Levothyroxine question

[Judyrabbit]

sorry to have to write again. When I visited the endo last week she put my prescription up from 100mg to 100mg/125mg on alternate days. I have just been for my prescription and not only did they give me a different brand of 100mg from Teva to Accord but they then gave me Lockhardt for the 25 mg tablet so two different brands. The thing that the endo said to me was that they should be the same brand. The chemist said it didn’t matter and that at the moment Teva was not making 100mg. I don’t know what to do should I take them or try to get in touch with the dr to give me 50 mg of Accord which I can cut in two. It will also mean that in six weeks time I will have to be tested again because of change of brand! Why is everything so difficult nowadays?

[Jaydee1507 Administrator]

Many health professionals aren't aware about brand differences so don't let that put you off getting what you want.

Go back to the GP for another prescription and phone around chemits before you take it to the one who has what you want. Actually, phone around before you do that, then you will know what your prescription needs to be for.

Your GP can write your preferred brands in the first line of the prescription as per the image attached.

named brand prescription

[beh1]

I take 50 mcg Accord and 25mcg wockhardt. Have done for years. No problem with different brands in my case but I make sure it’s always these brands now for continuity.

[SlowDragon Administrator]

Were you on Teva before

Is this best brand for you

Are you lactose intolerant

The chemist said it didn’t matter and that at the moment Teva was not making 100mg.

They love to make up complete fictional stories…..just because can’t be arsed to supply what you need

Lactose free brands - currently Teva or Vencamil only

Teva makes 25mcg, 50mcg, 75mcg and 100mcg

Many patients do NOT get on well with Teva brand of Levothyroxine.

Teva is lactose free.But Teva contains mannitol as a filler instead of lactose, which seems to be possible cause of problems. Mannitol seems to upset many people, it changes gut biome 

Teva is the only brand that makes 75mcg tablet.

So if avoiding Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half

But for some people (usually if lactose intolerant, Teva is by far the best option)

Vencamil (currently 100mcg only) is lactose free and mannitol free. 25mcg and 50mcg tablets hopefully available from summer 2024

March 2023 - Aristo now called Vencamil

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Other brands that contain lactose

Mercury Pharma make 25mcg, 50mcg and 100mcg tablets 

Mercury Pharma also boxed as Eltroxin. Both often listed by company name on pharmacy database - Advanz

Accord only make 50mcg and 100mcg tablets. Accord is also boxed as Almus via Boots, 

Wockhardt is very well tolerated, but only available in 25mcg tablets. Some people remain on Wockhardt, taking their daily dose as a number of tablets 

Helpful post about different brands

healthunlocked.com/thyroidu...

List of different brands available in U.K.

thyroiduk.org/if-you-are-hy...

Posts that mention Teva

healthunlocked.com/search/p...

Teva poll

healthunlocked.com/thyroidu...

Once you find a brand that suits you, best to make sure to only get that one at each prescription.

Watch out for brand change when dose is increased or at repeat prescription.

Government guidelines for GP in support of patients if you find it difficult/impossible to change brands

gov.uk/drug-safety-update/l...

If a patient reports persistent symptoms when switching between different levothyroxine tablet formulations, consider consistently prescribing a specific product known to be well tolerated by the patient.

academic.oup.com/jcem/artic...

Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).

And here

pharmacymagazine.co.uk/clin...

Discussed here too

healthunlocked.com/thyroidu...

[Milkyway88]

my chemist has changed my Teva to Accord and says they can’t get Teva atm.

[helvella Administrator Thyroid UK]

In an ideal world, yes, should always be the same make. But the world is even further away from ideal than it used to be!

(By the way, dosages of levothyroxine are in micrograms - mcg - not milligrams - mg.)

Because of this imperfection, I wrote a blog on the issues of mixing:

helvella - Mixing Levothyroxine Formulations

A discussion about mixing (and switching) formulations of levothyroxine.

helvella.blogspot.com/p/hel...

helvella's medicines documents (UK and Rest of the World) can be found here:

helvella - Thyroid Hormone Medicines

helvella has created, and tries to maintain, documents containing details of all thyroid hormone medicines in the UK and, in less detail, many others around the world. There is now a specific world desiccated thyroid document.

I highly recommend viewing on a computer screen, or a decent sized tablet, rather than a phone. Even I find it less than satisfactory trying to view them on my phone.

helvella - Thyroid Hormone Medicines - UK

The UK document contains up-to-date versions of the Summary Matrixes for levothyroxine tablets, oral solutions and also liothyronine available in the UK. Includes descriptions of tablet markings which allow identification. Latest updates include all declared ingredients for all UK products and links to Patient Information Leaflets, etc.

dropbox.com/s/bo2jzxucgp9hl...

helvella - World Desiccated Thyroid

Contains details of all known desiccated thyroid products.

dropbox.com/scl/fi/gx6dmz5i...

helvella - Thyroid Hormone Medicines - RotW

Contains details of all levothyroxine, liothyronine and combination products - excluding desiccated thyroid products. Details available vary by country and manufacturer.

The link below takes you to a blog page which has direct links to the documents from Dropbox and QR codes to make it easy to access from phones. You will have to scroll down or up to find the link to the document you want.

helvella.blogspot.com/p/hel...