Application 210831

Type
ANDA
Sponsor
AMNEAL PHARMS LLC

Application Products#

Product, Drug, Ingredient table
ProductDrugIngredientFormStrengthReference drugReference standard
001LEVOTHYROXINE SODIUMLEVOTHYROXINE SODIUMTABLET;ORAL0.025MGNoNo
002LEVOTHYROXINE SODIUMLEVOTHYROXINE SODIUMTABLET;ORAL0.05MGNoNo
003LEVOTHYROXINE SODIUMLEVOTHYROXINE SODIUMTABLET;ORAL0.075MGNoNo
004LEVOTHYROXINE SODIUMLEVOTHYROXINE SODIUMTABLET;ORAL0.088MGNoNo
005LEVOTHYROXINE SODIUMLEVOTHYROXINE SODIUMTABLET;ORAL0.1MGNoNo
006LEVOTHYROXINE SODIUMLEVOTHYROXINE SODIUMTABLET;ORAL0.112MGNoNo
007LEVOTHYROXINE SODIUMLEVOTHYROXINE SODIUMTABLET;ORAL0.125MGNoNo
008LEVOTHYROXINE SODIUMLEVOTHYROXINE SODIUMTABLET;ORAL0.137MGNoNo
009LEVOTHYROXINE SODIUMLEVOTHYROXINE SODIUMTABLET;ORAL0.15MGNoNo
010LEVOTHYROXINE SODIUMLEVOTHYROXINE SODIUMTABLET;ORAL0.175MGNoNo
011LEVOTHYROXINE SODIUMLEVOTHYROXINE SODIUMTABLET;ORAL0.2MGNoNo
012LEVOTHYROXINE SODIUMLEVOTHYROXINE SODIUMTABLET;ORAL0.3MGNoNo

Orange Book products#

Application-product, Trade name, Ingredient table
Application-productTrade nameIngredientStrengthDosage form / routeTE codesRLD / RSApproval date
A210831-001LEVOTHYROXINE SODIUMLEVOTHYROXINE SODIUM0.025MGTABLET / ORAL2019-02-19
A210831-002LEVOTHYROXINE SODIUMLEVOTHYROXINE SODIUM0.05MGTABLET / ORAL2019-02-19
A210831-003LEVOTHYROXINE SODIUMLEVOTHYROXINE SODIUM0.075MGTABLET / ORAL2019-02-19
A210831-004LEVOTHYROXINE SODIUMLEVOTHYROXINE SODIUM0.088MGTABLET / ORAL2019-02-19
A210831-005LEVOTHYROXINE SODIUMLEVOTHYROXINE SODIUM0.1MGTABLET / ORAL2019-02-19
A210831-006LEVOTHYROXINE SODIUMLEVOTHYROXINE SODIUM0.112MGTABLET / ORAL2019-02-19
A210831-007LEVOTHYROXINE SODIUMLEVOTHYROXINE SODIUM0.125MGTABLET / ORAL2019-02-19
A210831-008LEVOTHYROXINE SODIUMLEVOTHYROXINE SODIUM0.137MGTABLET / ORAL2019-02-19
A210831-009LEVOTHYROXINE SODIUMLEVOTHYROXINE SODIUM0.15MGTABLET / ORAL2019-02-19
A210831-010LEVOTHYROXINE SODIUMLEVOTHYROXINE SODIUM0.175MGTABLET / ORAL2019-02-19
A210831-011LEVOTHYROXINE SODIUMLEVOTHYROXINE SODIUM0.2MGTABLET / ORAL2019-02-19
A210831-012LEVOTHYROXINE SODIUMLEVOTHYROXINE SODIUM0.3MGTABLET / ORAL2019-02-19

openFDA label cross-check#

Cross-check layer: openFDA label JSON enriches search and identifies hydration gaps. The DailyMed Structured Product Label remains the canonical label presentation on FDA.report.

Brand, Generic, Manufacturer table
BrandGenericManufacturerSPL set IDEffective dateAvailable safety fieldsJoin
Levothyroxine SodiumLEVOTHYROXINE SODIUMCoupler LLC55f4c679-86cb-b97f-e063-6294a90ad5ef2026-07-06Boxed warning, Warnings, Adverse reactionsName fallback
Levothyroxine SodiumLEVOTHYROXINE SODIUMCoupler LLC55f67831-4680-edbf-e063-6294a90a1d362026-07-06Boxed warning, Warnings, Adverse reactionsName fallback
Levothyroxine SodiumLEVOTHYROXINE SODIUMBryant Ranch Prepack489ffba8-983e-478f-8f62-fe08bf3d0e0b2026-06-23Boxed warning, Warnings, Adverse reactionsName fallback
Levothyroxine SodiumLEVOTHYROXINE SODIUMCoupler LLC544d67eb-8487-cb5d-e063-6394a90a31102026-06-15Boxed warning, Warnings, Adverse reactionsName fallback
levothyroxine sodiumLEVOTHYROXINE SODIUMBryant Ranch Prepack3b282e57-1009-4d2c-8ca2-9cca9f7919372026-06-12Boxed warning, Warnings, Adverse reactionsName fallback
Levothyroxine SodiumLEVOTHYROXINE SODIUMCoupler LLC53e84179-fe2a-5696-e063-6394a90a85662026-06-10Boxed warning, Warnings, Adverse reactionsName fallback
LEVOTHYROXINE SODIUMLEVOTHYROXINE SODIUMCoupler LLC5383a4d8-319a-5bf6-e063-6294a90a54972026-06-05Boxed warning, Warnings, Adverse reactionsName fallback
Levothyroxine SodiumLEVOTHYROXINE SODIUMNCS HealthCare of KY, LLC dba Vangard Labsabe173cc-1579-43a5-b12d-a31958d0a5392026-06-04Boxed warning, Warnings, Adverse reactionsName fallback
Levothyroxine SodiumLEVOTHYROXINE SODIUMCardinal Health 107, LLC66a3bd4a-770b-4f67-bfa7-6d5e23f2ecbf2026-06-04Boxed warning, Warnings, Adverse reactionsName fallback
Levothyroxine SodiumLEVOTHYROXINE SODIUMCoupler LLC53316e75-9897-4935-e063-6294a90a94cf2026-06-01Boxed warning, Warnings, Adverse reactionsName fallback
Levothyroxine SodiumLEVOTHYROXINE SODIUMBryant Ranch Prepack5852d874-1ebc-49ff-b6c2-1dd513fca7842026-05-27Boxed warning, Warnings, Adverse reactionsName fallback
Levothyroxine SodiumLEVOTHYROXINE SODIUMA-S Medication Solutionsc8ae9dc4-836f-4912-80d7-684fd374f40a2026-05-27Boxed warning, Warnings, Adverse reactionsName fallback
Levothyroxine SodiumLEVOTHYROXINE SODIUMCoupler LLC52cce695-4363-8a2c-e063-6294a90a1bbf2026-05-27Boxed warning, Warnings, Adverse reactionsName fallback
Levothyroxine SodiumLEVOTHYROXINE SODIUMCoupler LLC52cd19e4-a4b3-ecee-e063-6394a90ac33b2026-05-27Boxed warning, Warnings, Adverse reactionsName fallback
Levothyroxine SodiumLEVOTHYROXINE SODIUMBryant Ranch Prepackdb5cba81-9ad5-42ad-ac9e-a967337630f22026-05-22Boxed warning, Warnings, Adverse reactionsName fallback
Levothyroxine SodiumLEVOTHYROXINE SODIUMBryant Ranch Prepackd9ccea69-109d-44cf-927b-4ff67652b6a02026-05-22Boxed warning, Warnings, Adverse reactionsName fallback
Levothyroxine sodiumLEVOTHYROXINE SODIUMPreferred Pharmaceuticals Inc.4f40db1e-3dd9-4c7b-93e6-64f0fd10d5512026-05-21Boxed warning, Warnings, Adverse reactionsName fallback
Levothyroxine SodiumLEVOTHYROXINE SODIUMBryant Ranch Prepack50978a14-fd72-4c76-927f-667a1f097b872026-05-21Boxed warning, Warnings, Adverse reactionsName fallback
levothyroxine sodiumLEVOTHYROXINE SODIUMPreferred Pharmaceuticals, Inc.eb53dc23-8337-497e-b466-192f905563ed2026-05-21Boxed warning, Warnings, Adverse reactionsName fallback
Levothyroxine sodiumLEVOTHYROXINE SODIUMPreferred Pharmaceuticals Inc.6d65b528-f52b-4b5d-8b76-46fbd4576f992026-05-21Boxed warning, Warnings, Adverse reactionsName fallback

Boxed warning cross-check#

openFDA text is shown for search and cross-checking; DailyMed SPL is canonical.

boxed warning

WARNING: NOT FOR TREATMENT OF OBESITY OR FOR WEIGHT LOSS Thyroid hormones, including levothyroxine sodium tablets, either alone or with other therapeutic agents, should not be used for the treatment of obesity or for weight loss. In euthyroid patients, doses within the range of daily hormonal requirements are ineffective for weight reduction. Larger doses may produce serious or even life-threatening manifestations of toxicity, particularly when given in association with sympathomimetic amines such as those used for their anorectic effects [see Adverse Reactions (6), Drug Interactions ( 7.7 ), and Overdosage ( 10 )] . WARNING: NOT FOR TREATMENT OF OBESITY OR FOR WEIGHT LOSS See full prescribing information for complete boxed warning. Thyroid hormones, including levothyroxine sodium tablet, should not be used for the treatment of obesity or for weight loss. Doses beyond the range of daily hormonal requirements may produce serious or even life-threatening manifestations of toxicity ( 6 , 10 ).

Warnings cross-check#

openFDA text is shown for search and cross-checking; DailyMed SPL is canonical.

warnings and cautions

5 WARNINGS AND PRECAUTIONS Serious risks related to overtreatment or undertreatment with levothyroxine sodium tablet : Titrate the dose of levothyroxine sodium tablet carefully and monitor response to titration. ( 5.1 ). Cardiac adverse reactions in the elderly and in patients with underlying cardiovascular disease: Initiate levothyroxine sodium tablet at less than the full replacement dose because of the increased risk of cardiac adverse reactions, including atrial fibrillation. ( 2.3 , 5.2 , 8.5 ) Myxedema coma: Do not use oral thyroid hormone drug products to treat myxedema coma. ( 5.3 ) Acute adrenal crisis in patients with concomitant adrenal insufficiency: Treat with replacement glucocorticoids prior to initiation of levothyroxine sodium tablet treatment. ( 5.4 ) Worsening of diabetic control: Therapy in patients with diabetes mellitus may worsen glycemic control and result in increased antidiabetic agent or insulin requirements. Carefully monitor glycemic control after starting, changing, or discontinuing thyroid hormone therapy. ( 5.5 ) Decreased bone mineral density associated with thyroid hormone over-replacement: Over-replacement can increase bone resorption and decrease bone mineral density. Give the lowest effective dose. ( 5.6 ) 5.1 Serious Risks Related to Overtreatment or Undertreatment with Levothyroxine sodium tablets Levothyroxine sodium tablet has a narrow therapeutic index. Overtreatment or undertreatment with Levothyroxine sodium tablets may have negative effects on growth and development, cardiovascular function, bone metabolism, reproductive function, cognitive function, gastrointestinal function, and glucose and lipid metabolism in adult or pediatric patients. In pediatric patients with congenital and acquired hypothyroidism, undertreatment may adversely affect cognitive development and linear growth, and overtreatment is associated with craniosynostosis and acceleration of bone age [see Use in Specific Populations ( 8.4 )] . Titrate the dose of Levothyroxine sodium tablets carefully and monitor response to titration to avoid these effects [see Dosage and Administration ( 2.4 )] . Consider the potential for food or drug interactions and adjust the administration or dosage of Levothyroxine sodium tablets as needed [see Dosage and Administration ( 2.1 ), Drug Interactions ( 7.1 ), and Clinical Pharmacology ( 12.3 )] . 5.2 Cardiac Ad...

Adverse reactions cross-check#

openFDA text is shown for search and cross-checking; DailyMed SPL is canonical.

adverse reactions

6 ADVERSE REACTIONS Adverse reactions associated with levothyroxine sodium tablets therapy are primarily those of hyperthyroidism due to therapeutic overdosage [see Warnings and Precautions ( 5 ) and Overdosage ( 10 )] . They include the following: General: fatigue, increased appetite, weight loss, heat intolerance, fever, excessive sweating Central nervous system: headache, hyperactivity, nervousness, anxiety, irritability, emotional lability, insomnia Musculoskeletal: tremors, muscle weakness, muscle spasm Cardiovascular: palpitations, tachycardia, arrhythmias, increased pulse and blood pressure, heart failure, angina, myocardial infarction, cardiac arrest Respiratory: dyspnea Gastrointestinal: diarrhea, vomiting, abdominal cramps, elevations in liver function tests Dermatologic: hair loss, flushing, rash Endocrine: decreased bone mineral density Reproductive: menstrual irregularities, impaired fertility Seizures have been reported rarely with the institution of levothyroxine therapy. Adverse Reactions in Pediatric Patients Pseudotumor cerebri and slipped capital femoral epiphysis have been reported in pediatric patients receiving levothyroxine therapy. Overtreatment may result in craniosynostosis in infants who have not undergone complete closure of the fontanelles, and in premature closure of the epiphyses in pediatric patients still experiencing growth with resultant compromised adult height. Hypersensitivity Reactions Hypersensitivity reactions to inactive ingredients have occurred in patients treated with thyroid hormone products. These include urticaria, pruritus, skin rash, flushing, angioedema, various gastrointestinal symptoms (abdominal pain, nausea, vomiting and diarrhea), fever, arthralgia, serum sickness, and wheezing. Hypersensitivity to levothyroxine itself is not known to occur. Adverse reactions associated with levothyroxine sodium tablets therapy are primarily those of hyperthyroidism due to therapeutic overdosage: arrhythmias, myocardial infarction, dyspnea, muscle spasm, headache, nervousness, irritability, insomnia, tremors, muscle weakness, increased appetite, weight loss, diarrhea, heat intolerance, menstrual irregularities, and skin rash. ( 6 ) To report SUSPECTED ADVERSE REACTIONS, contact Lupin Pharmaceuticals, Inc. at 1-800-399-2561 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

NDC Listings For This Application#

NDC, Name, Nonproprietary name table
NDCNameNonproprietary nameLabelerMarketing categoryStatus
69238-1163Levothyroxine SodiumLevothyroxine SodiumAmneal Pharmaceuticals NY LLCANDACurrent
69238-1163Levothyroxine SodiumLevothyroxine SodiumAmneal Pharmaceuticals NY LLCANDACurrent
69238-1164Levothyroxine SodiumLevothyroxine SodiumAmneal Pharmaceuticals NY LLCANDACurrent
69238-1164Levothyroxine SodiumLevothyroxine SodiumAmneal Pharmaceuticals NY LLCANDACurrent
69238-1168Levothyroxine SodiumLevothyroxine SodiumAmneal Pharmaceuticals NY LLCANDACurrent
69238-1168Levothyroxine SodiumLevothyroxine SodiumAmneal Pharmaceuticals NY LLCANDACurrent
69238-1169Levothyroxine SodiumLevothyroxine SodiumAmneal Pharmaceuticals NY LLCANDACurrent
69238-1169Levothyroxine SodiumLevothyroxine SodiumAmneal Pharmaceuticals NY LLCANDACurrent
69238-1177Levothyroxine SodiumLevothyroxine SodiumAmneal Pharmaceuticals NY LLCANDACurrent
69238-1177Levothyroxine SodiumLevothyroxine SodiumAmneal Pharmaceuticals NY LLCANDACurrent
69238-1178Levothyroxine SodiumLevothyroxine SodiumAmneal Pharmaceuticals NY LLCANDACurrent
69238-1178Levothyroxine SodiumLevothyroxine SodiumAmneal Pharmaceuticals NY LLCANDACurrent
69238-1183Levothyroxine SodiumLevothyroxine SodiumAmneal Pharmaceuticals NY LLCANDACurrent
69238-1183Levothyroxine SodiumLevothyroxine SodiumAmneal Pharmaceuticals NY LLCANDACurrent
69238-1275Levothyroxine SodiumLevothyroxine SodiumAmneal Pharmaceuticals NY LLCANDACurrent
69238-1275Levothyroxine SodiumLevothyroxine SodiumAmneal Pharmaceuticals NY LLCANDACurrent
69238-1276Levothyroxine SodiumLevothyroxine SodiumAmneal Pharmaceuticals NY LLCANDACurrent
69238-1276Levothyroxine SodiumLevothyroxine SodiumAmneal Pharmaceuticals NY LLCANDACurrent
69238-1277Levothyroxine SodiumLevothyroxine SodiumAmneal Pharmaceuticals NY LLCANDACurrent
69238-1277Levothyroxine SodiumLevothyroxine SodiumAmneal Pharmaceuticals NY LLCANDACurrent
69238-1278Levothyroxine SodiumLevothyroxine SodiumAmneal Pharmaceuticals NY LLCANDACurrent
69238-1278Levothyroxine SodiumLevothyroxine SodiumAmneal Pharmaceuticals NY LLCANDACurrent
69238-1279Levothyroxine SodiumLevothyroxine SodiumAmneal Pharmaceuticals NY LLCANDACurrent
69238-1279Levothyroxine SodiumLevothyroxine SodiumAmneal Pharmaceuticals NY LLCANDACurrent