Levoxyl may cause choking and gagging when the thyroid hormone is not swallowed with a full glass of water, the drug’s manufacturer and the Food and Drug Administration (news - web sites) warned Tuesday. Jones Pharma Inc., a subsidiary of Bristol, Tenn.-based King Pharmaceuticals, issued a letter warning doctors that the thyroid hormone replacement can rapidly swell and disintegrate, catching in patients’ throats and causing difficulty swallowing.