Had to start a new post to make people aware that 25mcg north star levo is actually by teva , in case your sensitive to the fillas as I am , its stated north star on the front but check the side of the box it states teva . Be aware .
North star / teva : Had to start a new post to... - Thyroid UK
North star / teva
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Jodiedebs55
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RedAppleAdministrator
A bit of clarification might be needed here.
Actavis do not and have not ever made 25mcg levo tablets. So it is possible that NorthStar 25mcg tablets have always been Teva? And maybe the NorthStar 50mcg and 100mcg tablets are still Actavis as they have been for many years now.
Worth checking this out.
Ok that sounds reasonable how do I check this out please ?
Other than asking in your local Lloyds pharmacy, I'm not sure! Maybe helvella will jump in here 
Lloyds pharmacy were shocked as they know how ill I am on teva which is why i wont use the pharmacy in my surgery as they only supply teva and besides they are very rude and mocked me for saying teva makes me ill, my gp is determined to reduce my dose of levo to 50mcg soon so I may be very ill then as I'm already under medicated but gp refuses to believe that my suppressed TSH is due to me taking T3 ... but what do I know eh . Not a lot but more than them lol
Suitably jumped in! See my MHRA email in this thread.
Northstar have not previously had a 25 microgram product. I have always been offered Wockhardt, Mercury Pharma or Teva as the 25 microgram product alongside 100 microgram Northstar (or Almus or Actavis).
Hi helvella is wockhardt ok because I always have mercury pharma but as they have stopped doing 25’s they’ve given me wockhardt instead. I know I can cut MP in half but just wondered about the substitute.
Dustpan, As far as I'm aware MercuryPharma have not stopped doing 25s, so if that's what you usually have, then no need to change.
This thread is about Northstar now doing Teva 25s.
My pharmacy has said they have stopped making 25”s in fact two pharmacies have told me the same so I just cut 50’s in half .
Yes I know what the thread is about but as we were talking about Levo I wanted to add about MP and whether the substitute is similar
Unfortunatey, this sort of 'untruth' is not uncommon from pharmacies. What they probably mean, is that their meds supplier isn't currently delivering MP 25s to their pharmacy, rather than the manufacturer actually discontinuing production.
In total agreement - we have seen it all too often.
I almost always suggest people contact the manufacturers/responsible companies. Most details are available here:
Yes you are right I have just rung mercury pharma and they do still do it but as you say the pharmacies suppliers don’t. I stand corrected.
Boots stock Mercury Levothyroxine 25mg
No - they (sometimes) stock Mercury Pharma Levothyroxine 25 microgram.
I work for Boots and my store stocks Mercury 25 and I would have thought all stores receive the same brand.
What region are you in
Wales
Different regions may stock particular brands.
They may do but they should still be able to get them from a supplier.
I'm in Callington Cornwall
I am sorry, my point was more to get the units right!
I have not always been able to get 25 microgram Mercury Pharam from my local Boots. But it could be they had run out! I can't remember.
It could be that your local Boots ran out or maybe they do stock a different brand but I would have thought every branch stocks the same as i think we all have the same supplier. At one point about 6 months ago we were receiving teva in but there must have been a problem with Mercury so they sent an alternative but since then we have received Mercury and if people want teva we would have to ring our suppliers to order it.
Not the one near me Iv rung them, only Teva
If they don't stock it in store they can ring up the suppliers and get it for you.
I would have thought they would have done that knowing some customer can’t tolerate other brands but they dont seem to be bothered.
If you take a prescription into a store and tell the dispenser/pharmacist that you need a certain brand they should try and source that brand for you from the suppliers and a note should be made on to your record that you can only have a certain brand.
Sometimes brands do go out of stock and we expect it to get worse after brexit so it might become more difficult to source certain brands.
If no pharmacies are willing to try and help you ask your GP to write the brand that you need on the prescription.
If all the above fails come on holiday to Wales and I will sort it for you 😂
So which bit of Wales do we have to look for holiday cottages?
I work in stores in mid and south Wales so anywhere around there. Only problem is we don't have electronic prescriptions in Wales you have to have the paper prescription so if you don't have that we can't do it.
So then your next option would have to be to move to Wales to have a paper prescription 😂
Is northstar 50mg the same as 50mg of accord which I normally have
Yes.
UK Levothyroxine Tablets
➖➖➖➖➖➖➖➖➖➖➖➖➖➖
Last updated 13/09/2020.
This is a list of currently marketed levothyroxine tablets in the UK.
Please note that re-branding (whether by a manufacturer or as an ‘own label supplier’) – which has happened with several products – does not mean any change to formulation.
—————————————————————
🔹 Accord (marketing authorisation holder) – formerly Actavis
🏭 Accord-UK (manufacturer)
🥛 contains lactose – 39.95mg in 50 microgram tablet, 54.90mg in 100 microgram tablet
50 microgram PL 0142/0104
100 microgram PL 0142/0105
🟢 50 microgram and 100 microgram PIL: mhraproducts4853.blob.core....
🟣 50 microgram SPC: mhraproducts4853.blob.core....
🟣 100 microgram SPC: mhraproducts4853.blob.core....
—————————————————————
🔹 Advanz (marketing authorisation holder) – branded both “Mercury Pharma Levothyroxine” and “Mercury Pharma Eltroxin” which are identical
🏭 Custom Pharmaceuticals Ltd. (manufacturer)
🥛 contains lactose – 30.49mg in 25 microgram tablet, 48.86mg in 50 and 100 microgram tablets
25 microgram PL 12762/0016 5.5mm diameter
50 microgram PL 10972/0031
100 microgram PL 10972/0032
🟢 Eltroxin 25 microgram PIL: mhraproducts4853.blob.core....
🟢 Eltroxin 50 & 100 microgram PIL: mhraproducts4853.blob.core....
🟢 Levothyroxine 25 microgram PIL: mhraproducts4853.blob.core....
🟢 Levothyroxine 50 & 100 microgram PIL: mhraproducts4853.blob.core....
🟣 Eltroxin and Levothyroxine 25 microgram SPC: mhraproducts4853.blob.core....
🟣 Eltroxin and Levothyroxine 50 microgram SPC: mhraproducts4853.blob.core....
🟣 Eltroxin and Levothyroxine 100 microgram SPC: mhraproducts4853.blob.core....
—————————————————————
🔸 Almus ‘own label supplier’ – (a brand owned by Walgreen Boots Alliance – Boots pharmacies and Alliance distributor)
50 microgram – This is repackaged Accord – formerly Actavis.
100 microgram – This is repackaged Accord – formerly Actavis.
—————————————————————
🔹 Aristo (marketing authorisation holder)
🏭 Aristo Pharma GmbH (manufacturer)
No lactose ingredient
100 microgram PL 40546-0159
🟢 PIL: mhraproducts4853.blob.core....
🟣 SPC: mhraproducts4853.blob.core....
—————————————————————
🔹 Glenmark (marketing authorisation holder)
Note: This product may not currently be dispensed.
🏭 Glenmark Pharmaceuticals Europe Limited (manufacturer)
No lactose ingredient
25 microgram PL 25258/0293
50 microgram PL 25258/0294
100 microgram PL 25258/0295
🟢 PIL: mhraproducts4853.blob.core....
🟣 25 microgram SPC: mhraproducts4853.blob.core....
🟣 50 microgram SPC: mhraproducts4853.blob.core....
🟣 100 microgram SPC: mhraproducts4853.blob.core....
—————————————————————
🔸 Northstar ‘own label supplier’ – (a brand owned by McKesson – Lloyds pharmacies and AAH distributor)
25 microgram – This is repackaged Teva. ❗
50 microgram – This is repackaged Accord – formerly Actavis. ❗
100 microgram – This is repackaged Accord – formerly Actavis. ❗
—————————————————————
🔹 Teva (marketing authorisation holder)
🏭 PLIVA Croatia Ltd (manufacturer)
No lactose ingredient
12.5 microgram PL 00289/1971
25 microgram PL 00289/1972
50 microgram PL 00289/0038
75 microgram PL 00289/1973
100 microgram PL 00289/0039
🟢 12.5 and 50 microgram PIL: mhraproducts4853.blob.core....
🟢 25, 75 and 100 microgram PIL: mhraproducts4853.blob.core....
🟣 12.5 microgram SPC: mhraproducts4853.blob.core....
🟣 25 microgram SPC: mhraproducts4853.blob.core....
🟣 50 microgram SPC: mhraproducts4853.blob.core....
🟣 75 microgram SPC: mhraproducts4853.blob.core....
🟣 100 microgram SPC: mhraproducts4853.blob.core....
—————————————————————
🔹 Wockhardt (marketing authorisation holder)
🏭 CP Pharmaceuticals Ltd (manufacturer)
🥛 contains lactose
25 microgram PL 29831/0130
🟢 PIL: mhraproducts4853.blob.core....
🟣 SPC: mhraproducts4853.blob.core....
➖➖➖➖➖➖➖➖➖➖➖➖➖➖
🔹 – identifies marketing authorisation holder
🔸 – identifies ‘own label supplier’ products
🏭 – identifies manufacturers (where known)
🥛 – contains lactose
❗ – Take particular note of the actual product which varies by dosage.
🟢 PIL – Patient Information Leaflet
🟣 SPC – Summary of Product Characteristics document
🟢🟣 Single document combining typical PIL and SPC information
—————————————————————
Only products which definitely contain lactose are identified (🥛 contains lactose). Please always check other products. Where products are ‘own label supplier’, check the marketing authorisation holder for the specific product.
There are links to product information on the MHRA (Medicines and Healthcare products Regulatory Agency) website. products.mhra.gov.uk/ These are the latest versions known.
If there is anything inaccurate in this information, please let me know by Private Message, or on the forum:
healthunlocked.com/user/hel...
➖➖➖➖➖➖➖➖➖➖➖➖➖➖
This document is updated whenever I am aware of any changes or enhancements are needed. Please check the Last updated date. The current version is available as a PDF here:
dropbox.com/s/6h3h0qi4eqwi6...
The PDF version of this document has QR code above this sentence. If your device has a camera and can interpret QR codes, this QR code should take you to the same place as the link and make it easier to download on devices, such as phones and tablets.
This isnt so , I'm afraid it's down to cost , I went to my gp yesterday and listed all my reactions to teva he told me himself the pharmacist orders TEVA 1st as its the cheapest 2nd mercury pharma and last resort wokhardt as that's most expensive, I'm now arranging my supply direct through wokhardt myself
Seems strange because our 1st choice is mercury 2nd teva and 3rd wokhardt. Could you ask your GP to put the specific brand on your prescription, then the pharmacy will have to source it for you?
Is that why I now get wockhart 25s
Yes probably
I really cannot answer whether Wockhardt is OK for you.
I prefer Mercury Pharma to top my dose up from 100 to 125 - but do not like taking only Mercury Pharma.
helvellaAdministrator
I have just written to the MHRA - email address info@mhra.gov.uk
Good evening,
The products known as Northstar Levothyroxine (supplied to the UK market via northstarrx.co.uk - part of McKesson Corporation) have, since launch onto the UK market, been manufactured by Accord Healthcare in Barnstaple (formerly Actavis) under product licences PL 0142/0104 and PL 0142/0105.
It appears that Northstar are now selling Teva Levothyroxine 25 micrograms in Northstar livery under Product Licence PL00289/1972.
(At time of writing, I do not know if there have been, or will be, any changes to the 50 and 100 microgram dosages.)
As you will know, a considerable number of patients have had issues with Teva Levothyroxine and many have put in Yellow Card reports.
Also, in the 2013 report, Levothyroxine Tablet Products: A Review of Clinical & Quality Considerations 07 January 2013, it is made clear that bioequivalence is an outstanding issue.
Further, the European (primarily French) issues with the change of Euthryox formula from lactose to mannitol demonstrated that existing bioequivalence testing is wholly unacceptable. The idea that healthy volunteers will experience the same issues as those with thyroid disease and, quite possibly, other diseases is wishful thinking and has never been proved.
We are now in the situation that patients may be dispensed a mixture of two different formulations in what appears the same packaging – albeit the MA Holder details do enable identification to those who are aware enough to notice.
(Even if Northstar is also switching over to Teva for 50 and 100 microgram products, there will be a long period in which patients will see both Actavis and Teva products in Northstar livery at the same time. Indeed, were pharmacies were to ensure a clean cutover, patients may well have remaining packets.)
You may remember that when there were issues with Mercury Pharma Levothyroxine and Eltroxin, the question was raised as to why the formulations differed by dosage. This was, I believe, addressed by adjusting the formulations. It was, though, accepted as an issue.
Now we are back to having different dosages having not just slightly but wholly different formulations.
1) Patients will be unaware of the change to formulation.
2) Patients who might already have found themselves unable to tolerate Teva Levothyroxine will inadvertently be subject for a second time to whatever side effects they have already suffered.
3) Patients who notice any changes will very likely not readily understand the underlying issue.
4) Because there is a lack of bioequivalence, patients could find themselves unable to achieve a stable dose. After all, if they are not bioequivalent two 25s will not be the same as one 50. Just changing tablet dosage (without changing the numerical dose) is likely to have an effect.
Indeed, there are questions over the use of mannitol, sorbitol and lactose in levothyroxine tablets.
Ledeți I, Romanescu M, Cîrcioban D, et al. Stability and Compatibility Studies of Levothyroxine Sodium in Solid Binary Systems-Instrumental Screening. Pharmaceutics. 2020;12(1):E58. Published 2020 Jan 10. doi:10.3390/pharmaceutics12010058
Finally, I have been unable to locate any approved Northstar Levothyroxine packaging. I can find the PARs for many products but not these. Does this mean that you do not approve, or have not approved, the packaging for these repackaged products? Or just that I cannot find the approvals?
I volunteer as an administrator of a large online thyroid forum, and would appreciate an URGENT response so that we can, to the best of our ability, warn patients before they have any problems due to these issues.
Regards
There is nothing special about my letter. I am sure they would appreciate emails from each and every one of you.
Wow !!!! That's brilliant, i also did the survey earlier about symptoms from teva , I cant believe how even pharmacists are unaware that the 25mcg dose of north star is actually teva it's very misleading iv stopped taking it and I'm hoping I can get wokhardt tomorrow else my levels are going to be all over the place again
MercuryPharma also make 25mcg tablets so that may be an option if Wockhardt aren't available.
If you decide to email the MHRA (or anyone else!) please let us know by posting a response here.
Fanciful nonsense, but imagine them getting a hundred emails!
You do not have to make them long, detailed, or involved. Just (in your words) why this is a bad thing.
Please, please - will someone else please email the MHRA?
I'm doing it now x
helvellaAdministrator
Have a look at Teva UK's website:
products.tevauk.com/p/levot...
Levothyroxine
Northstar
25mcg
Tablets
28
Pack type: PP
PIP code: N/A
Product licence number: 00289/1972
Product code: 32050381
Product classification: POM
Categories: Levothyroxine
I note that 50 and 100 microgram products in Northstar livery are NOT identified.
RedApple
I have had a response from Northstar (my emphasis):
Hello Mr Hewitt,
I can confirm that Northstar livery Levothyroxine 50 mcg and 100 mcg Tablets are manufactured by Accord under licence number PL 0142/0104 (for the 50 mcg) and PL 0142/0105 (for the 100mcg strength).
There are no plans to change the manufacturer of Northstar livery Levothyroxine 50 mcg or 100 mcg Tablets.
Accord is not the manufacturer for NorthStar livery Levothyroxine 25 mcg Tablets.
Kind regards,
Thanks - I had bad reaction to Teva. It must be the cheapest which is why it is always prescribed. It gave me cluster headaches.
In the context of this thread, the initial impression is that they (Northstar) wanted a 25 microgram product but Accord (Actavis) do not make one. So they decided to source from another manufacturer. We have no evidence as to why they chose Teva - could be price, but could be willingness to supply.
Wow , I will be super observant in future and thank you so much for your invaluable info
Thanks for the heads up, I have turned away 25mcg Teva a few times as my script is 125 a day. I need to constantly remind them that pref 50mcg North Star then I cut them myself.
I will make sure I double check my meds now even more so.
So have teva taken iver north star or hace pharmacy changed box. Was box sealed both ends.
No and no.
Northstar are part of McKesson (who own Lloyds pharmacies and AAH distributors).
Northstar seem to have decied they want to have a 25 microgram levothyroxine tablet in their own branding. Actavis (Accord) do not make a 25 microgram levothyroxine tablet. So they are getting Teva 25 microgram tablets.
This means there are two entirely different formulations being supplied under the one branding (Northstar).
I had very bad reactions to Northstar. Good to hear I'm not the only one.
Ellie yes you are not the only one, I have prescribed Levo- Northstar and after a year It get worst but never aware of its side effects.. I got drowsiness - sluggish- really bad like things just going to be shutted round late afternoon & evening
whats your bad reactions pls ?
Thank you for posting this. I've had reactions to TEVA in the past and now I know to avoid North Star too.
RedAppleAdministrator
EllieTa Snqanq ThyroidThora
Do bear in mind that it is ONLY the Northstar 25mcg levothyroxine tablet that is manufactured by Teva.
Northstar 50mcg and 100mcg levo tablets are still Actavis as they have been for many years.
Red Apple its no different i think been on actavis - northstar 100 mcg & 50mcg for ~ 3 years ..things get worst and Im just awared of it recently over this forum,
trying levo sodium - mercury pharmacy now to see If things ever change .. better..
Only realised that yesterday
I've just found this out. Explains the way I have been feeling I need to chat with my doctor . I have rang the pharmacy (lloyds) and been told yo open the boxes before I leave and if tea they will exchange for another brand.
You do need to open the bag - but you do not need to open the boxes. It says quite clearly who the Marketing Authorisation Holder (MAH) is. On most card outers (boxes) I have seen, it is along the lower edge - but this could vary across products.
It will also say on the actual blister packaging and the Patient Information Leaflet.
I have a document containing images of the packaging of quite a number of thyroid hormone products in the UK:
dropbox.com/s/7tte490umnz6s...
Image of part of the card outer box of 25 microgram NorthStar levothyroxine showing Teva.
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