A fixed combination of 2 drugs in one pill.
Sold as Thyrolar.
A combination is graded by its riskiest ingredient: each part of the score is the lowest of the ingredients' scores. This grade answers one narrow question: how strong is the public evidence and safety record behind this drug, and how clean is its money trail and court record? It is not a verdict on whether the drug is right for you.
Ingredients with a page of their own link to it: the FDA label, side-effect reports, recalls, evidence, and payments behind this grade are there.
Score breakdown (62/100)
Safety ×35%
C
Evidence ×25%
F
Regulatory ×15%
B
Money & lawsuits ×15%
B
Options ×10%
C
Safety: 70
Graded by its riskiest ingredient, levothyroxine (70)
Carries an FDA boxed warning, the strongest warning the FDA issues (-30)
1,386 FDA reports naming it as the suspect drug per million Medicare fills, 0.5x the median drug on this site
Death share in reports is near or below the FAERS average (0.8x)
Evidence: 21
Graded by its riskiest ingredient, liothyronine (21)
28 randomized trials and 4 systematic reviews/meta-analyses indexed in PubMed
No Cochrane review found (-5)
Only 15% of completed registered trials posted results (-15)
'Drug ineffective' is the single most-reported item about this drug in FAERS (-5)
Regulatory history: 80
Graded by its riskiest ingredient, levothyroxine (80)
Recalls since 2016: 0 Class I, 68 Class II, 2 Class III across 20 generic makers (-7)
9 label changes approved since 2021: the safety story is still moving (-8)
Label lists recent major changes to warnings or indications (-5)
Money & lawsuits: 85
Graded by its riskiest ingredient, levothyroxine (85)
Pharma paid doctors $579,638 tied to this drug last year (-15)
Not named in any pending federal MDL
Options: 70
Graded by its riskiest ingredient, levothyroxine (70)
Generic versions approved (20 applications)
No same-class alternatives found: little leverage to switch (-30)
Money and lawsuits
In 2024, drug companies reported $0 in payments to US physicians and hospitals tied to this combination's brands across 0 transactions.
No pending federal MDL names this combination or its brands.
The ingredients' own payments and lawsuits are on their pages and already count toward this grade.
Who takes it and what it costs
Not in the Medicare Part D spending file.
Questions to ask your prescriber
This is a fixed combination of levothyroxine and liothyronine. Why both together, instead of only the one I need?
This drug carries a boxed warning. Which specific risk does it cover, and does it apply to me?
The most-reported problems in FDA's adverse event data are fatigue, nausea, diarrhoea, headache. How would we recognize and handle those?
Off-label use is among the most-reported items for this drug. Is my use on-label, and if not, what evidence supports it?
What result are we expecting, by when, and what is the plan if it does not happen?
If 100 people like me took this drug, how many would actually get better because of it, and how many would be harmed by it? (Doctors call these the number needed to treat and the number needed to harm.)
The most-reported problems in FDA's adverse event data are fatigue, headache, nausea. How would we recognize and handle those?