My recent package of Levothyroxine says on it "... - Thyroid UK

Thyroid UK

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My recent package of Levothyroxine says on it "this patient may be eligible for targeted MUR"

Caroline888
Caroline888

I am a bit concerned. I am now self-medicating even though I have only increased my dose from 58.3 mcg, which was the dose last prescribed by my GP, to 67.85 mcg. Is this going to be a problem? And do i have to submit to an MUR (medicines use review - I looked it up!) by a pharmacist?

I get enough tablets each month to accommodate my small increase in dose with a few left over. I am worried that a pharmacist might reduce my supply.

Anybody know anything about this?

Any help or advice would be appreciated.

Best wishes

Caroline

33 Replies
Hidden
Hidden

You dont have to do this.It is just a conversation with chemist, voluntary.

Caroline888
Caroline888 in reply to Hidden

Thank you so much for your quick reply. I’ll sleep better for knowing that😊😊😊.

I was beginning to think I was being silly about the dose increase as it is very small and perhaps the pharmacist wouldn’t care but I worry about anything and everything at 3 o’clock in the morning!

I am really grateful to you. Didn’t really expect a reply this late.

Thanks again.

Best wishes

Caroline

I have had two changes( or attempts to change) my long term prescriptions over the last 6 or so months- the first was clearly an attempt to save the NHS money by cancelling a drug for hay fever that could now be bought over the counter anywa. The second is a letter from the Gp surgery stating they are stopping routine prescriptions for ibuprofen, accept for acute use...I would accept this if it was a mixture of saving NHS money, or was an attempt to stop patients mistakenly eating them like sweets( and the link to addiction), but this was not apparently the problem... what we needed was a 'swop' to daily lansoprazole to lower our stomach acid! Sorry if I seem to have gone off point Caroline, but I think surgeries are looking for ways to save money...unless you have recent bloods that might indicate your Gp thinks you are overmedicated, and need less levothyroxin( I am assuming T4 and not T3), I would doubt anyone is thinking about saving money on your modest prescription by reducing your meds. Perhaps the money saving will be by getting the pharmacist to do your annual review, or MUR, instead of a Gp or Heath assistant/nurse, because you are 'stable' on the meds you have!

Thank you so much, Judith, for taking the trouble to reply at this time of night. I am very grateful.

I just saw the note as I was getting ready for bed and went into panic mode! I’m sure you’re right. The NHS is always trying to save money and sometimes this is at the patient’s expense but I agree with you that my modest quantity of levo is unlikely to be the target of their money-saving endeavours.

Thank you again. And thank goodness for this forum. Where would I be without you all?

Hope you sleep well.

Best wishes

Caroline

Zzzzzzzz x

😊 xx

twinks
twinks in reply to Judithdalston

Hi Judith, pharmacy dropped my antihistamine down to 1. I could take up to 3 a day, mine is for itching. I tried stopping them b4 and rash itching drove me crackers so I'm hoping it won't get worse again.

Caroline888
Caroline888 in reply to twinks

Hi twinks

I don't know why but I appear to be receiving messages meant for other people!! I'm not sure but I suspect Judith has not received the above.

twinks
twinks in reply to Caroline888

Hi Caroline I replied to Judith but it didn't put the message just next to hers, I think messages are just out of sync lol.

I had to have a review with pharmacy a few yrs ago, they asked me and I didn't realised I could refuse.

It was only to tell me the best way to take medication, on empty stomach etc etc

You can just say no thank you politely 😁

Caroline888
Caroline888 in reply to twinks

Hi twinks

That's fine then. Sometimes I'm not too sure how it works😐

Thank you for telling me about your MUR experience. If they approach me, I will politely refuse as you say. I learn everything I need to know from the forum!

Thanks again

Best wishes

Caroline

Hi Shaws

Did you mean this message for me?

shaws
shawsAdministrator in reply to Caroline888

Sorry - I've removed it. Thank you.

Caroline888
Caroline888 in reply to shaws

Not a problem😊

Hope you are keeping well.

Best wishes

Caroline

shaws
shawsAdministrator in reply to Caroline888

Thankfully, yes I am well and hope you are too.

Medicine Useage Review - a way for pharmacies to get extra money - they get very little for dispensing prescriptions. There's a limit on how many MURs can be done and how often. They may be looking at patients with particular prescriptions (like levo) that need to be taken away from food etc. Don't worry about it. You don't have to do it and I'm pretty sure only doctor can change meds.

Thank you, that's good to know. I was looking into what makes someone eligible for a targeted MUR and it seemed to indicate that only a person on multiple medicines is eligible, with the one exception of someone on a high-risk medicine, which levothyroxine doesn't appear to be classified as. So properly speaking, I don't think I'm actually eligible as I only take levo. They must really be scraping the bottom of the barrel! Which I suppose makes sense if they need the extra money.

Anyway as you say, I am able to decline and will do so if approached. I don't think they would be able to tell me anything I haven't already learned on the forum!

Thanks again for the info.

Best wishes

Caroline

Caroline888 Pharmacists are free to offer MURs to any of their patients, although 70% of the 400 pa they are allowed to carry out must be to patients in one or other of these national target groups:

- patients taking high risk medicines;

- patients recently discharged from hospital who had changes made to their medicines while they were in hospital. Ideally patients discharged from hospital will receive an MUR within four weeks of discharge but in certain circumstances the MUR can take place within eight weeks of discharge;

- patients with respiratory disease; and

- patients at risk of or diagnosed with cardiovascular disease and regularly being prescribed at least four medicines.

So 120 of their annual number of patient MURs can have none of these conditions/situations.

Angel_of_the_North Their fee for each is, I think, just £28 so it's not a get rich quick route for them, but in any case, they didn't ask to carry them out, it's an initiative that came from the Govt, partly to check that patients understand what their drugs are for and how to take them safely and effectively; and partly to identify where patients are continuing to order and collect medicines that they then don't use. When my mother died she had tonnes of the stuff unopened, including one particular pain-relief gel none of which she was using. I think she thought that as the items were on repeat, she had to have them. So in her case, and I guess many others, £28 would have saved £000's.

Thanks so much, Maisie, for all that information. So, although, strictly speaking, I'm not eligible for an MUR, the pharmacist can still invite me to take part as one of the 30% who are not eligible but might benefit. I am so pleased now to have all the facts. Thank you, I'm grateful.

Of course, because I read lots of posts on the forum and have learned so much since I was diagnosed over a year ago thanks to all the knowledgeable members, I can't see that there'd be any benefit to me in having an MUR. It's great to know that it isn't compulsory.

You are a real fount of knowledge!! Are you in the medical profession or just an excellent researcher?

Thanks anyway for sharing😊.

Best wishes

Caroline

I think Boots has stopped doing these reviews. At one point I was called into the medical centre to have a review with one of their pharmacists, but now at our medical centre anyway they are done online. I don't think you have to do it.

I'm a bit puzzled myself. Last time I picked up levo, the pharmacy assistant said that I need to see the GP, otherwise the next prescription might be denied! I interpreted this as a prompt to have the annual blood test.

Alma1
Alma1 in reply to Christabel

Yes.My GP denies re-issue of levothyroxine every time they want to retest blood for thyroid levels.This is the way they enforce a blood test I've learned!Trouble is I have gone without meds because of it.

posthinking01
posthinking01 in reply to Alma1

But this is good as we need to tested - more regularly than a year I would say.

Hi Christabel

Thank you - I will certainly decline!

I think you're probably correct in thinking they want you to have another blood test - after all what else could it be?

I am hoping my GP forgets all about me and leaves me to my own devices but it sounds as if the pharmacy might be the trigger for further blood tests. What a pity! I am much happier sorting out my own dose of Levothyroxine with the help of the forum and Medichecks. Will you have to adjust your dose for a time before the blood test to be sure of an acceptable, within-range result, or is your GP one of the few knowledgeable ones?

Hope it all goes your way anyway.

Best wishes

Caroline

I had the blood test, than about a week later there was a call from the surgery - the GP needs to speak to me about them, which is happening on Monday.

I did adjust the dose beforehand. This hasn't happened before.

Is your GP any better than most? Probably not, since you had to adjust your dose beforehand. When my GP was unhappy with my low TSH I was able to persuade him to let me re-test, and fortunately this time my TSH came back just in range and so "no action"😊. I haven't been to see him since. I'm really hoping he's forgotten me!! If your TSH is too low in your GP's opinion, perhaps you can do the same. After all, levels do fluctuate with Hashimoto's. If he surprises you and wants to increase your dose, well that's not a problem is it. You will be able to adjust as you see fit with no problem relating to supply.

Isn't it truly dreadful that we have to try to manipulate our results because the doctors are so lacking in knowledge?

Hope it all goes well on Monday anyway.

Best wishes

Caroline

Thank you :-)

I was invited to a MUR interview which I agreed to take part in. I do like to know first hand what these things are about and how could it affect me. My prescription is made up of Levothyroxine Nifepidine Statin and Asprin. The meeting took place in a private room with a very nice female pharmacist who went through the meds and explained how they could react with other drugs over the counter as well as prescribed, It was a very informative interview and I was able to ask questions etc, When the meeting was over she presented me with a nice pack of books all relating to my different conditions. Didn't find any ulterior motive so please don't worry.

Keep Well

proffishopper

Hi

Thank you so much for telling me all about your experience during a medicines use review. Glad to know it was quite useful and non-threatening! I was mainly concerned that the pharmacist would try to reduce my monthly supply of levo. At present, I receive a quantity each month which allows me a little flexibility and I don't want to lose that as my GP is intransigent and does not allow my symptoms to affect my dose in any way. I feel I need a degree of autonomy!

I am so glad your visit to the pharmacist was useful for you😊. I am only taking levothyroxine so my situation is so much more simple.

Thank you so much for your reassuring message. I was quite worried last night, but all of you kind people have, as usual, rushed to help put my mind at ease. I am so grateful.

Thanks again

Best wishes

Caroline

Hi there - may I ask how you get such accurate amounts of hormone - 58.3 etc.

Hi

It's not been difficult to achieve these doses. The last time I visited my GP, he prescribed 50 mcg for two consecutive days, then 75 mcg on the third day, so 50/50/75 = an average of 58.3 mcg daily.

I later increased the dose by alternating the 50 mcg and 75 mcg tablets, i.e. 50/75 = an average of 62.5 mcg daily and finally, this week, I have started taking 75 mcg for five days a week, then 50 mcg for two days which amounts to an average of 67.85 mcg.

Are you in the same position as me in that you need only a small increase to make a big difference?

This works well for me. Hope the above is helpful.

Best wishes

Caroline

Agh I understand now - yes I am the same but due to lactose intolerance I am lucky in that liquid levothyroxine is so easy to administer - if it is hot I need less if it is cold weather I need more - certain antibiotics I struggle with and need to take more - not a lot but it is needed sometimes perhaps only 5 mcg but it makes all the difference to me tolerating an antibiotic or not.

Oh that's great that you can adjust your dose so easily! It's funny that you should mention needing a little more when the weather is cold. I've been wondering if that was the reason I had felt the need of a small increase.

You sound as if you've got it all worked out anyway. Hope you continue to do well.

Best wishes

Caroline

Thanks Caroline - if you need to know more just ask - I consider myself an expert now on this awful condition and certainly know more than most endos !!!

Thanks. Will do☺️. Doctors and endos know nothing it seems. Thank goodness for this site. Am so pleased I found it!!

Best wishes

Caroline

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