Tirosint Side Effects: What the FDA Label Lists | Dose Track
[Side effects · Tirosint]

Tirosint side effects

levothyroxine sodium capsules · once-daily oral soft-gel capsule, 13 mcg to 200 mcg · Label checked

Short answer: The Tirosint label says its side effects are mainly those of too much thyroid hormone (overdosage): fast or irregular heartbeat, palpitations, nervousness, trouble sleeping, tremor, heat intolerance, excess sweating, weight loss, diarrhea, headache and changes in menstrual periods. It gives no percentages. Tirosint has a boxed warning that it must not be used for obesity or weight loss.

What Tirosint is approved for: Tirosint is approved for adults and children 6 years and older as replacement therapy for hypothyroidism from any cause (thyroid, pituitary or hypothalamic, present at birth or acquired), and as an add-on to surgery and radioiodine to suppress TSH in TSH-dependent well-differentiated thyroid cancer. It is not approved to suppress benign thyroid nodules or nontoxic goiter in people with enough iodine, or for short-term hypothyroidism during recovery from subacute thyroiditis (section 1).

Source
TIROSINT (levothyroxine sodium) capsules, for oral use, prescribing information and Patient Information. IBSA Pharma. DailyMed, version published March 27, 2026. DailyMed setid 7a7ade79-0165-4e31-b84e-667416c00c7e

Does Tirosint have a boxed warning?

Boxed warning

WARNING: NOT FOR TREATMENT OF OBESITY OR FOR WEIGHT LOSS

Thyroid hormones, including Tirosint, should not be used to treat obesity or for weight loss, alone or with other drugs. In people with normal thyroid function, usual doses do not cause weight loss, and larger doses can cause serious or even life-threatening toxicity, especially with stimulant appetite suppressants.

What are the most common Tirosint side effects?

These are the label's own numbers from the Adverse Reactions section. Where the label compares with placebo (a dummy treatment), both columns are shown, so you can see how much more often a reaction happened on Tirosint.

Listed in the Adverse Reactions section (no frequencies given) [Section 6]
Body systemReactions the label lists
Generalfatigue, increased appetite, weight loss, heat intolerance, fever, excessive sweating
Central nervous systemheadache, hyperactivity, nervousness, anxiety, irritability, emotional lability, insomnia
Musculoskeletaltremors, muscle weakness, muscle spasm
Cardiovascularpalpitations, tachycardia, arrhythmias, increased pulse and blood pressure, heart failure, angina, myocardial infarction, cardiac arrest
Respiratorydyspnea
Gastrointestinaldiarrhea, vomiting, abdominal cramps, elevations in liver function tests
Dermatologichair loss, flushing, rash
Endocrinedecreased bone mineral density
Reproductivemenstrual irregularities, impaired fertility

The label says adverse reactions with Tirosint are primarily those of hyperthyroidism due to therapeutic overdosage. It gives no percentages and no placebo comparison.

Other numbers in the Adverse Reactions section

  • Section 6

    Seizures have been reported rarely when levothyroxine is started.

  • Section 6

    In children, pseudotumor cerebri (raised pressure around the brain) and slipped capital femoral epiphysis (a hip growth-plate problem) have been reported. Overtreatment can cause early closure of the skull bones in infants and of growth plates in children, which can reduce adult height.

  • Section 6

    Allergic-type reactions to inactive ingredients have occurred with thyroid hormone products: hives, itching, rash, flushing, swelling (angioedema), stomach symptoms, fever, joint pain, serum sickness and wheezing. The label says allergy to levothyroxine itself is not known to occur.

  • Section 17

    Partial hair loss may occur rarely during the first few months of Tirosint therapy, and the label says it is usually temporary.

What serious risks does the Tirosint label warn about?

The Warnings and Precautions part of the label lists these. Each line gives the label's heading and what it means in plain words.

  • Section 4

    Who should not use it. Tirosint is not used by people with uncorrected adrenal insufficiency.

  • Section 5.1

    Heart effects in older people and people with heart disease. Overtreatment can raise heart rate, heart wall thickness and strength of contraction, and may bring on chest pain (angina) or irregular heartbeat. These people start at lower doses. If heart symptoms develop or worsen, the label says the dose is reduced or held for one week and restarted lower.

  • Section 5.2

    Myxedema coma. Myxedema coma is a life-threatening emergency in which absorption from the gut is unpredictable. Oral thyroid hormone is not recommended for it; intravenous thyroid hormone is used instead.

  • Section 5.3

    Adrenal crisis with untreated adrenal insufficiency. Thyroid hormone speeds the clearance of steroid hormones. Starting it before steroid replacement can trigger an acute adrenal crisis, so adrenal insufficiency is treated with glucocorticoids first.

  • Section 5.4

    Too much or too little thyroid hormone. Tirosint has a narrow therapeutic index. Overtreatment or undertreatment can affect growth, the heart, bones, fertility, thinking, mood, digestion and blood sugar and fat levels, so the dose is titrated carefully and drug and food interactions are watched.

  • Section 5.5

    Worse blood sugar control in diabetes. Adding levothyroxine may worsen blood sugar control and raise diabetes medicine or insulin needs.

  • Section 5.6

    Bone loss from over-replacement. Too much levothyroxine can increase bone breakdown and lower bone density, especially after menopause. The label calls for the lowest dose that achieves the desired response.

When does the label say to call your doctor?

From the Patient Counseling Information (section 17) that comes with Tirosint:

  • Rapid or irregular heartbeat, chest pain, shortness of breath, leg cramps, headache, nervousness, irritability, sleeplessness or tremors: notify your healthcare provider.
  • Change in appetite, weight loss, vomiting, diarrhea, excessive sweating, heat intolerance, fever, changes in menstrual periods, hives or skin rash, or any other unusual medical event: notify your healthcare provider.
  • Diabetes: check blood sugar closely after starting, changing or stopping Tirosint (Patient Information).

How do I keep track of side effects in Dose Track?

Dose Track has a side-effect log. Each entry records the symptom, a severity (none, mild, moderate, severe or life-threatening), the date and an optional note, and can be tied to a specific dose or logged on its own. The history screen shows what you logged over time, which makes it easier to tell your prescriber when a reaction started and whether it is easing. The app records what you enter; it does not judge whether a symptom is serious. For anything on the label's call-your-doctor list, call your doctor.

This page is what the FDA label says, in plain words. It is not medical advice. Follow your prescriber, and ask them or your pharmacist about anything here.

Side effects for similar medicines

Frequently asked questions

What are the most common side effects of Tirosint?+
The label says they are mainly signs of too much thyroid hormone: fast or irregular heartbeat, nervousness, trouble sleeping, tremor, heat intolerance, sweating, weight loss, diarrhea and menstrual changes (section 6). It gives no percentages.
Does Tirosint have a boxed warning?+
Yes. Like all thyroid hormones, Tirosint has a boxed warning that it is not for treating obesity or for weight loss, and that large doses can cause serious or life-threatening toxicity.
Can Tirosint cause hair loss?+
The label says partial hair loss may occur rarely during the first few months of therapy and is usually temporary (section 17).
Is Tirosint different from Synthroid in side effects?+
Both labels list the same kind of reactions, mainly from too much thyroid hormone, with no percentages (section 6). Tirosint is a soft-gel capsule rather than a tablet.
Can you be allergic to Tirosint?+
The label says allergy to levothyroxine itself is not known to occur, but reactions to inactive ingredients in thyroid hormone products have been reported (section 6).