How to Help Your Patients Find Tirosint in Stock: A Provider's Guide

Your patient needs Tirosint. Their pharmacy doesn't have it. Now they're calling your office — frustrated, anxious, and possibly running low on their thyroid medication. It's a scenario playing out in endocrinology and primary care practices across the country.

Tirosint (Levothyroxine Sodium capsules, IBSA Pharma) occupies a unique niche in hypothyroidism management. Its gel capsule formulation with minimal excipients makes it the preferred option for patients with absorption challenges, excipient sensitivities, or difficult-to-stabilize TSH levels. But that niche status also makes it harder to find than generic Levothyroxine tablets.

This guide gives you a practical, step-by-step approach to helping your patients maintain access to Tirosint — and what to do when they can't find it.

Current Availability

Tirosint is not in a formal shortage as recognized by the FDA or ASHP. IBSA Pharma continues to manufacture both Tirosint capsules (12 strengths, 13-200 mcg) and Tirosint-SOL oral solution (15 strengths, 13-200 mcg). An authorized generic capsule is also available through YARAL Pharma.

The challenge is at the pharmacy level. Many retail pharmacies — especially large chains — don't routinely stock Tirosint because prescription volume is low relative to generic Levothyroxine tablets. Patients often encounter "out of stock" responses not because there's a supply problem, but because their pharmacy simply doesn't carry it.

Why Patients Can't Find Tirosint

Understanding the root causes helps you guide patients more effectively:

• Low pharmacy demand: Most hypothyroid patients are on generic Levothyroxine tablets. Pharmacies stock based on demand, so Tirosint may not be on their regular order list.
• Single brand manufacturer: Only IBSA Pharma makes brand Tirosint. The authorized generic from YARAL Pharma adds supply, but the total production volume remains smaller than the tablet market.
• Insurance friction: Prior authorization requirements and step therapy protocols mean fewer patients fill Tirosint at retail, further reducing pharmacy stocking incentive.
• Patient timing: Patients who wait until the last minute to refill compound the problem — there's no buffer time for ordering.

What Providers Can Do: 5 Steps

Step 1: Direct Patients to Medfinder

The most immediate action you can take is to point patients toward Medfinder. This tool checks real-time pharmacy availability for Tirosint across multiple locations. Patients can search by zip code and find pharmacies that currently have their medication in stock.

Consider adding Medfinder to your patient education materials or after-visit summaries for patients on Tirosint or other hard-to-find medications.

Step 2: Recommend Independent and Specialty Pharmacies

Independent pharmacies are often more willing to special-order Tirosint and maintain ongoing supply for regular patients. Build a list of independent pharmacies in your area that reliably stock or can order Tirosint, and share this with patients proactively.

Step 3: Connect Patients With the Tirosint Direct Program

IBSA Pharma's Tirosint Direct Program offers mail-order Tirosint at fixed pricing:

• $65 for a 30-day supply
• $170 for a 90-day supply

This program bypasses local pharmacy availability entirely. It's particularly valuable for patients in rural areas or those who've had repeated difficulty at retail pharmacies. Information is available at tirosint.com.

Step 4: Consider Tirosint-SOL as an Alternative

If capsules are unavailable, Tirosint-SOL (oral solution) may be in stock. It contains the same active ingredient, is made by the same manufacturer, and offers additional dosing flexibility with 15 strengths including 37.5 mcg, 44 mcg, and 62.5 mcg. A new prescription is needed — pharmacies cannot substitute capsules for solution without a prescriber order.

Step 5: Proactively Manage Refill Timing

Encourage patients to refill 7-10 days before running out. If your EHR supports it, set prescription refill reminders. For patients with a history of fill difficulties, consider writing 90-day prescriptions to reduce the frequency of fill attempts.

Alternatives When Tirosint Is Unavailable

When a patient truly cannot access Tirosint in any form, the following alternatives may be appropriate. Always consider the clinical reason the patient was originally placed on Tirosint before switching:

• Authorized Generic (YARAL Pharma): Same gel cap formulation, same inactive ingredients. Closest 1:1 substitution. Ask the pharmacy to check availability.
• Synthroid: Widely available brand-name Levothyroxine tablet. Contains multiple excipients including lactose and dyes. Not ideal for patients with absorption concerns or excipient sensitivities.
• Levoxyl: Another brand-name Levothyroxine tablet option.
• Generic Levothyroxine Tablets: Most affordable option ($4-$20/month). Available from multiple manufacturers. Suitable for patients without specific absorption or sensitivity concerns.
• Armour Thyroid: Desiccated thyroid (T4 + T3). Fundamentally different from Levothyroxine monotherapy. Reserve for patients who may benefit from combination T4/T3 therapy.

After any switch, recheck TSH in 6-8 weeks and monitor for clinical symptoms of under- or over-replacement. For more detail on these options, see our guide to Tirosint alternatives.

Workflow Tips for Your Practice

Streamline Tirosint management in your practice with these workflow suggestions:

• Flag Tirosint patients in your EHR: Use a problem list note or medication comment to flag patients on Tirosint so staff can proactively check availability at refill time.
• Pre-write prior authorizations: Have a templated PA letter documenting the clinical rationale for Tirosint (absorption issues, excipient allergy, GI conditions, TSH instability on tablets). This speeds up the process when insurers require it.
• Create a handout: Develop a patient-facing handout with Tirosint fill tips, including the Medfinder link (medfinder.com/providers), Tirosint Direct Program information, and the Copay Savings Card details.
• Establish a backup plan: During the initial visit, discuss with the patient what alternative they'd prefer if Tirosint becomes temporarily unavailable. Document this in the chart.
• Connect patients to savings: The Tirosint Copay Savings Card can reduce costs to as low as $25/month. The IBSA Patient Assistance Program provides free medication for eligible patients. Share these resources proactively — see our provider's guide to saving patients money on Tirosint.

Final Thoughts

Tirosint access challenges are unlikely to disappear in 2026, but with the right systems in place, you can minimize disruption for your patients. The combination of Medfinder for real-time availability, the Tirosint Direct mail-order program, and proactive refill management covers most scenarios.

For a broader look at the Tirosint supply landscape, read our provider shortage briefing. And for patient-facing content you can share, direct patients to our guide to finding Tirosint in stock.