France’s highest court has ordered European drugmaker Merck KGaA to pay more than $3.6 million to patients who received a thyroid drug Levothyrox (levothyroxine sodium) with diminished quality following a change in its formulation.  

In 2017, the company removed lactose and added mannitol and citric acid to the drug’s formulation to make it easier to tolerate.

But patients complained of diminished efficacy and side effects, which included dizziness, headaches, memory loss, extreme fatigue, hair loss, digestive problems, muscle cramps, depression — and even thyroid cancer.

Per the ruling, the company will pay each of the 3,330 plaintiffs more than $1,100 in damages.