Is Cytomel available on NHS?

[Ocean2]

My GP has prescribed Cytomel but I can't find it in pharmacies.

On the prescription is says Cytomel (imported from United States)

Any ideas if I can get this on NHS?

thanks

[RedApple Administrator]

If this a green NHS prescription written by an NHS GP, then yes a pharmacy can obtain this for you through whichever importer's account they have.

[Ansteynomad]

Why would an NHS GP go to the trouble of prescribing Cytomel when you should be able to walk into any pharmacy and get liothyronine sodium, which I believe is the same stuff, there and then?

[helvella Administrator Thyroid UK in reply to Ansteynomad]

One reason might be that Pfizer/King Cytomel is available in 5 microgram tablets (as well as 25 mcg) which makes things much easier for those needing small doses.

Although both Pfizer/King Cytomel and Mercury Pharma are based on the active ingredient liothyronine, patients very often report differing reactions to the two products.

[shaws Administrator]

Maybe some GPs don't know what liothyronine is and T3 came up as Cytomel.

[helvella Administrator Thyroid UK in reply to shaws]

Often thought that when we see this sort of topic!

[sarahstevenson]

My endo has said to ask for a named patient script from my GP for cynomel as I feel ill on current amdipharm mercury batches they don't work the same for me.Will approach the GP in the New Year as I have enough bought privately for a couple of months. We'll see.

[helvella Administrator Thyroid UK in reply to sarahstevenson]

Which Cynomel? You might (just) get Sanofi Cynomel, though I think we have seen some failures reported here, but I really doubt you would get Grossman Cynomel.

[sarahstevenson in reply to helvella]

I'm doing better on Grosman and haven't tried others or cytomel - endo has written to take whichever suits me ha ha think she's saying ”bothered am I bothered?" Will tackle GP in January. Sanofi might be an option.

[helvella Administrator Thyroid UK in reply to sarahstevenson]

Almost everyone seems to be happier on Grossman than anything else - but I suspect that niceties such as legal ownership of brand names might preclude it ever being available - although they could obviously sell the same stuff under another brand name if they really wanted to.

[nobodysdriving in reply to sarahstevenson]

you will NOT get Cynomel by Grossman on NHS prescription as they cannot import it, I have asked ALL the importers in UK and none of them can import it either privately or on NHS. They can import Cynomel by Sanofi Avent (the french one).

[sarahstevenson in reply to nobodysdriving]

Very Many Thanks NBD ! Really helpful to know when I face the Quest.

Do we know whether strengths are similar to cynomel Grossman( I think I've seen it spelt with one 's' , with 2 x's'and with 2 x 'n' )will check when at home?

I think when we say Grossman they assume it's the German pharmaceutical firm not the Mexican Laboratorios Grossman a subsidiary of Valeant Pharmaceuticals. I shall say France to them !

[nobodysdriving in reply to sarahstevenson]

Hi, the only CyNomel available on NHS prescription (unlicensed on a 'named patient basis') is the French one by Sanofi-Aventis (the Grossman is NOT importable, the mexican one).

Ocean, the CyTomel is by Pfizer and is imported from the US (again unlicensed on a named patient basis).

CyNomel by Sanofi-Aventis comes in 25mcg tabs Sarahstevenson.

[Ocean2 in reply to nobodysdriving]

Thanks a lot for the reply nobodysdriving..

It just says Cytomel (imported from United States) on my prescription. Is this by Grossman or Sanofi Avent (french one)? And are they any different from each other?

Sarahsteventsen talks about 'named patient script from GP for cynomel'. Is this something I could do to get Cytomel perhaps?

Sorry, I haven't got a clue how this whole thing works!

[helvella Administrator Thyroid UK in reply to Ocean2]

No!

Cytomel imported from United States IS the Pfizer/King one. (Maker King was taken over by Pfizer and there might be some confusion over branding.)

Yes, they are different to each other.

[RedApple Administrator in reply to Ocean2]

Something is not making sense here. You have already said in your original question that

My GP has prescribed Cytomel

It might be helpful if you explained to us why you have been prescribed Cytomel from the USA rather than the usual UK brand of T3 by MercuryPharma. What is the dose that's been prescribed?

Let's see if we can clarify things... is this a private prescription written by a private doctor, or an NHS prescription written by an NHS GP?

CyTomel is a brand of T3 manufactured in the USA. If you have a normal NHS prescription, then you can take it to any pharmacy that deals with an appropriate importer such as IDIS. Local independent pharmacies are usually more helpful than the supermarket pharmacies.

If however, you have a private prescription, then you still need to take it to an appropriate pharmacy that will obtain the medication through an importer such as IDIs. But you will have to pay for the medication yourself.

If you're having trouble finding one locally that will get it for you, there is a list of pharmacies on the main website that will be able to help. Give them a call and ask what the charge would be. Here's the link:

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

[Ocean2 in reply to RedApple]

Yes GP has prescibed Cytomel on NHS, however, he had no clue what type of T3 to prescribe and since my endo said I was on Cytomel he just typed cytomel on his PC and gave me a prescription for that!

I am currently on the Mexican Cytomel/Cynomel by Grossman.

So let me get this right, NHS T3 prescriptions available for the following:

1) Standard NHS which is liothyronine

2) Cynomel French one by Sanofi-Aventis

3) CyTomel by Pfizer and imported from the US

AND the Mexican Cynomel/Cytomel by Grossman is not importable, right?

I am not sure which one would be a best option really. I heard some people don't do well on the standard NHS liothyronine. What would be people's choice in order of preference? Which one do you think I should go for??

My GP is nice enough and I am pretty sure I could ask him to prescribe whichever is available/possible on NHS.

Also, what does 'named patient basis' prescriptiion is suppose to mean??

thanks all! X

[RedApple Administrator in reply to Ocean2]

All T3 is liothyronine. That is the pharmaceutical name for T3.

The brand name for the UK supplied T3 is AmCo / MercuryPharma. Unless there is a specific reason to prescribe an imported version, your GP would not normally do so because the importation costs make it unnecessarily expensive.

No matter how 'nice' your GP is, once he finds out how much the imported CyTomel costs compared to the usual brand of T3, it's likely he will not be so happy to prescribe it. T3 is considered to be an expensive thyroid treatment anyway, without paying the additional exorbitant charges on top.

The usual brands of T3 imported into the UK through the NHS are from the USA (CyTomel and Paddock).

So, no, I do not believe you can get 'Cynomel French one by Sanofi-Aventis' through the NHS. Nor the Mexican CyNomel.

The 'Named Patient Basis' process is only required for obtaining imported medications, because they are not 'licensed' for use in the UK. Info here: thyroiduk.org.uk/tuk/treatm...

If you have no specific reason to be trying to obtain an imported T3 medication, then the easiest and most cost effective route for everyone concerned would be for you to retrun to your GP and ask for a prescription for liothyronine. That would then be easily obtained from any pharmacy.

[Ocean2 in reply to RedApple]

Thanks a lot for the reply RedApple.

I have no specific reason other than that I am currently on Cytomel/Cynomel by Grossman (Mexican one) and would have liked to continue with the same medication.

And also read/heard on forums that people had problems when they switched from Mexican Cynomel/Cytomel to NHS liothyronine.

I suppose you read/reply tons of messages through this forum. How true is this in your experience as administrators?

[RedApple Administrator in reply to Ocean2]

It's worth remembering that by far the majority of people posting here will be the ones that do have medication problems. Thyroid patients who are doing well have no need to seek help on a support forum.

On the basis that you're not going to get Mexican CyNomel on NHS prescription, and that you don't yet know whether the US CyTomel will work for you anyway, I would give the UK T3 a try. If you get on ok with it, then problem solved

If it doesn't work for you, then you will obviously have to re-assess where to go from there.

[Ocean2 in reply to RedApple]

ReadApple, thank you. Great advice, that makes perfect sense! much appreciated!! Why couldn't I work that out!!

So, for my reference let me see if I get this right!

Below are the T3 options:

AmCo / MercuryPharma - the only available UK supplied T3, right?

Then there are the imported brands into the UK through NHS, which are:

1) CyTomel by Paddock imported from USA unlicensed on a 'named patient basis.

2) CyTomel by Pfizer/King imported from the US (again unlicensed on a named patient basis).

3) Cynomel French one by Sanofi-Aventis - NOT available through NHS (though NBD mentioned in this post above that it is available on NHS on a 'named patient basis) NBD, is this the case?

Then there is the Mexican Cynomel by Grossman which is NOT importable.

Have I got all this right now?!!

[RedApple Administrator in reply to Ocean2]

Yes, I think that's correct now, except for the question of French Sanofi CyNomel. I think this would not usually be in the list of options, but in abnormal / emergency situations (e.g. a recall or some other reason for the unavailability of UK T3), then it might be.

[Ocean2 in reply to RedApple]

Thanks RedApple

So when I go back to my GP what should he be putting on the prescription? AmCo / MercuryPharma must be the name of the company. What is the brand name for the UK supplied T3? (he has no clue so I need to tell him!)

Also what do people mean when they talk about the 'generic' and the 'brand name'?!

thanks a million!

[RedApple Administrator in reply to Ocean2]

Your GP just needs to write a prescription for 'liothyronine', plus of course the relevant dose.

Generic versus branded… perhaps an easy way to illustrate this is to use a well known everyday product such as baked beans. Heinz make their own beans and put them in a tin with their own name on. This makes it a branded product. Sainsbury and Tesco also sell tins of baked beans with their own name on. However, Sainsbury and Tesco don't make their own baked beans. So when you buy their product, you don't know who made the beans inside the tin, and the beans might come from a different factory today than the last time you bought a tin. These are generic products.

When it comes to thyroid medications, there is only one T3 (liothyronine) product, which is manufactured and supplied by AmCo. It's a branded product.

We also currently have two main levothyroxine producers, one being MercuryPharma/AmCo, the other being Actavis. These are branded products - i.e. the manufacturers name and the name on the box are the same.

However, if for example you go to a Boots or Llloyds pharmacy for your levothyroxine, then you will get a box with the pharmacy name on it, not the tablet manufacturers name (Boots use the name Almus on their packaging). And inside the box could be any make of levothyroxine. This month your Almus or Lloyds box might contain Actavis tablets, next month it might contain MercuryPharma tablets. This is called 'generic' medicine.

Generic prescribing means that your prescription will state the name of the medicine, rather than the brand of medicine. So a prescription for levothyroxine allows the pharmacist to supply you with whichever levothyroxine tablets they have on their shelf today. Which might be a different make than they had last week. But if your prescription stated 'Actavis levothyroxine', then your pharmacist would not be able to give you MercuryPharam tablets instead.

So, when I said above that your GP just needs to put 'liothyronine' on your prescription, that is generic prescribing, meaning in theory your pharmacy can give you whichever make they have on the shelf. However, we only have the one T3 product in the UK, so that is the one you will get

[Ocean2 in reply to RedApple]

You are a star!! thank you. Makes sense now! X

[Julia187]

My endo and the pharmacist told me that if you need a 5mcg tablet it needs to be imported from the US/Canada as they aren't manufactured in the UK. I'm on the 5mcg dose twice a day and have a real performance getting them, I need to allow a week for them to come into the pharmacy.

[Marlene99 in reply to Julia187]

You can buy levothyroxine here without a previous prescription (the online consultation is easy) goodrxtabs.com