Levothroid (2025): Availability, Official Info, and NZ Alternatives
You typed a brand name and want straight answers, not a maze. Here’s the reality: Levothroid was a levothyroxine brand that’s now off the US market, and it’s not supplied in New Zealand. If you came here looking for the official label, whether you can still get it, and what to use instead (without messing up your TSH), this gives you the shortest path to action-plus safe switching tips that line up with what endocrinologists and regulators recommend.
What you’ll get here: the fastest way to verify brand status and pull the last official prescribing info; the NZ‑specific route to funded alternatives; and a practical playbook for switching brands or moving from a US script to a local one. No fluff, just the steps that matter.
Fast paths to the right Levothroid info (2025)
If you need to confirm what the brand was, whether it’s still around, and where to grab the official label, do this in order. It’s the same flow I use when helping friends who bring a US bottle to an Auckland pharmacy and hit a wall.
Confirm brand status (US): Check the US FDA’s Orange Book listing and archived drug records. Levothroid’s US discontinuation was reported years ago, and it hasn’t come back. The FDA Orange Book and DailyMed archives are the authoritative sources for status and last-approved labels.
Pull the last US label (archived): DailyMed keeps archived product labels. The Levothroid label tells you essentials like: approved uses (replacement therapy in hypothyroidism; TSH suppression in thyroid cancer); contraindications (untreated adrenal insufficiency; acute MI); and standard dosing principles (weight-based for full replacement; low and slow for cardiac disease and elderly). It’s worth reading the old label if you’re converting a dose from a US script.
Cross-check with up-to-date guidance: For practical dosing and monitoring, use clinical guidelines. The American Thyroid Association’s hypothyroidism guideline (2014; reaffirmed with updates and statements since) remains the reference clinicians lean on: start around 1.6 micrograms/kg/day for full replacement in healthy, non-elderly adults; use 12.5-25 microgram starts if older or cardiac; recheck TSH about 6-8 weeks after any dose or brand change.
New Zealand specifics (2025): Medsafe publishes the NZ data sheets and Consumer Medicine Information for levothyroxine products (e.g., Eltroxin and generic levothyroxine). The NZ Formulary (NZF) sets current clinical advice nationally. PHARMAC’s Schedule shows which brands and strengths are funded. These three sources answer nearly everything an NZ doctor or pharmacist will ask.
Pharmacy call script (if you’re holding a US bottle): When you ring your pharmacy, give: generic name (levothyroxine sodium), your daily dose in micrograms, and your brand history. Ask for a consistent NZ brand supply. Then book a TSH check 6-8 weeks after any switch. That one phone call avoids most of the back-and-forth.
Why this order? Status first (so you don’t chase a unicorn). Label next (so you know the exact indications and contraindications). Then the NZ playbook to actually get your tablets in hand.
Two quick safety notes, straight from regulators and endocrine guidance: levothyroxine is a narrow therapeutic index drug-stick to one brand when you can; if you switch brands or formulations, get a TSH (and free T4 if advised) in 6-8 weeks to re‑titrate. That simple habit prevents months of feeling “off.”
Is Levothroid available in New Zealand? What to use instead
Short answer: no. In NZ, you’ll be dispensed levothyroxine sodium under local brands (commonly Eltroxin, or a funded generic), not Levothroid. The active ingredient is the same: levothyroxine. What differs are excipients and manufacturing, and that can subtly change absorption in some people-which is why brand consistency matters.
Here’s how to navigate it cleanly in New Zealand right now.
What to ask for: “Levothyroxine sodium [your dose in micrograms] daily” with a note to maintain brand consistency once stable. If your GP includes “do not substitute” after you settle on a brand, pharmacies are less likely to switch you during stock changes.
Common NZ strengths: 25, 50, 75, 100, 125, 150, 200 micrograms. If you’re on a non‑NZ strength (e.g., 88 mcg in the US), your pharmacist will match the closest using available tablets-often combining tablets. Don’t split brands to make a single day’s dose.
Funding and availability: Check the PHARMAC Schedule for funded levothyroxine brands and any brand-switch notices. If a brand change is mandated, plan a TSH check at 6-8 weeks after the switch. NZF and Medsafe data sheets will flag any formulation changes that matter (like tablet scoring, lactose content, or dye differences).
How to take it so it actually works: Take levothyroxine on an empty stomach, same time daily. Either 30-60 minutes before breakfast with water, or at bedtime at least 3-4 hours after your last meal. Keep a 4‑hour gap from calcium, iron, magnesium, and some multivitamins. Coffee right after the tablet can reduce absorption; give it a buffer.
Common interactions and gotchas:
Iron, calcium, antacids, bile acid binders, and some phosphate binders bind levothyroxine in the gut-space them by 4 hours.
Large soy intake and high‑fiber supplements can blunt absorption; be consistent with diet or adjust dose with your clinician.
Biotin (often in hair/nail supplements) can distort thyroid blood tests-stop it 48-72 hours before labs. This lab interference warning has been highlighted by the FDA and endocrine societies for years.
Amiodarone, carbamazepine, phenytoin, rifampicin, sertraline, and estrogen therapy can change dose needs-your doctor may adjust based on labs.
Who needs a different start: If you’re over 60, have coronary artery disease, arrhythmias, or a recent MI, start low (12.5-25 micrograms/day) and go slow. The ATA guidance and NZF echo this to avoid provoking angina or arrhythmias.
Pregnancy and postpartum: Levothyroxine is safe and essential in pregnancy. Most people need a dose increase early in the first trimester (often 20-30% more). A common practical move is to add two extra tablets per week as soon as pregnancy is confirmed, then get TSH/FT4 checked promptly and every 4 weeks in the first half of pregnancy. Postpartum, dose usually returns to pre‑pregnancy levels, with labs to confirm. These patterns are well described in ATA guidance and standard obstetric endocrinology practice.
Infants and children: Doses are weight‑based and higher per kg, especially in congenital hypothyroidism. Early adequate dosing is crucial for neurodevelopment. NZF and pediatric endocrine guides give age‑tiered dosing ranges and close monitoring schedules.
Thyroid cancer follow‑up: When levothyroxine is used to suppress TSH after thyroid cancer, targets are different (often lower TSH). That’s a specialist‑guided plan; don’t extrapolate from standard hypothyroidism targets.
What if you’ve been fine on a US supply? You can’t reliably “keep it going” in NZ with Levothroid. The safer route is to transfer to a stable, funded NZ brand and lock in labs 6-8 weeks later. My own Auckland circle learned the hard way during a pharmacy brand shuffle in 2019: consistency beats wishful thinking.
Red flags to act on quickly: chest pain, a new fast or irregular heartbeat, severe anxiety, heat intolerance, or tremor after a dose increase or brand switch-call for medical advice sooner rather than later. On the flip side, stubborn fatigue, constipation, weight gain, and feeling cold after a decrease or switch usually means you need a dose tweak confirmed by labs.
Switching safely: dosing, monitoring, and quick answers
Here’s the clean, no‑drama method used by thyroid clinicians when converting brands or moving countries.
Match the micrograms: Levothyroxine is converted microgram for microgram between brands as a starting point. If your US tablet was 88 mcg and NZ doesn’t have that strength, your pharmacist may use a 75 + 12.5 combo (or closest practical pair). Keep it one brand if possible.
Lock in timing and habits: Take it the same way every day-same hour, same empty‑stomach rules. If you change your routine (start calcium, new multivitamin, new coffee timing), mention it when labs are checked.
Book the stability check: Test TSH (and free T4 if your clinician prefers) 6-8 weeks after any brand change or dose change. That window matches the hormone’s half‑life and tissue steady state. Testing too early leads to bad decisions; waiting months leaves you feeling lousy.
Adjust in small steps: Typical step sizes are 12.5-25 micrograms at a time, then re‑check in 6-8 weeks. Big jumps create symptoms and overshoot.
Stay with the winner: Once you feel well and labs are stable, don’t swap brands for convenience. If your pharmacy has a forced switch, ask for a supply of the same brand or set a plan to re‑test after the switch.
Quick checklists you can screenshot:
Take-it-right checklist
Empty stomach, same time daily.
Water only; coffee after a buffer.
Keep 4 hours from calcium, iron, magnesium, or multivitamins.
Hold biotin 2-3 days before blood tests.
Store tablets cool, dry, away from sunlight; don’t use past expiry.
Switching checklist
Microgram‑for‑microgram match to a single NZ brand.
Note the new brand and color/markings; photograph the box.
Book labs for 6-8 weeks after switch.
Track symptoms: energy, sleep, heart rate, heat/cold tolerance, weight change.
Avoid splitting daily dose across different brands.
When to call your doctor sooner
New chest pain, fast/irregular pulse, tremor, severe anxiety, or insomnia after a dose change.
Pregnant or trying-dose changes are time‑sensitive.
Infant dosing issues (spit‑up, refusal, growth concerns).
TSH wildly off target, or symptoms not matching labs.
Mini‑FAQ (the things people ask right after a brand change)
Do I need a brand, or is generic fine? Consistency is the key. Many people do well on a funded generic if they stay on it. If you feel off after a mandated brand change, lab‑confirm and adjust. Both Medsafe and the NZF recognize that some patients are sensitive to formulation differences.
How fast will I feel better? It’s gradual. Some notice improvement in 1-2 weeks; full steady‑state effects line up with that 6-8 week lab window.
Missed dose-now what? If you remember the same day, take it when you remember. If it’s almost time for the next dose, skip and resume. One missed dose won’t derail you; don’t triple up.
Can I take it at night? Yes-if you keep it truly on an empty stomach (3-4 hours after the last meal). Some people absorb it better at bedtime. Pick a time and stick to it.
Weight changes my dose, right? Often, yes. Full replacement in healthy adults commonly starts near 1.6 micrograms/kg/day, then is individualized. Major weight changes can shift needs-worth re‑checking TSH.
Is levothyroxine safe in breastfeeding? Yes. It replaces a natural hormone and is considered compatible with breastfeeding. Doses are tuned to keep your TSH in range.
My tablet looks different this month. Should I worry? Verify the brand and strength on the box. If the brand changed, mark your calendar and book a lab in 6-8 weeks. If the brand is the same but the color changed, pharmacies sometimes change suppliers temporarily-still worth noting.
What about combination therapy (T4+T3)? Standard care is T4 alone (levothyroxine). A small subset may trial combination therapy under specialist guidance. The ATA and NZF reserve this for selected cases after careful counseling and close monitoring.
Where all this comes from: the US FDA labeling archive (for the old Levothroid specifics), DailyMed (for historical product info), Medsafe and the NZ Formulary (for current NZ products and dosing), and the American Thyroid Association’s clinical guidance on hypothyroidism and pregnancy. These sources align on the big-ticket items: brand consistency, careful monitoring after changes, and patient‑specific dosing.
If you’re reading this in Auckland and juggling real life-kids’ lunches, the commute on a wet Monday, and a pharmacy queue-make it easy on yourself: settle on one NZ brand, take it the same way each day, set a reminder for your 6-8 week check after any change, and keep notes on how you feel. That routine beats guesswork every time.
