Mercury Pharma or Actavis dilemma: Evening all... - Thyroid UK

Thyroid UK
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Mercury Pharma or Actavis dilemma

Tasker
Tasker

Evening all.

My dose of levo was increased from 25mcg to 50mcg two weeks ago. Initially I took 2 X 25mcg to make the 50mcg, and those were MP. While I know it takes several weeks to get the full benefit, within the first week I experienced some improvement, sleeping much better and with hot flushes disappearing entirely (yay!). I then got the 50mcg prescription made up and was given Almus/Actavis. The positive side is that I think my gut prefers this brand - less bloating. But I am starting to get the occasional hit flush again so temperature regulation is not as good, and that affects my sleep; and I've also got itchy skin. So I don't know whether to stick with Actavis or see if the pharmacist will swap my tablets for MP ones.

I guess I'll only find out by trial and error which suits me best overall. But wondered if anyone else had had a similar experience, or any advice to offer...

Thanks!

43 Replies
oldestnewest

Whichever formulation of levothyroxine you take, stick to it and don't let the pharmacist swap. They may both be fine but switching between formulations may not be fine. I've found Actavis ok, not perfect but the best of the bunch. Stick to one or the other.

Tasker
Tasker in reply to Nanaedake

Thanks for your advice - appreciated.

Jojotay
Jojotay in reply to Nanaedake

I prefer Actavis

Tasker,

Different brands suit different people. When you decide which you prefer make sure you tell your pharmacist you will only accept that brand. If they can't guarantee the brand you want ask for your prescription back and take it elsewhere.

You can also report adverse effects to MHRA via the yellow care scheme yellowcard.mhra.gov.uk/

Tasker
Tasker in reply to Clutter

Thanks; will do.

helvella
helvellaAdministrator

Tasker,

A few years ago, I was more or less where you are.

Had reached 100 microgram dose and had prescription for 50 microgram tablets. I tried Actavis only (felt slightly under-dosed), Mercury Pharma only (felt slightly over-dosed shortly after taking them, but under-dosed by my next dose), one Actavis plus one Mercury Pharma (the best balance).

This was despite my starting out insisting that I would try to ignore branding!

Switched to Henning Thybon for some time and they were better for me. Eventually felt need of a small dose increase and switched to 100 Actavis plus 12.5 Uni-Pharma (latter bought from Greece). Happy.

(Now trying to get back onto Actavis-only to make life simpler.)

The above is not to tell you what to do - but to confirm that many of us find getting to a happy dose a long and tedious process. And each of us is an individual.

Tasker
Tasker in reply to helvella

Thanks, Helvella. That's what I suspected/feared! ie that I'll just have to work out a step at a time what suits me best, and continue trying to be patient in the meantime (not something I'm good at, unfortunately...). This evening, with a log fire lit due to the cold weather, the itchy skin has got worse in the lovely warmth of my living room so I think that alone may rule out Actavis for me as a long term option. Will have a chat with the pharmacist on Monday.

I switched to actives by chance (went to a different chemist) and was very surprised to find that all the aches and pains that I had put down to old age :) disappeared after a few days. But after a couple of weeks the hypo symptoms started. I added in 25mcg 3 days a week and was fine. GP said all tablets are the same dose, but fortunately said if I felt better a small dose increase was OK. As helvella says, we are all individual.

Tasker
Tasker in reply to carnation

Thanks for letting me know about your experience. It all seems to vary so much from individual to individual. At present it seems I need to choose between a happier gut (Actavis) and non-itchy skin (MP). But then I'm also addressing my vit & min needs and have changed my diet to gluten-free and introduced kefir - so there are any number of factors that could be affecting how I feel. Such fun, all this is 😉!

helvella
helvellaAdministrator in reply to carnation

carnation,

The GP clearly did not check the specification for levothyroxine!

In the UK, they are required to contain between 90-105% of claimed dose. The actual range is likely to be much tighter than that - but the products must be within that range from manufacture to expiry.

At the extreme, if you were taking 100 micrograms a day, at 90% that would be 630 a week, at 105% it would be 735. A difference of 105 (more than the 75 extra you take).

Of course, even if the tablets themselves are exactly 100%, there is every reason to question whether we ourselves absorb exactly the same amount from every make of tablet. We could well absorb a bit less, or more, from one make as against another.

carnation
carnation in reply to helvella

I had assumed there was a tolerance range, but wasn't prepared to argue as her attitude tended to be in the 'dose as you feel' camp - the only one in a surgery of 14 doctors!

Unfortunately she has recently retired. Am gearing up for more 'you are overmedicated' arguments after my blood tests next month.

Personally, I found I did not do well on actavis, at 100mcg tabs for 6 weeks my TSH came down to 0.08 and ft4 was over range. Most of all, I was having really weird, what I would call, neurological-type symptoms. I've been on Eltroxin by MP + MP generic now for a few months, at 100mcg my TSH was 3.65 m, at 125mcg my TSH was 1.04. I've been on 150mcg for 3 weeks now and slowly starting to feel really good, best I've been in years.

I'd say, for me, something in the actavis was not right and possibly accelerated absorption plus possibly a filler, which messed with my brain. You need to try them for yourself and see how you react to each brand. I have moved to boots as other chemists cannot easily source MP and the are very happy to keep a record that I only want MP, they order it in just for me now.

MiniMum97
MiniMum97 in reply to Sybilla14

Hi Sybila. Can I ask what your neurological symptoms were? Thanks.

Tasker
Tasker in reply to Sybilla14

Thanks for sharing your experience. Will go for a chat with my pharmacist tomorrow - it's Boots so hopefully they will be helpful.

helvella
helvellaAdministrator in reply to Tasker

Tasker,

The individual pharmacist may have a helpful attitude, but we have heard stories of Boots being very unhelpful as a company. Last time I used them, they insisted they only handled Almus (that is, Actavis packaged for a Boots group company called Almus). Though, as Actavis do not make a 25 microgram tablet, they do supply mercury Pharma in that dosage.

At the same time, other people have reported different stories from other Boots branches. Many branches seem to rely heavily on locum pharmacists.

Remember - they are no longer the same Boots Pure Drug Company Ltd. of Jesse Boot fame, but a part of the huge Walgreens Boots Alliance operation.

en.wikipedia.org/wiki/Walgr...

Tasker
Tasker in reply to helvella

Fair point. I will see what they say, and if no luck, will head round the corner to their competitor with my next prescription!!

Tasker
Tasker in reply to Tasker

It's my lucky day! Just back from speaking to the pharmacist at my local Boots who was very helpful and with no bother swapped my remaining Actavis 50mcg tablets for MP 50mcg, and said he'd add it to my notes for the future. It may of course have helped that I could tell him about itchy skin, ie an allergy-type reaction, rather than having to try to explain that I thought MP controlled my symptoms better (which is also the case).

Either way, a good outcome. I'd better go and buy a lottery ticket while I'm at it!

Chriskisby
Chriskisby in reply to Sybilla14

I know it was 2 years ago your post I am replying to but I am having difficulty obtaining MP even from Boots now. I am due to collect my prescription today and they are giving me another brand (I downright refuse Teva as it is a killer to me!). How is your current supply with Boots? I live in Notts/Lincolnshire area.

Sybilla14
Sybilla14 in reply to Chriskisby

Hi Chriskisby, so far I’ve been ok getting MP from boots. I ordered my prescription on Sunday but haven’t heard yet that it’s ready, I asked for the MP to be added to the prescription when ordering . When I collected the last one a couple of months ago they ordered a big pot of 100mcg and boxes of 50mcg for me. The pharmacist said that a lot of people have been asking for MP (I’m in Derby). Have you tried more than one boots as it may depend on the individual pharmacist you’re dealing with?

Chriskisby
Chriskisby in reply to Sybilla14

Thanks for your reply Sybilla 14. Just been to get my Almus from Boots in Gainsborough as they can’t get the MP. I read through the leaflet and it is exactly, word for word, the same as the MP one and the ingredients are almost the same. I am very reluctant to try it as I have been feeling quite well lately on the MP. My other nearest Boots are Retford (10 miles away), Lincoln and Doncaster over 20 miles away. My husband asked me to try the ones who send it through the post. Have you heard anything good about any of those?

Sybilla14
Sybilla14 in reply to Chriskisby

No I don’t really know them,I think these are paid for services so possibly not many people have the experience, given Levo is free. You could try calling the boots pharmacies and ask if they can order MP for you.

I have tried Almus/Actavis before and in my experience it was significantly different to MP. If you haven’t tried it before, it may be worth giving it a go if you’re prepared to deal with any effects from the change. Then again, you may find that it works well for you and it is an easy to source brand so it may be worth testing it.

Chriskisby
Chriskisby in reply to Sybilla14

Looks like I might not have much choice! I am still waiting for a reply to my email to MP asking them what is happening to their supplies. I will let you know the outcome! Thanks.

Sybilla14
Sybilla14 in reply to Chriskisby

Yes please do let me know what they say. I wonder why it’s so hard to get hold of this brand and why chains don’t seem to stock it but chose Teva despite patients not being too keen on it...

I haven’t heard from boots yet, may need to call them to chase. Hope there’s no problem here too. Good luck!

Sybilla14
Sybilla14 in reply to Chriskisby

Hi Chriskisby. Have you had much luck with getting MP? I called boots today and they have not been able to source 50mcg tablets for me. They said they tried 3 distributors, even going outside of their normal source and they cannot find any. They have 100mcg left so they’ll give me 28 extra if those so I can split them to make the 150mcg this way.

It is really worrying especially that the MP manufacturer seems to be saying there are no supply issues, based on recent posts on here. No idea why it’s so hard to get hold of if they’re supplying the market! I may email them myself.

Chriskisby
Chriskisby in reply to Sybilla14

Hi, Sybilla. I am still running round in circles trying to get MP at Boots. I have contacted Boots.com and they have advised me to contact my GP! For what I am not sure, but they say they are not qualified to answer pharmaceutical questions!! Can you believe it? I have emailed back and asked them to give me the contact number of someone in their company who is! I am due to arrange another prescription soon, but I am absolutely dreading it. I have managed to scrape together MP from my supply so have not yet tried the Almus ones yet, but within a week or two I will be out of MP, then I really don’t know what else to do. Someone suggested contacting Advanz and asking them to ring my Boots so they can tell them how to order MP. I suspect they will say it is all done centrally, though. I will start again on Monday tracking them down, but I think I will phone next time as emails seem to take longer for replies, and then the replies are unsatisfactory.

Sybilla14
Sybilla14 in reply to Chriskisby

I really don’t understand this as advanz’s revenues from selling Levo must be very low. None of the pharmacies I’ve tried here stocks it and I could only get them through boots. It seems as if it is deliberately made difficult to source. Why would Advanz not try to improve the availability, is it negligible in their portfolio?

I’ve just emailed Advanz so will see if I get a response. Perhaps calling them is a better option, may do it if I get no response next week. Please do let me know if you hear from them or get anywhere with Boots. I’ll keep you posted from my end.

Chriskisby
Chriskisby in reply to Sybilla14

Will do. I am going to phone Boots and Advanz on Monday. I looked at Advanz’s figures for the past few years and it quite clearly says they are now the source of MP (though they sometimes call it Eltroxin too, but I thought that was just the 25mcg). Perhaps we can compare notes next week.

At one time tolerance was +/- 10 so could be a huge change between different brands. In 2009 it changed to +/- 5 so much closer so you have potency to think about. I stuck with Mercury Pharmacy 25's nearly all my Levo life but then decided as 100 mcg were cheaper than 4x25 I would try to safe the NHS some money. It dint work! I found that 4x 25 was not the same as 1x 100. So may be better having you whole dose in 25's or be prepared to split them if you need a lesser dose.

Itchiness suggests an allergy to one of the fillers so bear that in mind as well.

Tasker
Tasker in reply to silverfox7

Thanks. This gets so complicated! I hadn't thought of there being a difference between one larger dose tablet and several smaller ones, within the same brand name...

silverfox7
silverfox7 in reply to Tasker

Well the tolerance is given as it would be very difficult to get it spot on so I would imagine it's almost impossible to get more than one spot on.

helvella
helvellaAdministrator in reply to silverfox7

silverfox7,

The tolerance in the USA is 95 to 105% - in the UK it is (I believe) 90 to 105%.

Hi I have recently got my GP to specify my favoured brand on the prescription so you definitely get the right brand. I struggled for a long time before this to get the pharmacist to take my brand preference seriously.

I am on 125 thyroxine per day....Side effects....Do not sleep, have given up on that. Occasionally had have dreadful itching around lower face and neck plus dry eyes. Ran out of meds when I had to extend a trip to France. Was amazed to find I got hot flushed and felt really tired very quickly without them. Went to the doctor and was given 125 thyroxine in ONE tablet.....so much easier. In the UK I am always given this as two packets ....100 and a 25. That's an extra box plus instruction leaflet. Surely, a waste of cash for the NHS. On my last prescription, the 25 was so small it was difficult to cope with. Fortunately, the chemist agrees.....so it will be back to the larger tablet......but still two packets.

Tasker
Tasker in reply to Seacape06

Hi Seacape. Sorry to hear about your experiences. Which brand of levo are you taking?

Seacape06
Seacape06 in reply to Tasker

MA HOLDEN. TEVA UK LIMITED EASTBOURNE BN22 2AG

Tasker
Tasker in reply to Seacape06

Ah, thanks.

I take 50 of Almis and 50 of murcary pharma I can take more of mp but not Almus for some odd reason, so I get my Gp to make sure I have MP on the prescription. Must admit I have not tried mp by itself.

I’ve been on Mercury Pharma for past 7 years but getting more difficult to get. Do I try and get it or go on to another brand ? Been stable on Mercury so in a real dilemma 😲

Tasker
Tasker in reply to Shona64

From all the advice I've had on this thread, if you're happy with how you feel on MP, do your best to try to stay on it - it seems changing is quite high risk. Good luck!

Shona64
Shona64 in reply to Tasker

Thank you I’ll keep trying as Pharmacist says it’s getting more difficult to source but will try other Pharmacies also xx

Yes. I was on mercury brand and I felt great then for the last month and a half I have been on actavis. Now I feel awful, tired, muscle cramps, really low mood bordering on depression zero libido and numb fingers. Whoo I'm now waiting to hear back from my pharmacist.

I had issues with the teva brand and once I researched I found that teva and actavis are one in the same. Why can my pharmacy not provide me with the same brand all the time. Money!!??

MaisieGray
MaisieGray in reply to Angel48

They aren't the same, but in any case, the drug tariff price ie what the pharmacy is reimbursed for dispensing the meds, is the same, £1.89 currently.

The same has happened to me I have to take 50 one day and seventy five the next. Actavis is causing me problems itchy skin flushing and sore you get, so am going to try and get a change back, but pharmacy said they couldn’t get Wockhardt

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