Approved Hospital Formulary
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Approved Hospital Formulary
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levothyroxine
levothyroxine
- Formulary
- Restricted Ermeza --> restricted to pedatrics and adults when crushing tablets is not appropriate.
- Non-formulary Tirosint-Sol --> all strengths.
- Therapeutic Interchange
| Drug Name | Form | Strength | Formulary Unrestricted | Formulary Restricted | Non-Formulary | Interchange |
|---|---|---|---|---|---|---|
| Synthroid | POWDER FOR INJECTION, INJECTABLE | 200 mcg (0.2 mg), 500 mcg (0.5 mg) | ||||
| Tirosint-Sol | SOLUTION, ORAL | 13 mcg/1 mL, 25 mcg/1 mL, 50 mcg/1 mL, 75 mcg/1 mL, 88 mcg/1 mL, 100 mcg/1 mL, 112 mcg/1 mL, 125 mcg/1 mL, 137 mcg/1 mL | ||||
| Thyquidity | SOLUTION, ORAL | 100 mcg/5 mL | ||||
| Ermeza | SOLUTION, ORAL | 150 mcg/5 mL | ||||
| Tirosint-Sol | SOLUTION, ORAL | 150 mcg/1 mL, 175 mcg/1 mL, 200 mcg/1 mL | ||||
| Euthyrox | TABLET, ORAL | 25 mcg, 50 mcg, 75 mcg, 88 mcg, 100 mcg,112 mcg, 125 mcg | ||||
| Levo-T | TABLET, ORAL | 25 mcg, 50 mcg, 75 mcg, 100 mcg, 125 mcg, 150 mcg, 200 mcg | ||||
| Levotabs | TABLET, ORAL | 25 mcg, 50 mcg, 75 mcg, 100 mcg, 125 mcg, 150 mcg, 200 mcg | ||||
| Synthroid, Leveothroid, Levoxyl, Unithroid | TABLET, ORAL | 25 mcg, 50 mcg, 75 mcg, 88 mcg, 100 mcg, 112 mcg, 125 mcg | ||||
| Eltroxin | TABLET, ORAL | 50 mcg, 100 mcg, 150 mcg, 200 mcg, 300 mcg | ||||
| Synthroid, Leveothroid, Levoxyl, Unithroid | TABLET, ORAL | 137 mcg, 150 mcg, 175 mcg, 200 mcg, 300 mcg | ||||
| Euthyrox | TABLET, ORAL | 150 mcg, 175 mcg, 200 mcg, 300 mcg | ||||
| Levo-T | TABLET, ORAL | 300 mcg | ||||
| Levotabs | TABLET, ORAL | 300 mcg |
Last updated: Sep. 25, 2023
- Black Box Warning: Treatment of obesity or weight loss
Synthroid is approved for sample use in HH Endocrinology and Diabetes Clinics.
Levothyroxine Solutions:
Ermeza will be utilized as the preferred levothyroxine oral liquid formulary product. Use will be restricted to pediatric patients and adults who are not candidates for crushing the tablet formulation of levothyroxine.
Thyquidity & Tirosint-Sol - Non-Formulary. Automatic interchange to Ermeza at a 1:1 ratio. (These formulations may be utilized in drug shortage situations if needed.)
Reviewed: 27 Aug 19 (Tirosint-Sol), July 2023 (Ermeza & Thyquidity)
Updated: July 2023 (Tirosint-Sol)
Levothyroxine Oral Solution Update