Can You Crush Or Split Levothyroxine Tablets?

In our latest question and answer, the pharmacist discusses whether or not levothyroxine tablets can be crushed or split.

3 min read Updated Jun 2026 Read by 20,549 people
Can You Crush Or Split Levothyroxine Tablets?
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Andrea asked

I am having some trouble taking my levothyroxine tablets. Is it okay to crush them?

Jun 06, 2022
The quick answer
  • You can crush or split levothyroxine tablets, but even small amounts of material loss during the process can significantly affect how the medication works since levothyroxine is dosed in very small amounts. If you do crush levothyroxine, mix the powder with a small amount of soft food like applesauce or pudding rather than liquid to make sure you get the full dose. Levothyroxine is available in other easier-to-take forms such as capsules or solutions, so ask your pharmacist if your dose is available in one of these alternatives.
A quick summary of Dr. Brian Staiger, PharmD's full answer below, condensed by AI from that answer only (not from any outside source). The pharmacist's answer is the source of record.
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Hello and thank you for your question! This is a two-pronged answer. First off, yes, you can crush or split levothyroxine tablets. Doing so does not affect the drug in any negative way. However, I generally recommend against it since levothyroxine is dosed in such low amounts.

It is dosed in micrograms, which is 1/1000th of 1 milligram so small changes in dosage can result in big differences in how you respond to the medication.

Be Careful Crushing Or Splitting Levothyroxine Tablets

When you crush or split any tablet, there is bound to be at least a little material loss of the tablet from the process.

This is especially true if you are then mixing the crushed or split tablet with a liquid (it's hard to ensure you are taking all of the tablet contents).

You really must ensure you are taking the full dose, so you want to be careful to take the medication in a way that ensures you are doing that.

I really emphasize this since, as I said in the section above, levothyroxine dosages are so small. Even a small adjustment in dose can produce very different results in individuals.

If you want to crush or split levothyroxine, again, it won't affect the actual drug, but be sure you then take it in a way that ensures you are receiving the full dose.

The ideal way to take the powder of a crushed tablet is not to mix it in water or juice, since you generally have some of the tablet contents sticking to the side of the glass/cup.

Nevertheless, if this is your preferred method, use a very little amount of water (10-15 mL, or around one tablespoon), mix the powder in the water, and drink. Then, rinse the cup with the same amount of water and drink again to be sure you are getting as much of the powder as you can.

You generally want to mix or sprinkle the contents of the crushed tablet on a portion of solid food, like pudding, jello, or applesauce. This way, you can be sure you are ingesting all of the crushed tablet.

Alternative Options?

Some individuals have trouble swallowing solid dosage forms, especially tablets, and based on your question, it seems like you fall into that category.

If you can crush your levothyroxine tablet and ensure you are taking all of the tablet powder, you can certainly do that.

However, I recommend you try the other dosage forms levothyroxine is available.

Along with being available as a tablet, it is also available in the following dosage forms:

  • Capsule
  • Solution

Capsules are often much easier to swallow than tablets and solutions are generally easier still.

Ask your doctor or pharmacist if the dose you take is available in one of these alternative dosage forms.

Final Words

Thanks again for your question!

We get many regarding crushing medications and are always happy to answer.

As it concerns levothyroxine tablets, it's an interesting case because, on the surface, it is fine to do so as it is not an extended or modified-release drug, but there are the concerns that I outlined above.

References & sources
  1. Levothyroxine Prescribing Information — AccessFDA
  2. A Review of the Pharmacokinetics of Levothyroxine for the Treatment of Hypothyroidism — PubMed
  3. Levothyroxine Monograph — NIH
Glossary — Terms in This Answer
Levothyroxine
A synthetic thyroid hormone medication used to treat thyroid hormone deficiency.
Micrograms
A unit of measurement equal to one millionth of a gram, used for very small drug doses.
Dosage
The amount of medication prescribed to be taken at one time or over a period of time.
Tablet
A solid, compressed form of medication that is typically swallowed whole.
Extended-release
A medication formulation designed to release the drug slowly over an extended period rather than all at once.
Modified-release
A medication formulation designed to release the drug at a specific time or location in the body rather than immediately.
Dosage forms
The different physical shapes and formats in which a medication can be prepared, such as tablets, capsules, or liquids.
Solution
A liquid medication where the drug is dissolved in a liquid base for easier administration.
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Dr. Brian Staiger, PharmD
About the pharmacist

Dr. Brian Staiger, PharmD

Clinical Pharmacy

Doctor of Pharmacy, board certified clinical pharmacist (BCPS), American Herbalist Guild, Medication Therapy Management certified

Brian Staiger, PharmD, BCPS, is a licensed pharmacist with more than 13 years of experience across retail pharmacy, clinical pharmacy, medication safety, pharmacy program development, and healthcare administration. He is the founder of HelloPharmacist.com, where he helps patients...

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