fingers crossed.....eltroxin......edited to add pic

[mandy72]

few days ago i called most chemists in swindon asking if they could get eltroxin

asda told me its no longer available so i told her it was because i talk to people who take it, she says i have spoke to manufacturer and they are no longer making it

i call boots and they put in an order for it there and then and said it went through

dr called today and i asked if i could have eltroxin instead of thyroxine and he said yes so i asked for the prescription to be written as the chemist at the drs cant get it and it should be at the drs waiting for me now

lets hope boots had the delivery

why are some places saying its no longer made when it clearly is unless its a supplier thing

[jimh111]

Certainly until quite recently AMCo have made both Eltroxin and the generic version, which have the same Product Licence and are identical concordiarxinternational.co... . So, they have got rid of one generic and kept a generic that is identical to Eltroxin.

This all seems good... However, we are dealing with Concordia / AMCo who have ripped off the NHS on liothyronine. Eltroxin is branded and so subject to price regulation. Generics are usually cheaper than branded medicines. In the case of levothyroxine AMCo generic levothyroxine has been priced a bit more expensive than Eltroxin. Notwithstanding they are identical AMCo has managed to create 'shortages' of levothyroxine (as per above link) and somehow persuaded the MHRA that they couldn't manage to package it as Eltroxin.

Now it seems pharmacists are experiencing difficulties obtaining Eltroxin, and so have to dispense the higher priced identical generic! I've seen a letter from AMCo saying Eltroxin is available, it was a letter to a patient posted on a forum, but I can't find it now.

So, get your GP to specify 'Eltroxin'. Point out you prefer it and it will save the NHS a little money. No doubt AMCo / Concordia are hoping that the Eltroxin market shrinks to a level where they can discontinue it. Once the branded competition is removed they can raise the price of levothyroxine, 'competitors' will be happy to obtain a higher price also.

[mandy72 in reply to jimh111]

i find it all confusing if im honest

ive just looked on my repeat for and this is whats on there

Eltroxin 50microgram tablets (AMCo)

for some reason hes asked for 50mcg tablets (3 a day)

[Nanaedake in reply to jimh111]

I'm disgusted. Perhaps we should all club together and produce an effective levothyroxine at low cost that we can all 'own' like partners?? Why should we be held to ransome by Big Pharma??

[Rapunzel in reply to jimh111]

Is there no end to the nefarious practises of this bliddy Pharma Co? Top reply jimh111

[Clutter]

Mandy72,

AMCo said a couple of years ago that Eltroxin and Mercury Pharma are identical. They have the same Product Licence and the same ingredients.

[mandy72 in reply to Clutter]

when i called boots about eltroxin they said they could get it so hopefully i get eltroxin but will have to settle for mercury pharma if not

[Nanaedake in reply to mandy72]

Let us know what you get.

[Nanaedake in reply to mandy72]

Well I never!! I had to stop taking it because it was withdrawn and I was well and then I was unwell on Mercury Pharma's version they swore was exactly the same.

Can you tell me if the Eltroxin packet or leaflet says anhydrous levothyroxine or not?

I'm pretty sure Mercury Pharma is anhydrous levo.

[mandy72 in reply to Nanaedake]

it says this leaflet concerns two strengths of eltroxin tablets. Each strength contains respectively 50 and 100mcg of anhydrous levothyroxine sodium

[Nanaedake in reply to mandy72]

Ok, thanks it's anhydrous then.

[mandy72 in reply to Nanaedake]

what is it?

[Nanaedake in reply to mandy72]

I think it's produced without the need for a drying process but not totally clear. Some levo's seem to be anhydrous and some are not. I seem to have trouble with anhydrous ones but I don't know why or whether just the particular formulation. I get a rapid heart rate when trying to increase the dose. Doesn't seem to happen with levothyroxine that is not anhydrous. A bit of a mystery. Having said that I was alright on the old formulation of Eltroxin.

[mandy72 in reply to Nanaedake]

thats a strange one

[Nanaedake in reply to mandy72]

Well, I think we are only just beginning to untangle the mysteries of levothyroxine and why it made some of us so ill before the MHRA brought in the changes after the investigation in 2012. I think all the old stock was withdrawn in 2015 finally so some people are only just starting to feel a bit better now. I still don't feel confident about the quality of levo. It will take a long time for me to regain confidence in the products as well as in the MHRA and the Commission for Human Medicines who failed to regulate it properly and the CCG's who've tried to block us sourcing better quality products iwhile this fiasco was getting sorted out. Instead the doctors tried to pacify thyroid patients by handing out anti-d's like smarties and telling everyone they had an anxiety condition rather than they were taking c**p levothyroxine.

[helvella in reply to Nanaedake]

The Patient Information Leaflet (PIL) for Wockhardt is clearer than some. It says:

Each tablet contains 27.8 micrograms of levothyroxine sodium equivalent to 25 micrograms of anhydrous levothyroxine sodium.

medicines.org.uk/emc/PIL.26...

All levothyroxine tablets are formulated on the basis of anhydrous levothyroxine.

Levothyroxine can be any of several states of hydration and readily changes state depending on the environment in which it is. It makes sense to measure it on a consistent basis - and the obvious choice is anhydrous. If Wockhardt know the hydration level of their levothyroxine ingredient, then they can take account of the extra 2.8 micrograms of water when they are adding it to the mixture.

It is difficult (or impossible) for us to know the hydration level of the levothyroxine in the end product - even if we know that for the raw ingredient. I believe I have read that the tablets can absorb or release water depending in circumstances (temperature and humidity, I assume).

Most PILs state that you can you can disperse the tablet in water. I would expect doing that to fully hydrate any levothyroxine - at least fairly quickly. (Not that I am a pharmaceutical expert!)

[Nanaedake in reply to helvella]

Ok, that's interesting helvella. Do you think there is any reason why anhydrous levothyroxine might act differently from others such as Wockhardt or Actavis?

[helvella in reply to Nanaedake]

Mercury state anhydrous.

Actavis state:

The active substance (the ingredient that makes the tablets work) is anhydrous levothyroxine sodium. Each tablet contains either 50 micrograms or 100 micrograms of the active substance.

That is a statement which is open to interpretation. If you are being picky it doesn't say that the substance is anhydrous when poured into the mixing bowl.

Teva do not say anything about anhydrous/hydrated.

I can't think of any reason for the anhydrous to be any different to hydrated - but that does not mean it isn't. Just that it reaches and goes beyond my brain's ability to see why it would make a difference.

Imagine a slurry made of all the ingredients, mixed with some water, and pressed into moulds. Then dried out. End result might be that the levothyroxine has become hydrated - or the drying process might remove what was there if it was hydrated to begin with. Unless someone with detailed understanding can explain, I shall remain unconvinced that the precise wording on the PIL translates into any difference in effect.

[Nanaedake in reply to helvella]

Ok, well that makes a kind of sense. So what do you think about the quality of levothyroxine available in the UK today? Is it good enough, have the manufactureres got it right at last? Is it only the fillers that make a difference or do you think some of the manufacturing processes affect the way the tablets work for some people?

[helvella in reply to Nanaedake]

I felt happiest on Aliud or Henning from Germany. But have also felt pretty good on 100 Actavis plus 12 Uni-Pharma levothyroxine.

I end up in the same place as many - why add things that are not necessary? Hence, why don't we all get Tirosint (or equivalent)?

(Obviously the answer is cost. But there doesn't even seem to be any appreciation in the world of medics.)

When we are taking medicine like levothyroxine, an interaction with just, say, 20 micrograms of active ingredient would be significant. Whereas with most medicines being in the many milligram range, 20 micrograms of interaction would be utterly ignorable. Or, similarly, a destruction of 20 micrograms due to processes.

[DeeD123 in reply to Nanaedake]

That's interesting. A few years ago before I startedto ask questions I was given eltroxin and I became quite ill. As it was the only changein meds I had I asked chemist if I could have the same as I used to be on. They swapped them and told me not everyone could take them but gps prescribed them as they were cheaper

[Nanaedake in reply to DeeD123]

You might have got ill because of lack of bioequivalence as there was a 50% difference between Levothyroxine s at that time.

[jimh111]

Boots are the sole distributer for AMCo liothyronine and it's possible the same or similar situation applies to Eltroxin. I would contact AMCo and point out you can't get hold of Eltroxin, that you want Eltroxin as you may be given another company's levothyroxine otherwise. AMCo will probably give you a reply saying it is available, you can then hand this to the pharmacist and let them sort it out.

Many years ago I worked for Kodak. Kodachrome slide film came processed paid, you could not buy just the film and have it processed cheaper elsewhere (there are technical reasons why this gives better quality). The monopolies commision ruled that they must also sell Kodakchrome without processing. They did but they never marketed it, noone ever bought a roll and Kodak continued with a larger profit margin. I believe AMCo are playing the same game, they are making Eltroxin difficult to obtain and pushing the higher margin generic.