Knocked for Six with Change from Actavis to Eltroxin (Aspen). Is it the excipients or 'potency?'

[TheLadyOfShalott]

I have been doing well on 225 - 250mcg of the Actavis levothyroxine. Despite this, my GP 'believes' this dose is too high, so altered my prescription to only 50mcg!!

So I bought some levothyroxine online, it's Eltroxin by the Aspen Group, New Zealand. My first identical dose of 250mcg on Thursday night caused increased heart rate, and 'movement of catarrh.' So the following night (last night, Friday), I reduced the dose to 150mcg - I had the same increased heart rate, and have a mild headache today with catarrh now developing into an earache (and I haven't had so much as a cold in over 15 years)!

Has anyone else experienced this after switching to Aspen Eltroxin from Actavis? It's hard to believe I'm suddenly feeling over-medicated. Is the dose more 'potent' or is it the excipients etc? Any ideas?

I took a look at the ingredients:

ACTAVIS INGREDIENTS: Lactose, Magnesium stearate, Maize starch, Pregelatinised maize starch, Stearic acid.

ASPEN ELTROXIN INGREDIENTS: Microcrystalline cellulose, Pregelatinised maize starch, Talc, Colloidal anhydrous silica, Magnesium stearate.

MERCURY PHARMA INGREDIENTS (just for comparison): Sodium citrate, Lactose, Maize starch, Acacia powder, Magnesium stearate.

[Pink_Bear]

I take Aspen's Eltroxin, made in Germany, and I'm really well on it, now in my 4th year. I've come to think that stability is very important - maybe you need to give it a bit of time on a redused dose?

[helvella Administrator]

Irony here!

When New Zealand first switched over to GSK Eltroxin made in north America to what is now Aspen Eltroxin made in Germany (and the formulation changed), it precipitated the great NZ levothyroxine issues.

medsafe.govt.nz/hot/alerts/...

I applaud your post for its clarity about precisely which products you mean and for helpfully listing the ingredients. Unfortunately, I simply do not know the answer.

[bd79og]

I've just looked up the Eltroxin and my list finds Acacia powder. Can you check yours? I know that I and many others can't cope with Acacia powder. I too find I'm better on one brand of levo, I take Actavis but also tried Wockhardt which made me feel wheezy and flushed despite me having checked all the ingredients carefully so to get my 75mg I take one and a half 50mg Actavis (they don't do 25mg). I also found that I had to increase from 50mg to 75mg by just a quarter of a tablet for a fortnight you may have to build up gradually to your dose on the new brand.

[helvella Administrator in reply to bd79og]

I suspect you are taking MercuryPharma Eltroxin?

That is made in the UK for MercuryPharma and is a different formulation to Elxtroxin from Aspen (made in Germany) and to Eltroxin from GSK (made in north America). There might be others - indeed, I think there are in various countries.

Just because it has the same brand name does NOT mean it is the same product.

[Hidden]

I agree with bd79og re slow dose increase .. only in reverse. I think your dose was cut down way too quickly. x

[diogenes Remembering]

I think this is a matter of bioavailability. There are two great differences between Actavis and Aspen. The first prep contains nothing that can't be digested or taken into the body. The second contains talc and silica which certainly aren't. Mercury is like Actavis in this respect. So the talc/silica pass right through your body unchanged. If they have any T4-carrying capacity at all this will change the way that T4 is absorbed, so bioactivity might be significantly changed. It might actually be potentiated by spreading out the area over which T4 can be taken in.