Seals on levothyroxine packages

[helvella]

Among the very much less important things about levothyroxine tablets is a recent change to packaging.

The outer box of my Almus tablets has a clear plastic seal on the end. It doesn't appear to be anything more than a piece of Sellotape (no obvious markings in ink, or embossing).

I assume this will also be applied to Actavis (Accord) and Northstar packaging. If not right now, sometime soon.

Am now wondering if this is an initiative of Accord? Or a widespread change in the pharmaceutical industry? Or somewhere in-between.

Has anyone noticed this on other levothyroxine products? Or other medicines?

(Obviously, I am asking about recent changes - not all packaging across all medicines. )

I found it quite difficult to photograph - you might have to look quite carefully to see the seal.

[ Correction: I usually get Northstar but this month had to go to Boots. They are Almus, not Northstar. ]

[SeasideSusie Remembering]

Nothing different on any of mine Helvella, I had my repeat prescription filled last week (only get one month at a time) - Actavis Levo and an antibiotic are the same in their normal boxes with no seal on the end flaps, 2 inhalers have a seration on the end flap of the boxes that you have to break open and they've always been like that.

I wonder if it's some kind of anti-tamper precaution being brought in.

[helvella in reply to SeasideSusie]

That is what I think. But I'd like to know whether it is just seen, broadly as "A Good Idea" - or there is something more specific?

Possibly the added handling involved in stockpiling medicines in anticipation on leaving the EU has acted as an encouragement to improve anti-tamper measures?

I guess we'll be able to think a bit more about it as replies tell us if it covers other companies and medicines.

[bantam12]

My latest boxes of Almus are sealed, took me a while to work out why I couldn't open the box !

[SeasideSusie Remembering in reply to bantam12]

That's interesting, I expect my Actavis will have a seal soon then, when new stock filters through to my pharmacy.

[helvella in reply to SeasideSusie]

Might be Accord by the time you get them?

[SilverAvocado]

Very strange to be able to make this connection, but I've noticed similar seals on a few food items recently. They've drawn my attention because the narrow sellotape-like seal has been underneath the main label on the packet. This means it can't be peeled off, and it ends up looking very untidy after it's been stretched and torn off. I got out my scissors and snipped a few of them at once.

The food items were: a couple of jars of jam, tub of salt, and a jar of coconut oil.

Dont know if there's any connection, but the sticky strips look very similar.

[carnation]

I have noticed this on my inhalers so suspect it anti tampering. Takes ages to open the boxes!!

[Scrummy9]

Its an EU wide regulation part of the Falsified Medicines Directive (FMD). You will find it on all medicines as the stock comes through the system. You will also start to notice the addition of 2D barcodes to all items as part of this.

There is no relation to food, this is purely to do with medicines supply chain.

[helvella in reply to Scrummy9]

Thank you, now you mention it, I have some very vague recollection of something being mentioned! Ages ago.

gillian68

[gillian68]

The Falsified Medicines Directive was introduced from the 9th February this year to stop fake medicines getting into the supply chain.

Unique barcodes and tamper evident seals are being added to packaging. The barcodes are to be scanned at numerous points throughout the supply chain from manufacture to patient to authenticate them.

[Citrine77 in reply to gillian68]

Do you know what happens about the medication that is bought in bulk and transferred to small pots by the pharmacist. My 25mcg Mercury Levo comes like that, although the 50 and 100 are still in packs. I work in a pharmaceutical company but haven't had anything to do with the FMD changes, so am interested.

[Scrummy9 in reply to Citrine77]

Yes, that will remain as it is. It's the bulk pack that will be decommissioned at dispensing.

The system is really to control the supply chain before it gets to the patient, rather than than have a direct impact in this way on the patient.

The crux of it is, that once that barcode is scanned out as dispensed, that pack cannot be dispensed elsewhere (with some time sensitive caveats). The seals are a belt a braces effort to ensure that the strips cannot be swopped out for something else by a nefarious character!

[jenp657]

All my boxed meds have this now. I find it super annoying!..I guess it's just extra protection from tampering.

[bristolboy]

Nothing on last month's Mercury Pharma levo.

[Missd66]

My Mercury pharma Levo is not sealed but my last 2 boxes of Teva Lio have been, (glued flap not sticky seal). Also my painkillers have recently had clear seals.

[MaisieGray]

I've not had any meds dispensed locally with a seal, but due to yet another incidence of NHS and allied systems being not fit for purpose and staff being at best incompetent, and at worst, beligerant, and deliberately unhelpful, my prescription for 5 different meds that I ordered last week, was wrongly sent to a pharmacy 192 miles away and had to be couriered to me. I notice that one of them, Perindopril, had seals on the boxes, so presumably since the FM Directive, it will take time for old un-stickered stocks to be used up, which will vary from pharmacy to pharmacy and the drugs involved.

[MaisieGray]

Since packets have always been opened by the dispenser, to check the contents, I wonder what alternative checking is now taking place at source, to provide the same guarantee; or has that simply been written off after years of it being required, as unecessary ie we've gained one purported safeguard at the expense of another viz might we be at increased risk of having the wrong med or the wrong dose, but at least it won't be counterfeit ........

[cat_alli]

Yes I noticed on my levothyroxine these very strong clear round seals, which made the packs difficult to open without scissors, & probably affect the box’s recyclability. My husband has seen similar on either his statin or blood pressure boxes. We both prefer the boxes as they were before.

[TaraJR]

I've had these too. Tamper-proof is a good idea. Although I feel sorry for people with eg arthritis as it must be hard to open all this new packaging

[Minimol]

This is an interesting one - my Wockhardt 25mcg doesn’t have seals but my Actavis 100mcg does, at both ends, a clear strip of sellotape.

My question is if it’s ok for the dispensing pharmacy to continue to open the packs if these are designed to be anti-tamper and offer reassurance to the patient?

[Purplesash]

I noticed this on mine quite some months ago when I couldn’t just open the box. I don’t know what brand it started on, but my pharmacy give me different brands all the time, currently I have Teva (100mcg) and MercuryPharma (50mcg) and they both had the seals on.

[helvella in reply to Purplesash]

It is now universal.

The pharmacies have to be sure that, at least at point of delivery, the pack has not been tampered with.

However, it is not a requirement that the seal is still intact when handed out. There are several possible reasons such as a pharmacist needing to check the Patient Information leaflet.