Medication for hypothyroidism

Medication for hypothyroidism can be manufactured by one company but distributed by another company, which means the name on the package might not be the same as the PIL information. The information below will state when medication for hypothyroidism is the same product from different companies (e.g. Northstar distribute a Teva 25mcg tablet and Accord own Actavis and Almus). This can be confusing but if you note down the ingredients for the product that suits you, you will always know which generic (non-branded) is best for you.

Some of the Patient Information Leaflets (PIL) have been obtained from the MHRA website.

Feedback on medication for hypothyroidism

Be aware that we have received feedback from people who are finding they have adverse reactions when they are given a different brand of levothyroxine .  We are also aware of at least two countries (France and New Zealand) where, as a result of pressure from thyroid patients and support organisations, the prescribing of specific brands has been stopped.

On checking it seems that lactose has been replaced by mannitol in some brands of medication for hypothyroidism and it appears that this may be what is causing the adverse reactions in some people.

If this happens to you, check the Patient Information Leaflet (PIL) first to see whether the ingredients in the new brand are different from your previous brand of medication for hypothyroidism.  If so, ask your pharmacy to give you your usual brand and see if this helps.

You should always try to be aware of whether you have been given the same brand as usual and always check the PIL as the box may say one company but the PIL may say a different one.

If the new brand causes adverse reactions and it contains mannitol, then please fill out an MHRA (The Medicines and Healthcare products Regulatory Agency) Yellow Card as this informs the MHRA of any adverse effects in medication for hypothyroidism.  If they receive a lot about one particular medication, they will investigate.

Read more information about the MHRA Yellow Card Scheme

Download this article for printing or to read offline [PDF]

Index of medication for hypothyroidism

Levothyroxine

Levothyroxine tablets

Advanz

ManufacturerAdvanz
Product NameEltroxin – 25mcg, 50mcg, 100mcg Tablets
Emailenquiries@advanzpharma.com
IngredientsAnhydrous levothyroxine sodium, sodium citrate, lactose, maize starch, powdered acacia, magnesium stearate
PIL25mcg: https://tinyurl.com/svyqwcs
50 & 100 mcg: https://tinyurl.com/wvydd3y  
ManufacturerAdvanz
Product NameLevothyroxine – 25mcg, 50mcg, 100mcg Tablets
Emailenquiries@advanzpharma.com
IngredientsAnhydrous levothyroxine sodium, sodium citrate, lactose, maize starch, powdered acacia, magnesium stearate
PIL25mcg: https://tinyurl.com/svyqwcs
50 & 100mcg: https://tinyurl.com/wyym2kg

Actavis/Accord

ManufacturerActavis/Accord
Product NameLevothyroxine – 50mcg, 100mcg Tablets
Emailmedinfo@accord-healthcare.com
IngredientsAnhydrous levothyroxine sodium, lactose, magnesium stearate, maize starch, pregelatinised maize starch, stearic acid
CommentsExactly the same product as Almus and Northstar generic licence tablet numbers: 50mcg: 0142/0104 and 100mcg: 0142/0105
PILhttps://www.medicines.org.uk/emc/files/pil.5805.pdf

Almus/Accord

ManufacturerAlmus/Accord
Product NameLevothyroxine – 50mcg, 100mcg Tablets
Emailmedinfo@accord-healthcare.com
IngredientsAnhydrous levothyroxine sodium, lactose, magnesium stearate, maize starch, pregelatinised maize starch, stearic acid
CommentsExactly same product as Actavis and Northstar 50mcg &100mcg
PILhttps://www.medicines.org.uk/emc/files/pil.5805.pdf

Northstar/Accord

ManufacturerNorthstar/Accord
Product NameLevothyroxine – 50mcg, 100mcg Tablets
Emailmedinfo@accord-healthcare.com
IngredientsAnhydrous levothyroxine sodium, lactose, magnesium stearate, maize starch, stearic acid, pre-gelatinised maize starch
CommentsExactly same product as Actavis and Almus 50mcg & 100mcg
PILhttps://www.medicines.org.uk/emc/files/pil.5805.pdf

Northstar/Teva

ManufacturerNorthstar/Teva
Product NameLevothyroxine (Northstar/Teva) – 25mcg Tablets
Emailmedinfo@tevauk.com
IngredientsLevothyroxine sodium, maize starch, mannitol (E421), microcrystalline cellulose, sodium citrate, acacia, magnesium stearate
CommentsExactly same product as Teva 25mcg
PILhttps://tinyurl.com/upaejp3

Teva

ManufacturerTeva
Product NameLevothyroxine – 12.5mcg, 25mcg 50mcg, 75mcg, 100mcg Tablets (Lactose Free)
Emailmedinfo@tevauk.com
IngredientsLevothyroxine sodium, maize starch, mannitol (E421), microcrystalline cellulose, sodium citrate, acacia, magnesium stearate
Comments25mcg is the exact same product as Northstar 25mcg
PILhttps://tinyurl.com/upaejp3

Wockhardt

ManufacturerWockhardt
Product NameLevothyroxine – 25mcg Tablets
EmailDrug.Safety@wockhardt.co.uk
IngredientsLevothyroxine sodium, lactose, sucrose (fine powder), maize starch, magnesium stearate
PILhttps://tinyurl.com/vaw45wc  

Aristo

ManufacturerAristo
Product NameLevothyroxine – 100mcg Tablets (Lactose-Free)
Emailinfo@aristo-pharma.de
IngredientsAnhydrous levothyroxine sodium, microcrystalline cellulose, maize starch, heavy magnesium oxide, sodium starch glycolate type A, magnesium stearate
PILhttps://tinyurl.com/wyhg8pr  

Levothyroxine Oral Solutions

Advanz

ManufacturerAdvanz
Product NameEltroxin Oral Solution – 25mcg, 50mcg, 100mcg per 5ml (Lactose Free)
Emailenquiries@advanzpharma.com
Websitehttps://www.advanzpharma.com/
IngredientsLevothyroxine sodium (each 5ml of oral solution contains levothyroxine equivalent to levothyroxine sodium anhydrous 25mcg, 50mcg or 100mcg) glycerol, citric acid monohydrate, sodium methyl parahydroxybenzoate (E219), sodium hydroxide, purified water
PILhttps://tinyurl.com/wk4x8uw  
ManufacturerAdvanz
Product NameLevothyroxine Oral Solution – 25 mcg, 50mcg, 100mcg per 5 ml (Lactose-Free)
Emailenquiries@advanzpharma.com
IngredientsLevothyroxine sodium (each 5ml of oral solution contains levothyroxine equivalent to levothyroxine sodium anhydrous 25mcg, 50mcg or 100mcg), glycerol, citric acid monohydrate, sodium methyl parahydroxybenzoate (E219), sodium hydroxide, purified water
PILhttps://tinyurl.com/wk4x8uw  

Creo

ManufacturerCreo
Product NameLevothyroxine Oral Solution – 25mcg, 50mcg, 100mcg, 125mcg per 5ml (Lactose Free)
Emailpv@creopharma.com
IngredientsLevothyroxine sodium (each 5ml of oral solution contains levothyroxine equivalent to levothyroxine sodium anhydrous 25mcg, 50mcg, 100mcg or 125mcg), glycerol, citric acid anhydrous, sodium methyl parahydroxybenzoate (E219), citric acid 10%, purified wáter
PILhttps://www.medicines.org.uk/emc/files/pil.10313.pdf

Teva

ManufacturerTeva
Product NameLevothyroxine Oral Solution – 25mcg, 50mcg, 100mcg per 5ml (Lactose Free +)
Emailmedinfo@tevauk.com
IngredientsLevothyroxine sodium (each 5ml of oral solution contains levothyroxine equivalent to levothyroxine sodium anhydrous 25mcg, 50mcg or 100mcg), glycerol, citric acid monohydrate, sodium methyl parahydroxybenzoate (E219), sodium hydroxide, purified water
PILhttps://tinyurl.com/tmqq3aa

Ten Pharma

ManufacturerTen Pharma
Product NameLevothyroxine Oral Solution – 25 mcg, 50mcg, 100mcg per 5 ml (Lactose-Free)
Emailmedicalinformation@jensongroup.com
IngredientsLevothyroxine sodium (each 5 ml of oral solution contains levothyroxine equivalent to levothyroxine sodium 25mcg, 50mcg or 100mcg), glycerol, citric acid monohydrate, sodium methyl parahydroxybenzoate (E219), sodium propyl parahydroxybenzoate (E217), purified wáter
PIL25mcg: https://tinyurl.com/vxbxfv6
50mcg: https://tinyurl.com/rxqjllc
100mcg: https://tinyurl.com/ww8tk32

Wockhardt

ManufacturerWockhardt
Product NameLevothyroxine Oral Solution – 25mcg, 50 mcg, 100mcg per 5ml (Lactose-Free)
EmailDrug.Safety@wockhardt.co.uk
IngredientsLevothyroxine sodium (each 5ml of oral solution contains levothyroxine equivalent to levothyroxine sodium 25mcg, 50mcg or 100mcg), citric acid monohydrate, sodium methyl parahydroxybenzoate (E219), sodium propyl parahydroxybenzoate, propylene glycol, maltitol liquid, sodium hydroxide, hydrochloric acid, sodium hydroxide, purified wáter
PILhttps://tinyurl.com/vsleb8d

Ethypharm

ManufacturerEthypharm
Product NameCompounded Levothyroxine – Oral Suspension – various strengths and bottle sizes (Lactose-Free)
Emailconnect@ethypharm.com
IngredientsLevothyroxine sodium, mannitol, xanthan gum, parabens, sorbitol syrup, saccharin sodium, ethanol, sterile water
NotesDoctor must write on the prescription the strength, quantity and which filler.  Pharmacist must hold an account with Ethypharm.
ManufacturerEthypharm
Product NameCompounded Levothyroxine –  Capsules – various strengths and pack sizes (Lactose-Free +)
Emailconnect@ethypharm.com
IngredientsLevothyroxine sodium plus one filler (see below) – filler should be discussed with your doctor.
NotesAll the capsules are gelatin capsules and may contain a variety of fillers (see below) although they may not all be available. The doctor must write on the prescription the strength, quantity and which filler. The pharmacist must hold an account with Ethypharm.
·    lactose
·    avicel cellulose
·    calcium carbonate
·    mannitol
·    calcium phosphate
·    calcium carbonate

Roseway

ManufacturerRoseway
Product NameCompounded Levothyroxine Thyroid Suspension (Lactose-Free)
Emailinfo@rosewaylabs.com
IngredientsLevothyroxine, almond oil, silica gel, cellulose, vitamin E acetate
NotesA prescription medication that must state strength per ml of T4. 30mls of medication will have the required dosage calibrated to a 1ml dose. The shelf life is 30 days and the medication does not need to be refrigerated  

European Levothyroxine (not licensed in the UK)

Aliud Pharma

ManufacturerALIUD ® PHARMA
Product NameL-Thyroxin – 50mcg, 100mcg Tablets (Lactose-Free)
Emailinfo@aliud.de
IngredientsAnhydrous levothyroxine sodium (each tablet contains either 50mcg or 100mcg of levothyroxine sodium), microcrystalline cellulose, magnesium stearate (vegetable origin), colloidal silicon dioxide, pre-gelatinised starch (from maize), talcum
NotesObtainable by pharmacists holding an account with IDIS. PIL inside the box will be in German

Henning (Sanofi-Aventis)

ManufacturerHenning (Sanofi-Aventis)
Product NameL-Thyroxin – various strengths from 25mcg – 200mcg Tablets (Lactose-Free)
Emailmedinfo.de@sanofi.com
IngredientsLevothyroxine sodium, corn starch, pre-gelatinised starch (maize), microcrystalline cellulose, sodium carbonate, sodium thiosulphate (Ph. Eur.), highly dispersed silica, hydrogenated castor oil
NotesThis product is produced by the German branch but the UK company is very helpful (Tel: 01483 505515)
PILhttps://tinyurl.com/wfpbgz9 (in German)

  

Merck

ManufacturerMerck
Product NameEuthyrox – 25mcg, 50mcg, 75mcg, 88 mcg, 100mcg, 112mcg, 125mcg, 137mcg, 150mcg, 175mcg, 200mcg Tablets (Lactose Free)
Emailmedical.info.nl@merckgroup.com
IngredientsLevothyroxine sodium, citric acid anhydrous, corn starch, gelatin, magnesium stearate, mannitol, sodium croscarmellose
PILhttps://www.drugs.com/pro/euthyrox.html

American Levothyroxine (not licensed in the UK)

Unithroid

ManufacturerUnithroid
Product NameLevothyroxine –  various strengths between 25mcg – 300mcg Tablets
Emailinquiries@jeromestevens.com  Distributor: info@gemini-labs.com
IngredientsLevothyroxine sodium, synthetic crystalline L-3,31,5,51 – tetraiodothyronine sodium salt [levothyroxine (T4) sodium], colloidal silicon dioxide, lactose, magnesium stearate, microcrystalline cellulose, corn starch, acacia, sodium starch glycolate (See PIL for colouring information)
PILhttps://tinyurl.com/ugj4f9y

Synthroid

ManufacturerSynthroid
Product NameLevothyroxine –  various strengths between 25mcg – 300mcg Tablets
EmailContact form only on the website
Websitehttps://www.synthroid.com/
IngredientsSynthetic crystalline L-3,3′,5,5′- tetraiodothyronine sodium salt [levothyroxine (T4) sodium], acacia, confectioner’s sugar (contains corn starch), lactose monohydrate, magnesium stearate, povidone, talc (See PIL for colouring information)
PILhttp://www.rxabbvie.com/pdf/synthroid.pdf

Tirosint

ManufacturerTirosint
Product NameLevothyroxine – various strengths from 13mcg – 200mcg Gel Capsules (Lactose-Free)
Emailinfo@akrimax.com
IngredientsLevothyroxine sodium, gelatin, glycerin, water
PILhttps://tinyurl.com/rgrj9p3  

Mylan

ManufacturerMylan
Product NameLevothyroxine – various strengths between 25mcg – 300mcg Tablets (Lactose-Free)
Emailmguk_customer.services@mylan.co.uk
IngredientsLevothyroxine sodium, butylated hydroxyanisole, silicon dioxide, crospovidone, magnesium stearate, mannitol, microcrystalline cellulose, povidone, sodium lauryl sulfate, sucrose
PILhttps://tinyurl.com/ula33fc

Liothyronine

UK T3 (Liothyronine) Replacements

The half-life of T3 is one to two days, so you would get the maximum benefit of this after two to three days and the duration of effectiveness is up to three days after stopping T3. 

Advanz

ManufacturerAdvanz
Product NameLiothyronine (Tertroxin) – 20mcg Tablets
Emailenquiries@advanzpharma.com.

Ingredients

Liothyronine sodium, lactose, maize starch, acacia powder, sodium chloride, magnesium stearate, industrial methylated spirit, purified water
CommentsThis only comes in 20mcg tablets, which generally need to be cut in half or quartered for use with thyroxine
PILhttps://tinyurl.com/s6dzo32

Roseway

ManufacturerRoseway
Product NameCompounded Liothyronine Thyroid Suspension (Lactose-Free)
Emailinfo@rosewaylabs.com
IngredientsLiothyronine, almond oil, silica gel, cellulose, vitamin E acetate
NotesA prescription medication that must state strength per ml of T3. 30mls of medication will have the required dosage calibrated to a 1ml dose. The shelf life is 30 days and the medication does not need to be refrigerated

Teva

ManufacturerTeva
Product NameLiothyronine – 20mcg Tablets (Lactose-Free)
Websitewww.tevauk.com
Emailmedinfo@tevauk.com
IngredientsLiothyronine sodium, microcrystalline cellulose, maize starch, pregelatinised starch, colloidal anhydrous silica, magnesium stearate
PILhttps://tinyurl.com/surua9o

Morningside

ManufacturerMorningside
Product NameLiothyronine (Iraskin) – 5mcg, 10mcg, 20mcg Tablets
Emailmedicalenquiry@morningsidehealthcare.com
IngredientsLiothyronine sodium, lactose monohydrate, partially pregelatinised maize starch, spray dried acacia, sodium chloride, magnesium stearate
PILhttps://tinyurl.com/vpczg5j

European T3 (Liothyronine) Replacements

Sanofi-Aventis

ManufacturerSanofi-Aventis
Product NameThybon, Hennings – 20mcg, 100mcg Tablets (Lactose-Free)
Emailmedinfo.de@sanofi.com
IngredientsLiothyronine hydrochloride, pregelatinised starch (corn), corn starch, microcrystalline cellulose, sodium carbonates, sodium thiosulphate 5 H2O (Ph Eur), fumed silica, hydrogenated castor oil
PILhttps://tinyurl.com/u462b8y (in German)

Receptura

ManufacturerReceptura
Product NameSlow Release T3 (compounded) (Lactose-Free)
Emailinfo@receptura.de
IngredientsLiothyronine, hydroxypropylmethyl cellulose. The capsule is made of cellulose.  

Abdi Ibrahim

ManufacturerAbdi Ibrahim
Product NameTiromel – 25mcg Tablets
Emailinfo@abdiibrahim.com.tr
IngredientsLiothyronine sodium, lactose, polyvinylpyrrolidone, starch, magnesium stearate  

American T3 (Liothyronine) Replacements  

King Pharmaceuticals (Pfizer)

ManufacturerKing Pharmaceuticals (Pfizer)
Product NameCytomel – 5mcg, 25mcg, 50mcg Tablets (Lactose Free)
Emailhttp://www.pfizer.com/contact/contact_us_support
Websitehttp://www.pfizer.com/
IngredientsLiothyronine sodium, calcium sulphate, gelatin, corn starch, stearic acid, sucrose, talc
CommentsComes in 5mcg tablets, which some people find much easier.
Pfizer has taken over King Pharmaceuticals.
Note: We have been unable to confirm if King Pharmaceuticals have a TSE certificate which is required for import into the UK
PILhttp://labeling.pfizer.com/ShowLabeling.aspx?id=703

Mylan

ManufacturerMylan
Product NameLiothyronine – 5mcg, 25mcg, 50mcg Tablets (Lactose Free)
Emailmguk_customer.services@mylan.co.uk
IngredientsLiothyronine sodium, calcium sulfate anhydrous, gelatin, pregelatinized starch, stearic acid, sucrose, talc
PILhttps://tinyurl.com/slrudgn  

Mayne Pharma

ManufacturerMayne Pharma
Product NameLiothyronine – 5mcg, 25mcg, 50mcg Tablets (Lactose Free)
Emailmaynepharma@dlss.com
IngredientsLiothyronine sodium, calcium sulfate, microcrystalline cellulose, hypromellose, talc, silicon dioxide
PILhttps://tinyurl.com/wgdtrgp

Synthetic Combination Replacements

Synthetic combinations are not generally available on the NHS in the UK unless you can persuade your GP to prescribe on a “named patient” basis. These may be available from a private doctor (although they usually prefer the natural thyroid). This product would be suitable for people who are allergic to pork and therefore can’t take any of the natural thyroid hormone products.

Roseway

ManufacturerRoseway
Product NameCompounded Levothyroxine plus Liothyronine Thyroid Suspension (Lactose-Free)
Emailinfo@rosewaylabs.com
IngredientsLevothyroxine, liothyronine, almond oil, silica gel, cellulose, vitamin E acetate
NotesA prescription medication that must state strength per ml of T4 and/or T3. 30mls of medication will have the required dosage calibrated to a 1ml dose. The shelf life is 30 days and the medication does not need to be refrigerated

European Brand (not licensed in the UK)

Merck Serono GmbH

ManufacturerMerck Serono GmbH
Product NameNovothyral – 75mcg, 100mcg Tablets
Emailmedicalpartner@merckserono.de
ManufacturersMerck KGaA, Frankfurter Straße 250, 64293 Darmstadt
IngredientsLevothyroxine Sodium (T4), Liothyronine Sodium (T3), Lactose Monohydrate, Maize Starch, Gelatin, Croscarmellose Sodium, Magnesium Stearate
Details1 tablet Novothyral 75mcg contains 75mcg levothyroxine sodium and 15mcg liothyronine sodium
1 tablet Novothyral 100mcg contains 100mcg levothyroxine sodium and 20 mcg liothyronine sodium
PILhttps://tinyurl.com/rlg9vtp   

Natural Thyroid Hormone Replacements

Allergan

ManufacturerAllergan
Product NameArmour Thyroid – various strengths from 15mg (¼ grain) – 300mg (5 grains) Tablets (Lactose Free)
EmailNot known
Websitewww.allergan.com/products/key-products/product-prescribing
IngredientsThyroid tablets, USP (38 mcg levothyroxine (T4) and 9 mcg liothyronine (T3) per 60mg (1 grain) of thyroid), calcium stearate, dextrose, microcrystalline cellulose, sodium starch glycolate, opadry white
DetailsArmour contains approximately 38mcg T4 and 9mcg T3 plus an X factor (something not yet understood). This means that patients taking Armour Thyroid are automatically getting T3 immediately into the system
PILhttps://www.allergan.com/assets/pdf/armourthyroid_pi

RLC Labs

ManufacturerRLC Labs
Product NameNature-Throid® – various strengths from 16.25 mg (¼ grain) – 325mg (5 grains) Tablets
Emailhttp://getrealthyroid.com/get-real-now/contact-us/
IngredientsThyroid USP, colloidal silicon dioxide, dicalcium phosphate, lactose monohydrate*, magnesium stearate, microcrystalline cellulose, croscarmellose sodium, stearic acid, opadry II 85F19316 clear.
* Present in a traceable amount as part of Thyroid USP (diluent).
DetailsNature-Throid® (Thyroid USP) tablets, micro-coated, easy to swallow with a reduced odour, for oral use are natural preparations derived from porcine thyroid glands (T3 liothyronine is approximately four times as potent as T4 levothyroxine on a microgram for microgram basis). They provide 38 mcg levothyroxine (T4) and 9 mcg liothyronine (T3) for each 65 mg (1 Grain) of the labelled content of thyroid
PILhttps://getrealthyroid.com/assets/docs/Nature-Throid-Prescribing-Information.pdf  
ManufacturerRLC Labs
Product NameWP Thyroid – various strengths from 16.25 mg
(¼ grain) – 130mg (2 grains) Tablets
Emailhttp://getrealthyroid.com/get-real-now/contact-us/
IngredientsThyroid USP, inulin, medium-chain triglycerides , lactose monohydrate*
*Present in a traceable amount as part of Thyroid USP (diluent)
DetailsWP Thyroid tablets are natural preparations derived from porcine thyroid glands. (T3 liothyronine is approximately four times as potent as T4 levothyroxine on a microgram for microgram basis.) They provide 38 mcg levothyroxine (T4) and 9 mcg liothyronine (T3) for each 65 mg (1 Grain) of the labelled content of thyroid
PILhttps://getrealthyroid.com/assets/docs/WP-Thyroid-Prescribing-Information.pdf

Acella

ManufacturerAcella
Product NameNP Thyroid – 30mg, 60mg, 90mg, 120mg Tablets (Lactose Free)
Emailnpthyroid@acellapharma.com.
Ingredients38 mcg levothyroxine (T4) and 9 mcg liothyronine (T3) per grain of thyroid (or per 60 mg of the labelled amount of thyroid), calcium stearate, dextrose (agglomerated), mineral oil
PILhttps://npthyroid.com/wp-content/uploads/2018/03/AC-015_NPThyroid_WebPI.pdf  

ERFA (ECI2012)

ManufacturerERFA (ECI2012)
Product NameTHYROID® – 30mg, 60mg, 125mg Tablets
EmailGeneral Questions: info@ECI2012.net
Medical Questions: psq@ECI2012.net
IngredientsThyroid tablets, USP (35 mcg levothyroxine (T4) and 8 mcg liothyronine (T3) per 60mg (1 grain) of thyroid), desiccated thyroid containing lactose, derived from porcine thyroid glands, cornstarch, magnesium stearate, sugar, talc
DetailsGluten , paraben, sulfite and tartrazine-free
PILhttp://eci2012.net/wp-content/uploads/2015/11/Thyroid-Product-Monograph-En-PCR-15-084.pdf 

Date updated: 15/04/21 (V2.9) Review date:  05/03/22

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