrease it. T4 is highly protein-bound and has a half-life of about 6 to 7 days, and the liver is the main site of breakdown. It is cleared mainly by the kidneys, with about 20% in stool.

How to store Levothyroxine

▾

Store levothyroxine sodium tablets at 20°C to 25°C (68°F to 77°F); excursions permitted to 15°C to 30°C (59°F to 86°F) (see USP Controlled Room Temperature).

📄 Written from Levothyroxine’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Every point is grounded in that labeling — nothing is invented. How we use AI →

50

Supplements & herbs that interact with Levothyroxine

50 supplements and herbal products have documented interactions with Levothyroxine in the licensed clinical database we use. Most are manageable — but your pharmacist should know about everything you take, including vitamins and herbals.

Severity mix
  • Major · 2
  • Moderate · 39
  • Minor · 9
Every supplement checked against Levothyroxine — ranked by severity The full interaction hub: 2 major · 39 moderate · 9 minor · every one linked to its full report. Check Levothyroxine against your exact supplements

Educational information from a licensed clinical database (Natural Medicines) — see our data sources & update cadence. Not medical advice: an interaction being documented does not mean it will happen to you; do not start or stop medications or supplements without professional guidance.

🩺 Levothyroxine: pharmacist answers to common questions

Quick, plain-English answers to the questions patients ask most about Levothyroxine — the kind of thing our pharmacy team would talk through with you at the counter.

What is levothyroxine for?

▾
It replaces thyroid hormone when your thyroid doesn’t make enough, a condition called hypothyroidism. Oral forms are also used with surgery and radioiodine for certain thyroid cancers. The injection is used for myxedema coma.

How should I take it?

▾
Oral forms are usually taken once a day on an empty stomach, about 15 to 60 minutes before breakfast, depending on the product. Keep calcium, iron and antacids at least 4 hours away. Follow your prescriber and label.

How soon will I feel better?

▾
Full effect may take 4 to 6 weeks. Your doctor will check TSH and/or T4 blood tests to adjust your dose.

Can I use it to lose weight?

▾
No. It doesn’t cause weight loss at normal doses if your thyroid is normal. Larger doses can be seriously toxic.

What side effects should I call about?

▾
Call about chest pain, a racing or irregular heartbeat, shortness of breath, seizures, or an allergic reaction. Mild jitteriness, headache or trouble sleeping may mean your dose is too high, so tell your doctor.

Is it safe in pregnancy?

▾
Yes, and you shouldn’t stop it. Pregnancy often raises your dose needs, so your TSH will be monitored, and the dose usually returns to the pre-pregnancy level after delivery.

Is Levothyroxine available over the counter?

▾
Both — Levothyroxine is sold both over the counter and by prescription, according to its FDA labeling. Lower strengths or certain forms are often available without a prescription, while higher strengths or specialized forms still require one. Ask your pharmacist which version is right for you.

When was Levothyroxine first available?

▾
Levothyroxine has been available in the United States since at least 2000, based on FDA approval history (Drugs@FDA) and product marketing records.

Who makes Levothyroxine?

▾
Levothyroxine is supplied by 88 manufacturers listed in the FDA NDC Directory, including Bryant Ranch Prepack, A-S Medication Solutions, IBSA Pharma Inc..

💬 Answers drafted from Levothyroxine’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Grounded in that labeling — nothing is made up. How we use AI →

🧰 More about Levothyroxine on HelloPharmacist

💊 Levothyroxine forms and strengths (how it comes)

Levothyroxine is available in 4 forms. Different forms and brands can have different approved uses, doses, schedules, and directions. Follow the instructions for your exact product, and do not switch forms without guidance from your prescriber or pharmacist.

Tablet

By mouth
Brands Euthyrox Levo-t Levoxyl Synthroid Unithroid
How this form is used
What it may be used for
  • Synthroid is used for hypothyroidism and as an add-on to surgery and radioiodine therapy for thyrotropin-dependent well-differentiated thyroid cancer in adults and children, including newborns.
  • Levoxyl is used for hypothyroidism and as an add-on for well-differentiated thyroid cancer in adults and children.
Important instructions
  • Synthroid is taken once daily on an empty stomach, one-half to one hour before breakfast.
  • Levoxyl is taken once daily on an empty stomach with a full glass of water.
  • Levo-t should be taken with a full glass of water because the tablet may rapidly disintegrate.
Available strengths 24 strengths
Show 18 more strengths Show fewer strengths
1,359 FDA-listed product records ⓘ

Capsule

By mouth
Brands Tirosint
How this form is used
What it may be used for
  • Tirosint is used for hypothyroidism in adults and children 6 years and older.
  • Tirosint is used as an add-on to surgery and radioiodine therapy for thyrotropin-dependent well-differentiated thyroid cancer in adults and children 6 years and older.
Important instructions
  • Tirosint is taken once daily on an empty stomach, one-half to one hour before breakfast.
  • Swallow Tirosint capsules whole. Do not cut, crush or chew them.
  • Take Tirosint at least 4 hours before or after drugs that interfere with absorption.
Available strengths 15 strengths
Show 9 more strengths Show fewer strengths
100 FDA-listed product records ⓘ

Injection

Into a vein
How this form is used
What it may be used for
  • Levothyroxine Sodium injection is used to treat myxedema coma.
Important instructions
  • Levothyroxine Sodium injection is given intravenously, with a loading dose followed by daily maintenance doses until oral therapy can be tolerated.
  • Levothyroxine Sodium injection should not be added to other IV fluids.
  • Levothyroxine Sodium injection is not established as a dose-for-dose substitute for oral levothyroxine, so caution is needed when switching.
Available strengths 6 strengths
59 FDA-listed product records ⓘ

Oral solution

By mouth
Brands Ermeza Thyquidity Tirosint
How this form is used
What it may be used for
  • Tirosint-SOL is used for hypothyroidism in adults and children, including newborns.
  • Thyquidity is used for hypothyroidism and as an add-on to surgery and radioiodine therapy for thyrotropin-dependent well-differentiated thyroid cancer.
Important instructions
  • Tirosint-SOL is taken once daily on an empty stomach, 15 minutes before breakfast.
  • Tirosint-SOL can be squeezed from the single-dose ampule into water, directly into the mouth, or onto a spoon and taken right away.
  • Thyquidity is given by mouth using the syringe provided by the pharmacy, once daily, preferably on an empty stomach.
Available strengths 18 strengths
Show 12 more strengths Show fewer strengths
40 FDA-listed product records ⓘ

📊 Levothyroxine on the U.S. market: products, makers and brands

How Levothyroxine appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.

88 companies list 1,605 Levothyroxine product records with the FDA, mostly as tablet, capsule, injection; the earliest marketing or approval year on record is 2000. Brand names on the directory include Levo-t, Levoxyl, Synthroid and 10 more; the rest are generics.

4
Dose forms ⓘ
88
Manufacturers
11
Brand names
1,605
FDA-listed product records ⓘ
2000
First marketed ⓘ

FDA-listed product records by dose form (tablet variants merged) — FDA National Drug Code Directory. Record counts are not sales or prescription volume.

Also listed with the FDA, not a patient dose form: Powder (21) — bulk drug substance sold to compounders/manufacturers and multi-item kits. These aren’t counted in the dose-form total above.

Bryant Ranch Prepack11%
A-S Medication Solutions11%
IBSA Pharma Inc.6%
Alvogen, Inc.5%
Amneal Pharmaceuticals NY LLC3%
Proficient Rx LP3%
Other makers60%

Share of FDA-listed product records by manufacturer — FDA National Drug Code Directory. Record counts are not sales or prescription volume.

📈 How widely Levothyroxine is used (Medicaid data)

A general measure of how commonly Levothyroxine is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.

Think of this as a proxy for how widely Levothyroxine is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.

7,786,593
Medicaid prescriptions filled (Q1–Q4 2025)
$127.1M gross Medicaid reimbursement (before mandatory rebates — net cost is lower)

How commonly is Levothyroxine prescribed? Of the 1,600 medications we measure, Levothyroxine ranks #19 by Medicaid prescriptions — more than 99% of them.

Where Levothyroxine ranks among the drugs we measure · Q1–Q4 2025 · neighbors ±5

Utilization by Levothyroxine product

Pick a product to see its own Medicaid numbers. Each chip is one clinical product — a specific strength & dosage form as defined by RxNorm — with brand-name and generic versions combined.

The 0.05 mg oral tablet is the most-dispensed Levothyroxine product — about 19% of these Medicaid prescriptions.

levothyroxine sodium 0.05 MG Oral Tablet Most dispensed

1,451,448 Medicaid prescriptions (Q1–Q4 2025) 19% of Levothyroxine prescriptions shown $22M gross reimbursement (before rebates) ≈ $15 per prescription (gross)

Summed across the 28 of 156 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 966221

levothyroxine sodium 0.025 MG Oral Tablet

1,160,098 Medicaid prescriptions (Q1–Q4 2025) 15% of Levothyroxine prescriptions shown $16.7M gross reimbursement (before rebates) ≈ $14 per prescription (gross)

Summed across the 28 of 136 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 966220

levothyroxine sodium 0.075 MG Oral Tablet

1,131,175 Medicaid prescriptions (Q1–Q4 2025) 15% of Levothyroxine prescriptions shown $17.6M gross reimbursement (before rebates) ≈ $16 per prescription (gross)

Summed across the 28 of 147 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 966222

levothyroxine sodium 0.1 MG Oral Tablet

908,296 Medicaid prescriptions (Q1–Q4 2025) 12% of Levothyroxine prescriptions shown $14.4M gross reimbursement (before rebates) ≈ $16 per prescription (gross)

Summed across the 29 of 161 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 892246

levothyroxine sodium 0.125 MG Oral Tablet

635,047 Medicaid prescriptions (Q1–Q4 2025) 8% of Levothyroxine prescriptions shown $10.6M gross reimbursement (before rebates) ≈ $17 per prescription (gross)

Summed across the 25 of 131 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 966224

levothyroxine sodium 0.088 MG Oral Tablet

621,931 Medicaid prescriptions (Q1–Q4 2025) 8% of Levothyroxine prescriptions shown $10.9M gross reimbursement (before rebates) ≈ $18 per prescription (gross)

Summed across the 26 of 130 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 966253

levothyroxine sodium 0.112 MG Oral Tablet

490,099 Medicaid prescriptions (Q1–Q4 2025) 6% of Levothyroxine prescriptions shown $8.8M gross reimbursement (before rebates) ≈ $18 per prescription (gross)

Summed across the 25 of 112 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 966248

levothyroxine sodium 0.15 MG Oral Tablet

456,958 Medicaid prescriptions (Q1–Q4 2025) 6% of Levothyroxine prescriptions shown $7.8M gross reimbursement (before rebates) ≈ $17 per prescription (gross)

Summed across the 25 of 120 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 966225

levothyroxine sodium 0.137 MG Oral Tablet

312,586 Medicaid prescriptions (Q1–Q4 2025) 4% of Levothyroxine prescriptions shown $5.6M gross reimbursement (before rebates) ≈ $18 per prescription (gross)

Summed across the 24 of 113 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 966270

levothyroxine sodium 0.175 MG Oral Tablet

297,995 Medicaid prescriptions (Q1–Q4 2025) 4% of Levothyroxine prescriptions shown $5.3M gross reimbursement (before rebates) ≈ $18 per prescription (gross)

Summed across the 23 of 103 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 966249

levothyroxine sodium 0.2 MG Oral Tablet

289,977 Medicaid prescriptions (Q1–Q4 2025) 4% of Levothyroxine prescriptions shown $5.2M gross reimbursement (before rebates) ≈ $18 per prescription (gross)

Summed across the 24 of 101 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 892251

levothyroxine sodium 0.3 MG Oral Tablet

25,120 Medicaid prescriptions (Q1–Q4 2025) <1% of Levothyroxine prescriptions shown $572,285 gross reimbursement (before rebates) ≈ $23 per prescription (gross)

Summed across the 12 of 45 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 892255

levothyroxine sodium 0.05 MG Oral Capsule

662 Medicaid prescriptions (Q1–Q4 2025) <1% of Levothyroxine prescriptions shown $107,596 gross reimbursement (before rebates) ≈ $163 per prescription (gross)

Summed across the 1 of 5 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 966407

levothyroxine sodium 0.03 MG/ML Oral Solution

619 Medicaid prescriptions (Q1–Q4 2025) <1% of Levothyroxine prescriptions shown $142,458 gross reimbursement (before rebates) ≈ $230 per prescription (gross)

Summed across the 2 of 2 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 2626050

levothyroxine sodium 0.02 MG/ML Oral Solution

587 Medicaid prescriptions (Q3–Q4 2025) <1% of Levothyroxine prescriptions shown $136,519 gross reimbursement (before rebates) ≈ $233 per prescription (gross)

Summed across the 1 of 6 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 2473276

levothyroxine sodium 0.075 MG Oral Capsule

443 Medicaid prescriptions (Q1–Q4 2025) <1% of Levothyroxine prescriptions shown $63,304 gross reimbursement (before rebates) ≈ $143 per prescription (gross)

Summed across the 1 of 5 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 905458

5 ML levothyroxine sodium 0.02 MG/ML Injection

422 Medicaid prescriptions (Q1–Q4 2025) <1% of Levothyroxine prescriptions shown $172,024 gross reimbursement (before rebates) ≈ $408 per prescription (gross)

Summed across the 2 of 3 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 2166193

levothyroxine sodium 0.025 MG Oral Capsule

338 Medicaid prescriptions (Q1–Q4 2025) <1% of Levothyroxine prescriptions shown $41,255 gross reimbursement (before rebates) ≈ $122 per prescription (gross)

Summed across the 1 of 5 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 966406

levothyroxine sodium 0.125 MG Oral Capsule

297 Medicaid prescriptions (Q1–Q4 2025) <1% of Levothyroxine prescriptions shown $44,484 gross reimbursement (before rebates) ≈ $150 per prescription (gross)

Summed across the 1 of 5 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 966405

levothyroxine sodium 0.1 MG Injection

277 Medicaid prescriptions (Q1–Q4 2025) <1% of Levothyroxine prescriptions shown $312,655 gross reimbursement (before rebates) ≈ $1,129 per prescription (gross)

Summed across the 6 of 13 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1115267

levothyroxine sodium 0.112 MG Oral Capsule

252 Medicaid prescriptions (Q1–Q4 2025) <1% of Levothyroxine prescriptions shown $27,619 gross reimbursement (before rebates) ≈ $110 per prescription (gross)

Summed across the 1 of 5 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 905451

levothyroxine sodium 0.013 MG Oral Capsule

248 Medicaid prescriptions (Q1–Q4 2025) <1% of Levothyroxine prescriptions shown $26,066 gross reimbursement (before rebates) ≈ $105 per prescription (gross)

Summed across the 1 of 5 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 966412

levothyroxine sodium 0.5 MG Injection

150 Medicaid prescriptions (Q1–Q4 2025) <1% of Levothyroxine prescriptions shown $152,839 gross reimbursement (before rebates) ≈ $1,019 per prescription (gross)

Summed across the 1 of 10 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 966219

levothyroxine sodium 0.175 MG Oral Capsule

137 Medicaid prescriptions (Q1–Q4 2025) <1% of Levothyroxine prescriptions shown $19,039 gross reimbursement (before rebates) ≈ $139 per prescription (gross)

Summed across the 1 of 5 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1923047

levothyroxine sodium 0.137 MG Oral Capsule

116 Medicaid prescriptions (Q1–Q4 2025) <1% of Levothyroxine prescriptions shown $10,907 gross reimbursement (before rebates) ≈ $94 per prescription (gross)

Summed across the 1 of 5 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 905455

levothyroxine sodium 0.2 MG Oral Capsule

86 Medicaid prescriptions (Q1–Q3 2025) <1% of Levothyroxine prescriptions shown $13,474 gross reimbursement (before rebates) ≈ $157 per prescription (gross)

Summed across the 1 of 5 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1923050

5 ML levothyroxine sodium 0.1 MG/ML Injection

79 Medicaid prescriptions (Q1–Q4 2025) <1% of Levothyroxine prescriptions shown $18,288 gross reimbursement (before rebates) ≈ $231 per prescription (gross)

Summed across the 1 of 1 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 2166148

levothyroxine sodium 0.2 MG Injection

63 Medicaid prescriptions (Q1–Q4 2025) <1% of Levothyroxine prescriptions shown $29,244 gross reimbursement (before rebates) ≈ $464 per prescription (gross)

Summed across the 1 of 8 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1115269

5 ML levothyroxine sodium 0.04 MG/ML Injection

11 Medicaid prescriptions (Q2–Q3 2025) <1% of Levothyroxine prescriptions shown $9,916 gross reimbursement (before rebates) ≈ $901 per prescription (gross)

Summed across the 1 of 1 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 2166196

Other Levothyroxine products — combination packs and listings not yet matched to a specific clinical product (kept visible so every prescription is accounted for)

1,076 Medicaid prescriptions (Q1–Q4 2025) <1% of Levothyroxine prescriptions shown $19,459 gross reimbursement (before rebates) ≈ $18 per prescription (gross)

Summed across the 11 of 213 listed NDC products with Medicaid activity.

Shares are of the Medicaid prescriptions shown here. Product grouping follows RxNorm (the National Library of Medicine’s drug terminology), so “one product” means one strength & dosage form regardless of manufacturer. Dollar figures are gross Medicaid reimbursement before mandatory rebates — rebates (often large, especially for brand-name drugs) are confidential, so actual net cost to Medicaid is lower than shown.

Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Levothyroxine, and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 332 of 1,757 listed Levothyroxine NDCs with Medicaid activity.

🔍 Compare Levothyroxine products

A representative set of FDA-listed product records for Levothyroxine — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)

Showing 200 of 1,605 products — FDA National Drug Code Directory. See every product, package size and price: browse all 1,605 Levothyroxine NDCs →

🚨 Levothyroxine recall history

A recall is when a specific batch of a medicine is pulled from the market — usually a manufacturing issue, not a problem with the drug itself. Class I is most serious, Class III least.

No recall of any Levothyroxine product is on record in the FDA enforcement database.

✅No recalls found for Levothyroxine in the FDA database

Source: openFDA drug enforcement (recall) reports.

RxNorm Concept Web — From Ingredient to Every Form and Strength

This page starts with one ingredient concept (IN). The branches below show its dose-form concepts (SCDF), then the available clinical drug and strength concepts (SCD). Combination products remain separate concepts with their own pages.

Ingredient (IN) Levothyroxine RxCUI 10582 5 dose forms · 59 strengths
  1. Dose form (SCDF) Oral Capsule RxCUI 687432 In current FDA listings
    Clinical drug / strength (SCD) sodium 0.013 MG RxCUI 966412 sodium 0.025 MG RxCUI 966406 sodium 0.0375 MG RxCUI 2630738 sodium 0.044 MG RxCUI 2630742 sodium 0.05 MG RxCUI 966407 sodium 0.0625 MG RxCUI 2630746 sodium 0.075 MG RxCUI 905458 sodium 0.088 MG RxCUI 905462 sodium 0.1 MG RxCUI 966404 sodium 0.112 MG RxCUI 905451 sodium 0.125 MG RxCUI 966405 sodium 0.137 MG RxCUI 905455 sodium 0.15 MG RxCUI 966413 sodium 0.175 MG RxCUI 1923047 sodium 0.2 MG RxCUI 1923050
  2. Dose form (SCDF) Oral Powder RxCUI 1423482 No current FDA listing
    Clinical drug / strength (SCD) sodium 0.0022 MG/MG RxCUI 1423483
  3. Dose form (SCDF) Oral Solution RxCUI 1001569 In current FDA listings
    Clinical drug / strength (SCD) sodium 0.013 MG/ML RxCUI 2056492 sodium 0.02 MG/ML RxCUI 2473276 sodium 0.025 MG/ML RxCUI 2056462 sodium 0.03 MG/ML RxCUI 2626050 sodium 0.0375 MG/ML RxCUI 2566613 sodium 0.044 MG/ML RxCUI 2566617 sodium 0.05 MG/ML RxCUI 2056468 sodium 0.0625 MG/ML RxCUI 2566608 sodium 0.075 MG/ML RxCUI 2056472 sodium 0.088 MG/ML RxCUI 2056476 sodium 0.1 MG/ML RxCUI 2056480 sodium 0.112 MG/ML RxCUI 2056484 sodium 0.125 MG/ML RxCUI 2056488 sodium 0.137 MG/ML RxCUI 2056496 sodium 0.15 MG/ML RxCUI 2056500 sodium 0.175 MG/ML RxCUI 2056504 sodium 0.2 MG/ML RxCUI 2056508
  4. Dose form (SCDF) Oral Tablet RxCUI 372595 In current FDA listings
    Clinical drug / strength (SCD) sodium 0.0125 MG RxCUI 966280 sodium 0.025 MG RxCUI 966220 sodium 0.05 MG RxCUI 966221 sodium 0.075 MG RxCUI 966222 sodium 0.088 MG RxCUI 966253 sodium 0.1 MG RxCUI 892246 sodium 0.112 MG RxCUI 966248 sodium 0.125 MG RxCUI 966224 sodium 0.137 MG RxCUI 966270 sodium 0.15 MG RxCUI 966225 sodium 0.175 MG RxCUI 966249 sodium 0.2 MG RxCUI 892251 sodium 0.3 MG RxCUI 892255 sodium 0.4 MG RxCUI 892259 sodium 0.5 MG RxCUI 892263 sodium 0.6 MG RxCUI 892267 sodium 0.7 MG RxCUI 892271 sodium 0.8 MG RxCUI 892275 sodium 1 MG RxCUI 892279

Look up RxCUI 10582 in the RxCUI Atlas →

RxNorm is the U.S. National Library of Medicine’s normalized drug vocabulary. Its concept hierarchy can include forms that are not currently marketed; the status on each branch compares that concept with current FDA listings. RxCUIs identify vocabulary concepts, not individual packages or manufacturers.

🏷️ Levothyroxine brand names

Levothyroxine is sold under 13 brand names in the FDA directory — Levo-t, Levoxyl, Synthroid, Tirosint and others. A brand and its generic contain the same active ingredient; the brand name belongs to one company's product.

Levo-t Levoxyl Synthroid Tirosint Unithroid Levothroid Thyro-Tabs ThyroKare Euthyrox Thyquidity Ermeza Thyrocryn Tirosint SOL

🏭 Who makes Levothyroxine: manufacturers and labelers

40 companies list Levothyroxine products with the FDA. By number of product records, the largest are Bryant Ranch Prepack, A-S Medication Solutions, IBSA Pharma Inc.. Labelers include manufacturers and repackagers; the product in your bottle depends on which one your pharmacy stocks.

Bryant Ranch Prepack 165 A-S Medication Solutions 163 IBSA Pharma Inc. 87 Alvogen, Inc. 77 Amneal Pharmaceuticals NY LLC 48 Proficient Rx LP 46 Cardinal Health 107, LLC 39 Preferred Pharmaceuticals Inc. 39 AbbVie Inc. 36 Lupin Pharmaceuticals, Inc. 36 Lannett Company, Inc 36 YARAL Pharma Inc. 36 Neolpharma, Inc. 36 Northwind Health Company, LLC 36 Mylan Pharmaceuticals Inc. 36 Accord Healthcare Inc. 36 American Health Packaging 33 Direct Rx 32 Provell Pharmaceuticals, LLC 31 Remedyrepack Inc. 31 NuCare Pharmaceuticals,Inc. 29 Northwind Pharmaceuticals 26 Denton Pharma, Inc. DBA Northwind Pharmaceuticals 25 Lannett Company, Inc. 24

…and 16 more on the FDA NDC directory.

Levothyroxine drug class (RxNorm)

Levothyroxine belongs to the l-Thyroxine class.

Pharmacologic class l-Thyroxine
Drug family (ATC) Thyroid hormones

Classified by RxNorm RxClass — the U.S. National Library of Medicine's standardized drug-classification service (Established Pharmacologic Class from the FDA, the ATC drug family from the WHO, and mechanism of action). Reference only, not medical advice.

🔬 Sources for this Levothyroxine page

Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.

📄
FDA-filed drug labels (SPL) Uses, dosing, warnings & side effects from SPL records retrieved through openFDA; the linked representative set can be verified on DailyMed. ✓ Linked label effective May 15, 2026
🏭
Forms, brands & labelersAggregated from ingredient-matched FDA National Drug Code Directory product records for Levothyroxine.
📈
Real-world reportsThe FDA Adverse Event Reporting System (FAERS), served through openFDA.
🚨
Recalls & shortagesopenFDA drug-enforcement reports and the FDA drug-shortage database.
🧾 Clinical label set — FDA-filed SPL labels retained for Levothyroxine after exact ingredient or ingredient-combination matching and applicable route/form matching
Clinical labels in scope
287
NDC products indexed
1,605
Distinct labelers/manufacturers represented
88
Linked representative label ⓘ
Northwestern Memorial HealthCare
Linked label effective
May 15, 2026
Composite sections available
22
Linked SPL Set ID
51dee8fe-25c4-ad9f-e063-6294a90a04bc
Linked SPL Document ID
51dee8fe-25c5-ad9f-e063-6294a90a04bc
Open the linked representative label on DailyMed ↗
NDC package records associated with this linked SPL 1

How we combine label and product data

HelloPharmacist combines public FDA and NLM records; we don’t author the underlying clinical facts. We identified 287 FDA-filed SPL label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. The representative label is the starting point for the displayed reference monograph; the 12 largest stored in-scope SPL records, which may include that representative, are compared section by section, and the longest available version of each section is retained. Forms, routes, brands, labelers, product-listed strengths, and product-record counts are aggregated separately from ingredient-matched FDA NDC Directory records; package records listed above are associated with the linked SPL; and the normalized concept hierarchy comes from NLM RxNorm.

For canonical ingredient pages, bounded product-attributed indication and administration excerpts may be added to the AI evidence, and the generator is instructed to preserve available product, brand, route, and form qualifiers instead of treating one label as universal. Where a section is identified as AI-written, its plain-language text is generated from bounded label evidence. New draft drug pages remain in the admin review queue before first publication. Northwestern Memorial HealthCare is the representative DailyMed label linked for verification and dates; it is not the sole source used for the page.

This is general education, not medical advice — always consult your doctor or pharmacist about your medications and any medical condition. For the exact wording of the linked representative label, view that label on DailyMed; some displayed composite sections may come from other in-scope SPL labels. Learn how we use AI and our data sources & update cadence.