Is anyone else having problems on Actavis - Thyroid UK

Thyroid UK

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Is anyone else having problems on Actavis

Gerispice profile image
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Having been on this for a few days now, I’m feeling terrible. I have palpitations (never had those before unless I’ve had contact with salicylic acid), extreme fatigue, pain all over, headache and croaky voice. I think it’s a very low quality, cheap NHS substitute for the real medication 😡

Why are we not given a choice? I would willing pay a surcharge to be able to have a branded T4 rather than this cheap rubbish.

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Gerispice profile image
Gerispice
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SeasideSusie profile image
SeasideSusieRemembering

Gerispice

A few people have mentioned problems with Actavis, you can read through some of the posts found with a search:

healthunlocked.com/thyroidu...

I've taken Actavis for many, many years and I have noticed no difference at all, I use both the 100mcg and 50mcg dose tablets.

If you know that you do well on one particular brand, you can take your paper prescription to any pharmacy, check which one can supply your preferred brand. Or tell your pharmacist and/or GP that you react badly to Actavis (also Northstar and Almus which are the same) and ask for your preferred brand to be dispensed or stated on your prescription.

Gerispice Were you on Actavis originally, your first post on the forum said

"I have been well in the UK for 7 years on combination T4/T3. I’ve moved to New Zealand where Activis T4 is not licenced. "

Gerispice profile image
Gerispice in reply to SeasideSusie

Thanks Seaside Suzie, but I just had a little chat with the Pharmacist and he said my preferred brand isn’t available in this country. I’ve been living in Auckland for a while. They gave me Mercury Pharma there, which I reacted very badly to. So I bought UniPharma online. I’m going to have to continue to do that. It’s annoying when I’m entitled to free prescriptions.

SeasideSusie profile image
SeasideSusieRemembering in reply to Gerispice

But were you taking Actavis before, you mentioned it in your first post on the forum, as quoted above.

Did you check the ingredients of all the available Levothyroxine that I linked to for you in your previous post and compare them to the Unipharma T4?

Is there a common ingredient in the other brandsd that you may be reacting to?

There are alternatives, as you will see in that document, maybe explain your problem to your GP and ask for a brand which doesn't contain the offending ingredient. It can only be the fillers, the levothyroxine sodium will be the same.

helvella profile image
helvellaAdministratorThyroid UK in reply to SeasideSusie

I did notice that Actavis ablets are somewhat harder than they used to be - but that cvhanged happened quite a while ago. Other than that, I too have noticed no change and I take a tablet every day.

Gerispice profile image
Gerispice

I did look at it, thanks. I’m inclined to suspect that the levothyroxine sodium must be somehow different. Where are they sourcing it from? How do they manufacture it? I know that Drs say the different brands have different bioavailability. That can’t be down to the fillers alone, surely.

Nanaedake profile image
Nanaedake in reply to Gerispice

If you want to understand something about how levothyroxine is regulated in the UK, read the MHRA report. You need a good scientific background to understand it all.

gov.uk/government/publicati...

Gerispice profile image
Gerispice in reply to Nanaedake

I’m busy reading this now.

helvella profile image
helvellaAdministratorThyroid UK in reply to Gerispice

I suggest you read this page before making any assumptions about sources of levothyroxine.

The page is about why there were pretty substantial issues with delivery of the levothyroxine ingredient in a new formulation of Eltroxin in New Zealand.

Specifically, the following lists of the excipients (ingredients other than the active pharmaceutical ingredient):

Excipients - Old formulation

Magnesium stearate

Lactose monohydrate

Maize starch

Acacia

Excipients - New formulation

Magnesium stearate

Microcrystalline cellulose

Pre-gelatinized maize starch

Purified talc

Silicon dioxide (Colloidal anhydrous silica)

And the sourcing of the active pharmaceutical ingredient:

Is there any difference in the active ingredient (levothyroxine) contained in the old formulation and the active ingredient contained in the newly formulated tablets?

No. The active ingredient (levothyroxine also known as thyroxine) contained in the new formulation is identical to the active ingredient contained in the old formulation, and is sourced from the same manufacturing site, namely Sandoz GmbH, Schaftenau Plant, Biochemiestrasse 10, Langkampfen, Tyrol, Austria.

And the production process:

How is the new formulation of Eltroxin manufactured?

The new formulation of Eltroxin is manufactured by blending of the ingredients (initially the levothyroxine and a portion of the microcrystalline cellulose and later the remaining ingredients), then direct compression of the blend to form tablets.

The old formulation of Eltroxin was manufactured by blending all the ingredients except for the magnesium stearate and a portion of the maize starch. The blend was wet granulated and the granules dried and blended with the magnesium stearate and remaining portion of the maize starch prior to compression into tablets.

medsafe.govt.nz/hot/alerts/...

In that case, it appears the difference was not due to a changed active pharmaceutical ingredient which remained the same. But was either the change in excipients, or the change in process, or the combination.

There are many reasons to believe that the precise manufacturing processes can have quite an impact even if all ingredients remain the same. An example of that occurs with oral solutions of levothyroxine. They can only be made at all by dissolving the levothyroxine in an alkali, then neutralising the alkaline solution with an acid. That is, the order and intervening processes (such as mixing) absolutely have to be done in the right order for the product to even exist. Looking at lists of ingredients doesn't tell you that! :-)

Gerispice profile image
Gerispice

I have noted that some preparations use anhydrous levothyroxine sodium, whereas some use just levothyroxine sodium. I spoke with the Pharmacist in Hazel Grove today about this, as it appears it’s the anhydrous form that doesn’t agree with me. He agreed that this could be an influencing factor, although I don’t fully understand why there is a difference. This is just how it appears to be to me, and I need to do further research.

SeasideSusie profile image
SeasideSusieRemembering in reply to Gerispice

There's an old thread here about the difference between anhydrous levothyroxine sodium and levothyroxine sodium which helvella contributed to:

healthunlocked.com/thyroidu...

Gerispice profile image
Gerispice in reply to SeasideSusie

Thanks!

helvella profile image
helvellaAdministratorThyroid UK in reply to Gerispice

And I have now posted a brand new post on the question:

healthunlocked.com/thyroidu...

Dlm3557 profile image
Dlm3557

I’ve been taking Actavis 50mg for about 4 years now with no problems at all.

Haven’t noticed any changes other than the odd occasion when it’s hard to get hold of! No idea why.

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