Tirosint-Sol

[helvella]

A new levothyroxine product is being launched in the USA on March 1 2019 - Tirosint-Sol. It is a liquid levothyroxine in small white ampoules.

Tirosint®-SOL Use & Important Product Information

TIROSINT®-SOL (levothyroxine sodium) oral solution, is a prescription medicine that contains a hormone called levothyroxine which is normally produced in your body by the thyroid gland. It is meant to replace the hormone to treat a condition called hypothyroidism. TIROSINT-SOL is not for use in people with temporary hypothyroidism caused by thyroiditis, or inflammation of the thyroid gland.

tirosintsol.com/

TIROSINT-SOL oral solution is a clear, colorless to slightly yellow solution supplied in a 1 mL white, non-transparent, unit-dose ampule and is available in the following strengths (mcg/mL): 13, 25, 50, 75, 88, 100, 112, 125, 137, 150, 175, 200. The inactive ingredients in TIROSINT-SOL are glycerol and water

tirosintsol.com/wp-content/...

[shaws]

Interesting and hopeful if it is the fillers/binders etc that affect some people badly.

[TSH110]

Much better choice of strengths than tablet forms which is interesting.

[SilverAvocado in reply to TSH110]

I thought that. I wonder why. Is it maybe cheaper to do different strengths in this format?

[helvella in reply to SilverAvocado]

The price of Synthroid in the USA is waaaaay higher than any levothyroxine in the UK.

Even the awkward doses like 187.5 (100 + 50 + 25 + 12.5) are cheaper here than as a single tablet of Synthroid.

[helvella in reply to TSH110]

In some countries, a wide range of dosages is common - for example, Synthroid in the USA comes in: 25, 50, 75, 88, 100, 112, 125, 137, 150, 175, 200, 300 microgram tablets.

[TSH110 in reply to helvella]

I never knew that. I wonder why there are so many fewer choices here with the Levo companies

[helvella in reply to TSH110]

There are advantages and disadvantages to having many dosages.

1) The majority of products in many dosages use colourants to distinguish them one from another. (Not Tirosint nor Tirosint-Sol.)

2) Easier to just take one tablet.

3) More difficult to adjust dose - very often needing a complete new prescription.

4) Simpler pharmacy stock management.

[TSH110 in reply to helvella]

Fits in better with the one size fits all brigade 😂🤣😂

Good points, but is not the real reason for taking it to restore the patient to full health not sort of somewhere in that direction give or take 25mcg. Also, if ones dose is properly optimised why would it need frequently chopping and changing? That seems to be happening anyway with slavishly dosing to TSH despite fewer dosing choices.

Good to know we are helping to streamline pharmacy stock keeping through lack of choice. Is it not beyond the wit of man to devise an efficient method

of administration of a wider range of doses to better reflect individual need? It seems all cockeyed to me.

[helvella in reply to TSH110]

Absolutely, 100% agree, the aim should be the best dose for the patient.

I was delighted when Teva re-launched - with their 12.5 microgram dosage tablets potentially providing finer adjustment, easily.

Then I became very jaundiced (as in view not illness ) as the price of 12.5 is higher, by far, than all other dosages. And, when I tried it, even just adding that 12.5 to 100 micrograms of Actavis, I did not like it one little bit.

Chopping and changing day by day might indeed be poor practice. But with multiple tablets, it is usually easier to adjust by a small amount as winter comes, or as it warms up again. Or whatever else affects the required dose. (At least, it should be. So long as we can get prescribed the appropriate selection of tablets to permit that.)

If I were prescribed 125 as a single tablet, I would be unable to cut the dose by a small amount.

[TSH110 in reply to helvella]

Is making smaller tablets really more expensive? I presume it must be as the more hormone on NDT ones the less costly they are.

Pity the smaller dose did not suit you I guess due to the make. I think I preferred activis to the others. I seem to remember you saying that 112mcg suited you better than closest 25mcg multiples. I have often wondered if it might have helped in my case. I am still somewhat disgruntled that relatives felt/feel great on Levo but I recall my deep disappointment as I found it left me wanting even when optimised in the Toft meaning of the word (but perhaps only where TSH/free T4 were concerned) after 9 mths and even 2 years later. I certainly gave it a chance. I used to alternate 120/125 mcg but never liked it - I am a super fast reactor to drugs (genetically as well as experientally - if there is such a word) but not sure it would have been significant - I did feel different pretty fast on taking levothyroxine initially (slightly less deathly within 12 hours!) despite it supposedly building up slowly over 6 weeks. Perhaps if you have none at all it gets grabbed up fast.

I suspect no dose no matter how exactly titrated (ha ha predictive txt just put tortured for titrated how very knowing of it!) on its own would sort me out, being a pesky combination therapy type. The Endo nurse did say my hormone levels were not quite right and I might never feel properly well on being discharged. No mention of T3 or a trial of it.

The maths/accuracy of cutting up a 125 tablet would be challenging beyond 1/4s I’d prefer to 1/5 it - impossible. Will they ever 3D print tablets I wonder. Probably easier and faster to press them.

[Kitten44]

Isn't it the same as the one in Italy? It is called Tirosint Soluzione Orale and comes in little vials in boxes of 30. I was able to get some last year.

[helvella in reply to Kitten44]

It certainly sounds the same.

How was it?

[Kitten44 in reply to helvella]

Well, considering I haven't yet found the optimal dosage, all I can say I certainly had fewer headaches or gastrointestinal issues when I was taking it. It is a big box, and having only 30, it took considerable room in the suitcase.

[danym in reply to Kitten44]

isn't the same as the current Tirosint? what is different?

[helvella in reply to danym]

No gelatine. It must be thinner than the gel inside the Tirosint gel caps.

[danym in reply to Kitten44]

did you think it was more gentle on the stomach than the other meds?

[Kitten44 in reply to danym]

yeah, I think so

[danym in reply to danym]

can it be taken with food since it will be better absorbed? I get stomach burning from the others and would be curious to try this one

[Hidden in reply to Kitten44]

May I ask did you need a prescription or was it over the counter in a pharmacy.

[danym]

isn't the same as the current Tirosint? what is different?

[guysgrams]

It has few inactive ingredients in it unlike the other T4 thyroid hormone. I currently take this, however, it is very costly and they just introduced monthly supply of 30 pills versus the 28 they were providing before. Here in AZ through BCBS Advantage it is not an authorized drug. I have found it to be as high as $144+ for a month's supply and even with an exception from doctor it still was over $90 for one month. Utterly ridiculous.

[helvella in reply to guysgrams]

Are you sure you don't mean "ordinary" Tirosint? This has not yet been launched in the USA.

[guysgrams in reply to helvella]

They are little somewhat translucent pills with a yellowish tint to them. Have no idea if they are the same. Just know what I am taking.

[helvella in reply to guysgrams]

These are white ampoules filled with liquid. Same ingredients but probably more water - or less glycerin.

[danym in reply to helvella]

so how would you take the, just drink them? Wouldn't they burn the esophagus going down? wondering if it could be used sublingual.

[helvella in reply to danym]

I suggest you read the links in my original post.

• To administer TIROSINT-SOL in water, squeeze the contents of one single unit-dose ampule into a glass or cup containing water (2.1)

• To administer TIROSINT-SOL directly, either squeeze it into the mouth OR onto a spoon and immediately consume (2.1)

[Kitten44 in reply to helvella]

the Italian ones were in some sort of alcohol, only 2 ingredients, just that and the levothyroxine. I just opened the vial and drank neat, almost like a shot of vodka!

[helvella in reply to Kitten44]

I am aware of Liotir - which is Liothyronine (T3) - but was unaware of any alcohol-based levothyroxine products.

[danym in reply to Kitten44]

so is glycerol an alcohol? did it burn your mouth? wondering if it would be absorbed sublingual better and not have to ingest it if having stomach issues.

[Kitten44 in reply to danym]

Don't have the box anymore so no idea what exact alcohol it was.

I'm no expert to say anything about sublingual absorption, sorry. I just drank it.

[helvella in reply to danym]

Technically, yes, it is an alcohol.

Glycerin is a trihydroxyalcohol with localized osmotic diuretic and laxative effects. Glycerin elevates the blood plasma osmolality thereby extracting water from tissues into interstitial fluid and plasma. This agent also prevents water reabsorption in the proximal tubule in the kidney leading to an increase in water and sodium excretion and a reduction in blood volume. Administered rectally, glycerin exerts a hyperosmotic laxative effect by attracting water into the rectum, thereby relieving constipation. In addition, glycerin is used as a solvent, humectant and vehicle in various pharmaceutical preparations.

pubchem.ncbi.nlm.nih.gov/co...

[Ivybird]

Hello,

New to the site. Just a quick question, does anyone know how to get Tironsint-Sol in the UK?

Thanks

[helvella in reply to Ivybird]

Quite likely impossible. Unless you have a contact in the USA who can somehow get hold of it and send it to you.

(There is some thought that the same product, albeit under a different name) might be available in Italy. Not entirely sure.)

[Ivybird in reply to helvella]

Thanks

[danym]

has anybody tried it?