Overview of Tirosint: A Unique Levothyroxine Formulation

Research suggests this is a reasonable and effective alternative

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Tirosint is a unique brand of levothyroxine that is hypoallergenic and comes in a soft gel capsule.

There is also a liquid formulation of Tirosint, called Tirosint-Sol, although it's not yet available due to recent FDA approval. 

Who Its For

Tirosint was designed for people with allergies to fillers and dyes found in levothyroxine tablets. The soft gel capsules contain no dyes, gluten, alcohol, lactose, or sugar. In fact, besides T4, Tirosint contains only three other inactive ingredients: gelatin, glycerin, and water. 

In addition to those with allergies, Tirosint has been found particularly effective in treating people with hypothyroidism who also have certain digestive conditions like celiac disease, Crohn's disease, or atrophic gastritis. Due to intestinal absorption issues, these conditions make traditional levothyroxine tablets less effective—in other words, Tirosint seems to bypass the malabsorption problems.

Along the same line, Tirosint offers benefit to people whose typical levothyroxine tablets are interfered with by their breakfast food and/or morning coffee.

In fact, Tirosint appears to be "coffee-resistant" and, according to researchers, may be used to achieve a target TSH level (and proper medication absorption) in people who are unwilling or unable to change the way they take their levothyroxine.

Interestingly, even in people who do not drink coffee within an hour of taking their medication, TSH testing suggests that people may be achieving better absorption using Tirosint (both the gel capsules and liquid form), as compared to levothyroxine in tablet form.

Possible Side Effects

According to the Food and Drug Administration, Tirosint may cause heart problems, including an increased heart rate, chest pain, and an irregular heartbeat, as well as weak or brittle bones. Your risk of developing these heart and/or bone problems may be higher if you are elderly or take too much Tirosint.

If you have diabetes, Tirosint may make it harder to control your blood sugar levels. In this case, your doctor may have to alter your diabetes treatment regimen and monitor you more closely.

If your doctor prescribes Tirosint, be sure to review all possible side effects, as well as provide your doctor with a list of all your current medications, vitamins, and supplements.


Tirosint cannot be crushed, chewed, or cut, and the available ten doses include:

  • 13 mcg
  • 25 mcg
  • 50 mcg
  • 75 mcg
  • 88 mcg
  • 100 mcg
  • 112 mcg
  • 125 mcg
  • 137 mcg
  • 150 mcg

Patient Programs

Tirosint is marketed and distributed by Akrimax Pharmaceuticals and manufactured by IBSA Institute Biochimique, a privately-owned, global pharmaceutical company headquartered in Lugano, Switzerland. The U.S. contact location for Akrimax is in Cranford, New Jersey.

Patient Assistance Program

The Akrimax Patient Assistance Program is available to patients who meet specific income requirements, and those who are eligible can receive Tirosint for free for up to one year, with monthly Tirosint shipments by mail to eligible patients. Patients can re-enroll in the program after one year of participation. 

Direct Program

The Akrimax Direct program offers patients the option for direct mail ordering of prescription Tirosint. The pharmacy handling the program (Linden Care) will determine whether your insurance copay or the cash price is the lowest cost option. This includes the value of the Tirosint coupon currently available for Tirosint at the Tirosint website.

You can receive your medication by standard USPS delivery for free (it usually takes five days) or by Federal Express overnight or second-day delivery at additional cost.

A Word From Verywell

Tirosint may be a sensible alternative for you, especially if you are not tolerating or absorbing traditional levothyroxine formulations.

If you are switching to Tirosint, though, be sure to follow closely with your doctor. After switching formulations, you will need to have a blood test after six weeks to ensure you are on the proper dose.

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