Mixing up the brands of Levo?

[N5girl]

My Endo has increased my dose of Levo from 25 mcg to a mix of 25 / 50. I know it may be too low as T4 is currently only 20% through the range. I will have the debate about dosing again in a month when we have more data. The good news is that my Vits are now all optimal, so I should be making use of the Levo.

My question is that the hospital pharmacy wanted me to have a mix of Wockhardt and Accord, ie 25s and 50s. I wasn’t sure if this was a good idea, so didn’t get the prescription filled. So should I just shop around to see if I can get all Wockhardt (ie 25s) as that is what I have been taking so far?

[SlowDragon Administrator]

suggest you try Accord (also boxed as Almus via Boots)

Most easily available (and often most easily tolerated) are or Accord

or Mercury Pharma

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 

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

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

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...

Helpful post about different brands

healthunlocked.com/thyroidu...

List of different brands available in U.K.

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

[helvella Administrator Thyroid UK]

I can't remember if I've ever pointed this blog out to you?

helvella - Mixing Levothyroxine Formulations

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

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

[N5girl in reply to helvella]

Thank you!

I am going to try to stick with Wockhardt for now until my dose stabilises. The tablets are so small that it really isn’t an issue at the moment. Once the dose has stablised (which will probably be later than August), then I might try the Ventamil to see if that helps the gastro symptoms.

As always - thanks for the advice.

[Obsdian]

I worried about this just the other week and got the same advice. So far so good. Not feeling any difference.