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.

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

Answered by Dr. Brian Staiger, PharmD
Medical Content Reviewed By HelloPharmacist
Staff
Last updated Apr 16, 2025
Key points
- Levothyroxine tablets can be crushed or split, but you have to be very careful when doing so.
- Levothyroxine is dosed in very small amounts (micrograms), and small changes in dose can produce very different responses in individuals.
- Alternative dosage forms of levothyroxine exist, which may be better options than crushing or splitting tablets.
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.
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Dr. Brian Staiger, PharmD
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