| Hypothyroidism
Synthroid vs Tirosint
Side-by-side clinical, coverage, and cost comparison for hypothyroidism.Deep comparison between: Synthroid vs Tirosint with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsTirosint has a higher rate of injection site reactions vs Synthroid based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Tirosint but not Synthroid, including UnitedHealthcare
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Category
Synthroid
Tirosint
At A Glance
Oral
Daily
Synthetic thyroid hormone (T4)
Oral
Daily
Thyroid hormone replacement
Indications
- Hypothyroidism
- Thyroid carcinoma
- Hypothyroidism
- Thyroid carcinoma
Dosing
Hypothyroidism Once daily oral dose on an empty stomach one-half to one hour before breakfast; full replacement starting dose is 1.6 mcg/kg/day in adults (lower starting dose for patients at cardiac risk or geriatric patients); titrate by 12.5 to 25 mcg increments every 4 to 6 weeks based on serum TSH or free-T4; pediatric dosing starts at 10 to 15 mcg/kg/day in neonates and decreases with age.
Thyroid carcinoma Once daily oral dose; dosage is based on the target level of TSH suppression for the stage and clinical status of well-differentiated thyroid cancer.
Hypothyroidism Average full replacement dose approximately 1.6 mcg/kg/day orally once daily on an empty stomach, one-half to one hour before breakfast; dose individualized by age, body weight, cardiovascular status, and clinical response; adjust by 12.5 to 25 mcg increments every 4 to 6 weeks; elderly or cardiovascular patients start at 12.5 to 25 mcg/day.
Thyroid carcinoma TSH generally suppressed to below 0.1 mIU/L; usually requires TIROSINT dose greater than 2 mcg/kg/day; target TSH suppression level may be lower in high-risk tumors.
Contraindications
- Uncorrected adrenal insufficiency
- Uncorrected adrenal insufficiency
Adverse Reactions
Most common Fatigue, increased appetite, weight loss, heat intolerance, fever, excessive sweating, headache, hyperactivity, nervousness, anxiety, irritability, emotional lability, insomnia, tremors, muscle weakness, muscle spasm, palpitations, tachycardia, arrhythmias, increased pulse and blood pressure, dyspnea, diarrhea, vomiting, abdominal cramps, elevated liver function tests, hair loss, flushing, rash, decreased bone mineral density, menstrual irregularities, impaired fertility.
Serious Heart failure, angina, myocardial infarction, cardiac arrest, seizures (rare); in pediatric patients: pseudotumor cerebri, slipped capital femoral epiphysis, craniosynostosis in infants, and premature epiphyseal closure.
Postmarketing Hypersensitivity reactions to inactive ingredients including urticaria, pruritus, skin rash, flushing, angioedema, gastrointestinal symptoms, fever, arthralgia, serum sickness, and wheezing.
Most common Fatigue, increased appetite, weight loss, heat intolerance, fever, excessive sweating, headache, hyperactivity, nervousness, anxiety, irritability, emotional lability, insomnia, tremors, muscle weakness, muscle spasm, palpitations, tachycardia, dyspnea, diarrhea, vomiting, abdominal cramps, elevated liver function tests, hair loss, flushing, rash, decreased bone mineral density, menstrual irregularities, impaired fertility
Serious Arrhythmias, increased pulse and blood pressure, heart failure, angina, myocardial infarction, cardiac arrest, seizures (rare), pseudotumor cerebri and slipped capital femoral epiphysis in children, craniosynostosis in infants, premature closure of epiphyses in children
Hypersensitivity Urticaria, pruritus, skin rash, flushing, angioedema, abdominal pain, nausea, vomiting, diarrhea, fever, arthralgia, serum sickness, wheezing (reactions to inactive ingredients)
Pharmacology
Synthetic T4 (levothyroxine) exerts the same physiologic effect as endogenous thyroxine by binding thyroid receptor proteins in the cell nucleus to activate DNA transcription and protein synthesis; approximately 80% of circulating T3, the predominantly active form, is derived from peripheral deiodination of T4.
Synthetic levothyroxine (T4) that exerts the same physiologic effect as endogenous T4; thyroid hormones control DNA transcription and protein synthesis by diffusing into the cell nucleus and binding thyroid receptor proteins attached to DNA, with physiological actions produced predominantly by T3, approximately 80% of which is derived from T4 by peripheral deiodination.
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Most Common Insurance
Anthem BCBS
Synthroid
- Covered on 5 commercial plans
- PA (0/12) · Step Therapy (0/12) · Qty limit (0/12)
Tirosint
- Covered on 5 commercial plans
- PA (3/12) · Step Therapy (0/12) · Qty limit (0/12)
UnitedHealthcare
Synthroid
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Tirosint
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Synthroid
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (0/3)
Tirosint
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Synthroid.
No savings programs available for Tirosint.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.