Why do i feel such a difference changing from eltroxin to merc pharma ?

Like many others, I've had to change from eltroxin to Merc pharma Levo and i was lucky to get that !. I've only been taking for 3 days but am surprised at the presumably adjustment phase I'm going through considering they're both supposedly identical,,, I've checked the fillers and they are indeed the same...

I'm starting to wonder if they really are identical in make up etc,,, after all wouldn't a brand name be of better quality than the generic ? Thanks in advance ! Ian

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  • They are made in the same factory, they have the same ingredients (as you say), have the same licence number and are indistinguishable. Further Mercury have repeatedly advised that the only difference is the packaging.

    The MHRA report into problems with Teva levothyroxine identified an apparently very minor issue with formulation and said that meant Teva had been transgressing the terms of their licence. I do believe that they are indeed identical.

    That does not rule out an unintended difference between batches.

    If you feel that they are different, then please fill in a yellow card report:

    yellowcard.mhra.gov.uk/?

    You should not notice anything different so identify what you feel has changed/is changing. You might also consider talking to the pharmacy and your GP (so that an extra blood test could, possibly, be arranged - or an adjustment to dose).

    Rod

  • Hi rod,,, yes i heard about teva ,, they are now just distributing mercury pharma aren't they? I do know I'm sensitive to dose and brand change .

  • Teva 25 microgram always were Mercury (at the time, Goldshield). And yes, whatever Teva distribute comes from Amdipharm Mercury.

    Rod

  • Yeah , the chemist couldn't get my script from mercury so they contacted teva who gave me my script from,,,, yep indeed,, mercury or amdipharm or whatever they're called by next week..

  • Just tried to report on the Yellow Card, but it would not accept my GP's email address. Notified them and they will get back to me in 7 days. Will have forgotten about it by then. I notice a couple of people in this thread seem to be over-medicated. I am most definitely under-medicated. Janet.

  • Whilst the product licence IS the same for the Eltroxin 25mcg and the MP generic 25mcg. (both are PL 12762/0016).The product licences for the Eltroxin 50 & 100 mcg strengths are NOT the same as the generic versions. They are as follows:

    Eltroxin 100mcg - PL 10972/0032

    MP levothyroxine 100mcg - PL 16201/0002

    Eltroxin 50mcg - PL 10972/0031

    MP levothyroxine 50mcg - PL 16201/0001

    All this information is available from medicines.org.uk/emc/medicine

    The SPC (Summary of Product Characteristics) contains more information that in the P.I.L. (Patient Information Leaflets)

    The SPCs for Eltroxin (50 & 100 mcg) also contain subtle differences to those of the MP generic levothyroxine 50/100 mcg tablets. The shelf life for Eltroxin blister strips (50 & 100 mcg) is THREE years, whereas that for the generic levothyroxine (50 & 100mcg) blister strips is only TWO years (why?). In addition all the ingredients for Eltroxin 50/100mcg are BP (British Pharmecopia) whereas this is not stated on the generic and 25mcg Eltroxin versions.

    The SPC for the Eltroxin 25mcg is the same style as the SPCs for the MP generic levothyroxine.

    Something is definitely different. I have taken Eltroxin for 15 years with no problems until the beginning of 2012, when I had to stop taking the Eltroxin 25mcg tablets, as I became very unwell when I started a new batch. It had definitely changed, and I was getting allergy symptoms within 15 minutes of taking a tablet, as well as a return of many hypothyroid symptoms within days. After a couple of months of struggling and feeling really unwell, I managed to resolve the problem by switching to Eltroxin 50mcg and splitting the tablets which was fine – and like ‘normal’ Eltroxin. Then earlier this year when I got a new box of Eltroxin 50mcg. Once again I got immediate allergy symptoms within 15 minutes of taking it. Unfortunately, with no suitable alternatives I have had to carry on taking this. In the last 9 months as a result of these changes I have gone from being reasonably normal and active to being so hypothyroid that some days I don’t have the energy to get out of bed.

    With these new problematic batches of Eltroxin, if I sucked on a tablet, they tasted very, very salty. Whereas the tablets from the (slightly) older 'good' Eltroxin batches had no taste at all when sucked. I complained to Goldshield/Mercury Pharma about the problems I experienced. In their response, although they claim that the Eltroxin had not changed, they were unable to explain the pronounced salty taste. Shortly after my complaint Eltroxin became 'unavailable' because of manufacturing problems.

    I must stress that I tried sucking the tablets from both good and bad batches on the same day. There was only a few months between expiry dates of each strength.

    While I still had supplies of both good and bad batches to compare I went to see my nutrional doctor (an ex GP). With a Vega machine he tested the good and batches for effectiveness and how well my body tolerated them. The good batches were 100% effective and well tolerated. The problematic batches were only 70% effective and not tolerated at all.

    To mind it is likely that some aspects of Eltroxin have changed and the 'manufacturing problems' will be due to delays while Mercury Pharma get the licences for Eltroxin changed/updated/downgraded to match those of the generic product which, from my experience, is of a lesser quality.

    Unfortunately I never got on with the Atavis brands and I am also allergic to Natural thyroid (I have tried them all). My life has been completely ruined by this and neither my GP or Dr S in Birmingham know what to do about it!

  • That's fascinating,, although I don't understand what these differences mean. Right from start I have stuck to my guns in saying they are not the same. And I can only reminisce to when I was doing ok on eltroxin,, ok still had issues but also had a life. Thanks for this update.

  • Hi Ian, glad it's some help. For me its good to know that I'm not the only one struggling, although it's an awful situation :-(. I don't know about you but I had a helluva job getting diagnosed. Never dreamt the meds would let me down. If you can manage it can you complain to Mercury Pharma and do the yellow card reporting thing to MHRA. The more people who complain the better. When I contacted MP about problems with Eltroxin 25mcg I was told no other complaints had been made. To me it feels as though they are using 'cheap' thyroxine, abd my body doesn't understand how to use it. Does that sound familiar? Hav a good weekend xx I will dream of gardening, as can no longer manage the real thing. :-(

  • Hi,, was reading through this today and wondered how your doing now,, Ian

  • I take 100mcg of Eltroxin - no problems. three weeks ago I was started on 125mcg so because no Eltroxin 25mcg they gave me MercuryPharma 25mcg so far so good I thought as they are all the same.

    After a few days of the increase I had to stop taking the 25 every day and switch to every other as it was making me unwell. after just over a week of doing this I tried again taking every day but when so doing I get stomach cramps and nausea if I dont take the 25mcgs I dont get it.

    If it was any other medication I would be suspicious of the filler as I am GF but given these are supposed to be the same pills I can't suspect that. I can't also think that 25mcg would make that much difference to me would it? I have increased to this dose before without this side effect. Any suggestions?

  • Can you complain to MP and report to MHRA via yellow card scheme please. The more people who complain the better!

  • .

    This happened to me when changed from the goldshield to mercury 25mcg. They were supposed to be same? I complained to mercury pharma just received the report back.

    Thank you for returning your Levothyroxine 25mcg tablets to Mercury Pharma. These were sent to the manufacturer for analysis and we have now received their investigation report.

    The manufacturing and packaging documents were reviewed and no issues were reported, all processes were carried out according to the written procedures.

    The amount of Levothyroxine in each of the 6 tablets you returned was measured and found to be the correct amount.

    Tablet Content (mcg)

    1 25.4

    2 25.4

    3 25.1

    4 24.4

    5 24.9

    6 25.0

    Average 25.0

    I wonder if the goldshield/eltroxin were weaker and they are getting the products up to scratch for the new dissolution tests due in January?? Is this why we have had a lot of shortages/ withdrawal of products?

    Just increased to 100mcg Actavis so dont need to mix brands

  • thats really interesting ! im on 75 and didnt want to take 2 diff brands so fought to get merc pharma,,,, im sure ill get used to it all again just in time for the next change. ifelt really hyper yesterday on my second day of merc p ,, then shattered in afternoon.... hope you like the activis,,, now thats an easy one to get,,, even boots do it and call it almus,,, its everywhere,, lol

  • Well done for your efforts. Did they say if anyone else had complained? Take care Ann xx

  • I was fine on Goldshield but felt ill and my levels went off on the Merc Pharma. I now stick to Activis, just a shame they don't do a 25mcg.

  • It is. You could consider Wockhardt?

    Rod

  • Hi there,

    >I'm starting to wonder if they really are identical in make up etc,,, after all wouldn't a brand name be of better quality than the generic ?

    The tablets in the branded Eltroxin packs are not of better quality than Mercury's unbranded levothyroxine. They are the same product, sold by the same company and manufactured in the same factory. The only difference is the packaging.

    It is very common for pharmaceutical companies to sell exactly the same product in both branded and unbranded packaging. It's just a way for the company to increase their market share for that medicine. Companies that do this simply sell the 'generic' version in a different box. They do not manufacture the tablets with different fillers - to do that would be much more expensive and inefficient. To start with, they would have to apply for a new product license for the altered formulation.

    Pharmacy chains tend to dispense Actavis levothyroxine because Actavis offer special contract prices to these companies. Independent pharmacies are more likely to be dispensing the Mercury product.

  • Thank you for this,, helps to reassure in some way,, I've not much knowledge of this area of things,,, do you know why some Levo says anhydrous Levo and others just Levo ? Thanks Ian

  • They (i.e. Amdipharm Mercury) use both terms within the Patient Information Leaflets for Eltroxin and Mercury levothyroxine.

    As I read it, the first mention is saying simply that the tablets contain levothyroxine sodium as their active ingredient. The second mention is in the full list of ingredients and specifies exactly how much it contains. For that reason they have to be extremely precise about which form of levothyroxine sodium they are referring to.

    There have in the past been questions about this exact issue - so maybe MHRA even requested that this be made explicit? Not sure and I do not have old versions of the documents to hand.

    Rod

  • hi rod,,, you doing overtime ,, lol thanks for that,, seems like theres still so much to learn, many thanks for your help ! have good weekend,, ian

  • The tablet strength (25mcg, 50mcg or 100mcg) refers to the quantity of anhydrous levothyroxine sodium in the tablet. Anhydrous means that no water molecules are present in the drug substance. The presence of water molecules in a drug substance effectively dilutes it, so that a higher mass is needed to supply the same number of drug molecules.

    For example, Wockhardt levothyroxine sodium 25mcg tablets contain 27.8 micrograms of levothyroxine sodium, equivalent to 25 micrograms of anhydrous levothyroxine sodium. The tablets are therefore marked 25mcg because they contain the same amount of levothyroxine sodium as tablets of 25mcg anhydrous levothyroxine sodium.

    Do not worry about whether your tablets say anhydrous or not. In any case, the quantity of actual levothyroxine sodium per tablet will be correct. There presence or absence of water molecules is not important because it has been accounted for.

  • Many thanks ! Learn so much from here.. Then realise there's much more to learn..lol..

  • Sorry to repeat myself - I'm replying to the initial question, with the same post as above.

    Pureblue

    Whilst the product licence IS the same for the Eltroxin 25mcg and the MP generic 25mcg. (both are PL 12762/0016).The product licences for the Eltroxin 50 & 100 mcg strengths are NOT the same as the generic versions. They are as follows:

    Eltroxin 100mcg - PL 10972/0032

    MP levothyroxine 100mcg - PL 16201/0002

    Eltroxin 50mcg - PL 10972/0031

    MP levothyroxine 50mcg - PL 16201/0001

    All this information is available from medicines.org.uk/emc/me...

    The SPC (Summary of Product Characteristics) contains more information that in the P.I.L. (Patient Information Leaflets)

    The SPCs for Eltroxin (50 & 100 mcg) also contain subtle differences to those of the MP generic levothyroxine 50/100 mcg tablets. The shelf life for Eltroxin blister strips (50 & 100 mcg) is THREE years, whereas that for the generic levothyroxine (50 & 100mcg) blister strips is only TWO years (why?). In addition all the ingredients for Eltroxin 50/100mcg are BP (British Pharmecopia) whereas this is not stated on the generic and 25mcg Eltroxin versions.

    The SPC for the Eltroxin 25mcg is the same style as the SPCs for the MP generic levothyroxine.

    Something is definitely different. I have taken Eltroxin for 15 years with no problems until the beginning of 2012, when I had to stop taking the Eltroxin 25mcg tablets, as I became very unwell when I started a new batch. It had definitely changed, and I was getting allergy symptoms within 15 minutes of taking a tablet, as well as a return of many hypothyroid symptoms within days. After a couple of months of struggling and feeling really unwell, I managed to resolve the problem by switching to Eltroxin 50mcg and splitting the tablets which was fine – and like ‘normal’ Eltroxin. Then earlier this year when I got a new box of Eltroxin 50mcg. Once again I got immediate allergy symptoms within 15 minutes of taking it. Unfortunately, with no suitable alternatives I have had to carry on taking this. In the last 9 months as a result of these changes I have gone from being reasonably normal and active to being so hypothyroid that some days I don’t have the energy to get out of bed.

    With these new problematic batches of Eltroxin, if I sucked on a tablet, they tasted very, very salty. Whereas the tablets from the (slightly) older 'good' Eltroxin batches had no taste at all when sucked. I complained to Goldshield/Mercury Pharma about the problems I experienced. In their response, although they claim that the Eltroxin had not changed, they were unable to explain the pronounced salty taste. Shortly after my complaint Eltroxin became 'unavailable' because of manufacturing problems.

    I must stress that I tried sucking the tablets from both good and bad batches on the same day. There was only a few months between expiry dates of each strength.

    While I still had supplies of both good and bad batches to compare I went to see my nutrional doctor (an ex GP). With a Vega machine he tested the good and batches for effectiveness and how well my body tolerated them. The good batches were 100% effective and well tolerated. The problematic batches were only 70% effective and not tolerated at all.

    To mind it is likely that some aspects of Eltroxin have changed and the 'manufacturing problems' will be due to delays while Mercury Pharma get the licences for Eltroxin changed/updated/downgraded to match those of the generic product which, from my experience, is of a lesser quality.

    Given my awful experience with the 25mcg tablets I'm dreading having to try the generic MP levothryoxine. I keep praying that it will be the same as the original Eltroxin, but reading other peoples comments I fear not :-((

    Unfortunately I never got on with the Atavis brands and I am also allergic to Natural thyroid (I have tried them all). My life has been completely ruined by this and neither my GP or Dr S in Birmingham know what to do about it!

  • Hi Ian, nice to hear from you. I'm still not great tbh. No change on meds front. So still a shadow of my former self. Very sadly things have been further complicated by the sudden death of Dr S last November - he was my doctor :''(. So am now looking for a new dr who is prepared to prescribe T3. (my GP won't). I saw a new Dr in London a month ago who tested for everything - reverse T3, adrenals, antibodies etc. Cost a fortune but fingers crossed he will be able help. I have to back next week. How are things with you? Hopefully, you are doing better than me? Have a good weekend :-)

  • You still on mercury p ? I am but really not sure what to make of it,, deff ain't eltroxin.

  • Hi Ian, I am a new member and just read through your thread. I was finally changed from Eltroxin to MP after being on Eltroxin for many years. For the last 3 months I have been feeling symptoms of being over medicated and when I reported it to my endo and he checked my bloods they confirmed that my levels are hyperthyroid. He asked if I had changed brands recently and I told him. He explained to me about the differences and has now set about adjusting my dose to try and stabilise my levels. He said I must tell the GP and the pharmacist to keep me on the MP and not give me a different brand as they all differ.

    It is disappointing as I was so well on Eltroxin but at least I had about 12 good years on it.

    All the best, J.

  • jambalaya,

    This thread is rather old so you might not get much response. Feel free to raise a new question.

    There are only three makes of levothyroxine in the UK. As you are aware, Mercury Pharma make Eltroxin and the generic levothyroxine.

    I found that on MP I would feel over-dosed shortly after taking them but by the time I took my next dose felt a bit low. Actavis, I simply felt under-dosed. As I had 50 mcg tablets of both makes, I tried having one of each for a while. A bit better but not quite right. So I ended up trying the German make Aliud then, because Aliud were out of stock, I switched to Henning. I notice no difference between the two but am much happier on them than MP and Actavis. I do buy them myself!

    thyroiduk.org.uk/tuk/treatm...

    You might find this thread interesting:

    healthunlocked.com/thyroidu...

    I am very interested to know what your endo said were the differences!

    Rod

  • Thank you Rod, yes I have seen that other thread. My endo just explained to me that although the ingredients are the same, the manufacturing process, fillers and even the coatings on the tablets can differ between brands (and even between batch numbers in the same brand ) in such minute quantities but to a patient who is very sensitive (as I am) to medications and subtle changes it can affect the way the body absorbs the product. It seems my body needs less of the MP than it did of the Eltroxin as it has gone into overdrive.

  • Yes - I agree that tiny differences do seem to affect some people. I was surprised when I noticed differences as I had been assuming it made no difference to me!

  • they but the patent to make thyroxine but some of the brands are crap & we suffer the consequence

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