Switch from one brand of T4 to another - Thyroid UK

Thyroid UK

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Switch from one brand of T4 to another

17 Replies

I have read several times that you should not just switch from one brand of T4 to another. However, I have compared the package insert leaflets of Euthyrox which I'm currently taking and Levaxin (L-thyroxine) by Takeda that I would like to switch to since the reformulated Euthyrox contains mannitol (which seems to cause a lot of problems from I've read about Teva levothyroxine). So right now I have the "old" version of Euthyrox and would not like to switch to the new one. If I switched to Levaxin instead, would that be a problem, since it seems to contain the exact same fillers as "old" Euthyrox?

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17 Replies
SeasideSusie profile image
SeasideSusieRemembering

It shouldn't be a problem, but I'd retest levels in 6-8 weeks time to see if there's been any change.

in reply to SeasideSusie

Thanks!

helvella profile image
helvellaAdministratorThyroid UK

Containing what appear to be the same ingredients isn't a guarantee that the products are identical or that you will not notice any differences.

One example, a few years ago, Teva levothyroxine was taken off the market because it was failing to deliver its claimed dose. Without any change in listed ingredients. It appears that they switched one ingredient to slightly different specification - but the same name.

However, we all get to a point at which we have to change make for one reason or another. We just have to try it and see how it goes.

Best to try switching before you run out of the make that is OK - that way you have the option of reverting if you need to.

MaisieGray profile image
MaisieGray

A few points that might help you decide: it isn't that you "should not" swap between brands, no one can tell you that. Some people, myself included, can happily and comfortably swap between brands with no problem at all, others seem to be more sensitive to changes and might therefore be more comfortable staying with a brand they do well on. It is not proven that it is the mannitol in Teva that upsets those who are upset by it, it may be. But in any case not every person has a problem with Teva, and some report actively doing well on it; while some report not doing well on other brands that it seems many others do well on. No one can say what would be a problem or what would be fine, for you. Two brands may have the same range of excipients but perhaps in different ratios, that may or may not affect you. You can only find out by trying it, and see.

in reply to MaisieGray

There used to be a third levothyroxine drug available where I live, Elthyrone by Abbott. It was discontinued a few years ago and in the information sent to doctors the manufacturer stated that patients could not just be switched to another drug from one day to the next, but that this had to be done slowly and under a doctor's supervision.

MaisieGray profile image
MaisieGray in reply to

Wasn't that caution specific to the injectable version of the med, advising against swapping between injectable Elthyrone to tablet versions of other thyroxine?

silverfox7 profile image
silverfox7

I feel the don't swap came about because many were getting a different brand each 4 weeks rather than a never change you brand issue. Each different brand may have slightly different potency issues or you might come across a filler your body isn't happy with so it makes sense when you are happy with a brand to stick with it. Just imagine if you had saved up for years for the cruise of a life time and then find when miles from anyware the new brand you brought with you makes you poorly-not worth the risk!

Cica77 profile image
Cica77

Can only speak personally, but I find brand or dose changes will make me very depressed (to the point of suicidal thoughts) for 2-3 days a few days after the change. Now that I am aware of what it causing it, it's not as hard to handle. Teva however, makes me very ill (worse than non medicated symptoms). I only managed 3 weeks with it before chemist took one look at me and swapped the tablets. I find Activis makes me nauseous (but I can cope with it) and Mercury gives me no side effects on a day-to-day basis.

Chemist now makes sure that I always get the same brand. My advice would always be to find what brand works for you and stick to it. Remember, some people like Teva.

in reply to Cica77

Yes, but there have been so many complaints about Teva since it was reformulated that I'd hesitate to even try the new Euthyrox with mannitol...it reminds me of when Armour was reformulated ten years ago and the complaints started rolling in. Sure, some take it and like it, but many patients find it to work less well since they replaced sucrose with more cellulose. I cannot understand why they have to mess with pills that have worked well for people for decades, in the case of Armour even for over a century...! Or does the pharmaceutical industry think that, as long as the active ingredient stays the same, the fillers don't matter...?!

Cica77 profile image
Cica77 in reply to

Well, I had 2 (I think) GPs say that they were all the same!!! Luckily, my chemist is fully aware that they're not.

McMurtagh profile image
McMurtagh in reply to Cica77

I take T3 and really noticed a decline in my wellbeing when they moved me from Liothyronine Sodium to Liothyronine Hydrochloride! Fortunately the GP was receptive and I was able to change back - I take only Morningside

At the moment I can’t get the 5mcg tablets and have had to cut the 20mcg tabs, which is difficult as they are so tiny.

I miss the 5mcgs and have been having a 1/2 tablet instead of 1/4 at times as I haven’t been feeling as well since the change 😣

I don’t like to mess with my dosage but can’t think what else to do. I have spoken to the pharmacist who was very helpful and explained that the 5s are not on that list of ‘free’ meds and I’d have to pay. That would be a out £300 for 5 weeks so not affordable at the moment.

Cica77 profile image
Cica77 in reply to McMurtagh

That's a pain. I've had other (non thyroid) prescriptions free from local chemist and hospital pharmacy with exemption card so didn't realise there were exceptions.

helvella profile image
helvellaAdministratorThyroid UK in reply to McMurtagh

I am not aware that ANY medicine is chargeable if prescribed on the NHS - and the patient is either not in England or has exemption. And certainly not charged at full market price rather "current prescription charge".

However, if they are going to insist in only prescribing on a private prescription, that would be another matter. (It is also questionable whether they are allowed to do so. Would need to investigate further to be sure but I think not.)

McMurtagh profile image
McMurtagh in reply to helvella

I’m currently in the Channel Islands hence the slight difference

helvella profile image
helvellaAdministratorThyroid UK in reply to McMurtagh

Ah! Right, thank you.

waveylines profile image
waveylines

Thank heavens the chemist had more sense!

Im afraid GPs are generalists, even more so with the silly 10min window so if it isnt on their screen it doesnt exist....lol.

helvella profile image
helvellaAdministratorThyroid UK

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