Actavis

I have always had actavis Levothyroxine 50mg,but now my pharmacy have given me mercury brand.Since using this brand I have terrible ringing in my ears.My pharmacy is Co -op,anybody know who stocks this brand ?

[SlowDragon Administrator]

Are you still only on 50mcg ?

How long have you been on 50mcg ?

50mcg is only a starter dose

Bloods should be retested 6-8 weeks after each dose increase or brand change

Ring around different pharmacies to find the brand you need

Many people find different brands are not interchangeable

But tinnitus may more likely be due to being under treated and on too low a dose

Do you have any recent test results you can add?

The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH significantly under one) and most important is that FT4 is in top third of range and FT3 at least half way through range

NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.

nhs.uk/medicines/levothyrox...

Also what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

Ask GP to test vitamin levels

You may need to get full Thyroid testing privately as NHS refuses to test TG antibodies if TPO antibodies are negative

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Is this how you do your tests?

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or vitamins

thyroiduk.org.uk/tuk/testin...

For thyroid including antibodies and vitamins

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels

[Hidden in reply to SlowDragon]

Thank you for your reply.l recently had angioplasty,I did not need a stent.I was told to take aspirin lifelong.I was advised to take statins,as my family has history of stroke/heart disease.I suffer with depression,and I find it an uphill battle with my doctor to higher my Levothyroxine.l was told quite firmly I do not need to up my dose.I have stopped taking the statin,because it made my Tinnitus spike.Also I believe the change of brand to mercury has made the tinnitus louder.I will go back to see my Doctor,with my concerns.

[SlowDragon Administrator in reply to Hidden]

First thing is, do you have any actual blood test results? if not will need to get hold of copies. You are legally entitled to printed copies of your blood test results and ranges.

The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results

UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

Important to see exactly what has been tested and equally important what hasn’t been tested yet

We see hundreds or probably thousands of patients kept inappropriately on too low a dose of levothyroxine

First step is to get copies of recent tests, see exactly what has been tested.

Get private testing for any that are missing or if not done thyroid testing as advised at last test

All thyroid tests should be done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

Come back with new post once you get results

Then either see a more up to date GP or see an endocrinologist to get dose of levothyroxine increased

Depression is common hypothyroid symptom

Email Dionne at Thyroid UK for list of recommend thyroid specialist endocrinologists

thyroiduk.org/tuk/About_Us/...

[SlowDragon Administrator in reply to Hidden]

Tinnitus is frequently linked to low B12

See GP and request that they test B12, folate, ferritin and vitamin D

[SlowDragon Administrator]

Previous post from a year ago

healthunlocked.com/thyroidu...

[MissGrace]

Boots do Activas 50 under the name Almus. The foil pack inside says Activas on it. 🤸🏿‍♀️🥛

[SeasideSusie Remembering]

My Actavis comes from Rowlands Pharmacy.

It might be helpful for you to know that Actavis is rebranded for other pharmacies, different name but still Actavis (as shown on the foil backing of blister pack and also printed on the box):

Almus - for Boots but may occasionally be available at other pharmacies

Northstar - for Lloyd's Pharmacy but occasionally maybe available at other pharmacies.

Note that Northstar 25mcg tablets are made by Teva not Actavis.

Actavis is on the process of being renamed Accord so the brand name may change in the near future.

[Hibs1 in reply to SeasideSusie]

I have Accord on what was Activas from 4 weeks ago

[SeasideSusie Remembering in reply to Hibs1]

Mine was still Actavis 3 weeks ago, just put my prescription in for next lot, it will be interesting to see if they have the new packaging yet.

[Hibs1 in reply to SeasideSusie]

I also got 'literature ' about the name change with the tablets!🌞

[SlowDragon Administrator]

8 months ago post ....high cholesterol is linked to being hypothyroid

healthunlocked.com/thyroidu...

Statins are not recommended for anyone who is hypothyroid

nhs.uk/conditions/statins/c...

If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.

So often patients are started on far to small a dose...and left far too long, frequently refused dose increase in levothyroxine

gp-update.co.uk/Latest-Upda...

Starting levothyroxine treatment

Traditionally we have tended to start patients on a low dose of levothyroxine and titrate it up over a period of months. RCT evidence suggests that for the majority of patients this is not necessary and may waste resources.

For patients aged >60y or with ischaemic heart disease, start levothyroxine at 25–50μg daily and titrate up every 3 to 6 weeks as tolerated.

For ALL other patients start at full replacement dose. For most this will equate to 1.6 μg/kg/day (approximately 100μg for a 60kg woman and 125μg for a 75kg man).

If you are starting treatment for subclinical hypothyroidism, this article advises starting at a dose close to the full treatment dose on the basis that it is difficult to assess symptom response unless a therapeutic dose has been trialled.

See GP and get thyroid tested plus vitamin D, folate, ferritin and B12

Come back with new post once you get results

[helvella Administrator Thyroid UK]

First, Actavis seems currently to be in the process of re-branding as Accord. (No change to the tablets or the manufacturer.)

Second, both Northstar and Almus (both "own label brands") are actually Accord product (other than Northstar 25 microgram tablets).

Northstar brand is owned by the Lloyds pharmacy company group and is often obtainable there (including Sainsbury pharmacies).

Almus brand is owned by Walgreen Boots Alliance and is often available in Boots pharmacies.

Other than those hints, ring round every pharmacy you can get to and ask, I'm afraid.

UK Levothyroxine Tablets

➖➖➖➖➖➖➖➖➖➖➖➖➖➖

Last updated 24/02/2020.

This is a list of currently marketed levothyroxine tablets in the UK.

—————————————————————

🔹 Accord – formerly Actavis (manufacturer)

50

100

—————————————————————

🔸 Almus (an ‘own label supplier’ brand owned by Walgreen Boots Alliance – Boots pharmacies and Alliance distributor)

50 – This is repackaged Accord – formerly Actavis.

100 – This is repackaged Accord – formerly Actavis.

—————————————————————

🔹 Mercury Pharma (manufacturer – part of Advanz) includes both “Levothyroxine” and “Eltroxin” which are identical.

25

50

100

—————————————————————

🔹 Teva (manufacturer)

12.5

25

50

75

100

—————————————————————

🔸 Northstar (an ‘own label supplier’ brand owned by McKesson – Lloyds pharmacies and AAH distributor)

25 – This is repackaged Teva. ❗

50 – This is repackaged Accord - formerly Actavis. ❗

100 – This is repackaged Accord - formerly Actavis. ❗

—————————————————————

🔹 Wockhardt (manufacturer)

25

➖➖➖➖➖➖➖➖➖➖➖➖➖➖

🔹 – identifies manufacturers.

🔸 – identifies ‘own label supplier’ products.

❗ – Take particular note of the actual product which varies by dosage.

—————————————————————

Numbers refer to tablet dosages in micrograms.

If there is anything inaccurate in this information, please let me know by Private Message:

healthunlocked.com/user/hel...

➖➖➖➖➖➖➖➖➖➖➖➖➖➖

[legsgran]

Aspirin can give you tinnitus also.

[crimple]

I can only tolerate Actavis/Almus because it doesn't contain acacia powder. I was given 25mcg Mercury Pharma and had terrible gut problems. After 2 weeks I stopped taking the 25mcgm tablet and made up the dose with a 50mcgm Actavis levo tablet cut in half and things very soon went back to normal!

I wouldn't touch TEVA levo with a bargepole!

[Workingitout]

Interesting posts as I take 75mg Levo and was having 50mg Activas brand and 25mg Mercury Pharma. When using up a glut of 25mg's I noticed a significant difference in how I felt - had more energy and was less achy. So, for the past year or so I have have had only the Mercury Pharma brand but developed Tinnitus a year or so ago.

Could be that I am under medicated as SlowDragon suggests, but interesting that the symptoms developed around the same time I started taking only Mercury Pharma.

[MjM2015]

I've heard that 50mg of levo no matter the brand is the cleanest with no dyes or fillers and since I found this out I've been taking my meds his 50mg and I have no horrible symptoms apart from fatigue. But that's prob down to my vitamin levels being low

[helvella Administrator Thyroid UK in reply to MjM2015]

In the USA, and quite possibly other countries which have coloured/dyed levothyroxine tablets, the 50 microgram tablet simply has no colouring agents. It is otherwise the same as all the other dosages.

Further, it is usual for all tablets to be the same physical size in all dosages when they are coloured. If you need, say, 100 micrograms of levothyroxine, taking two 50 microgram tablets will very nearly double the amount of excipients you consume. (Excipients are ingredients other than the Active Pharmaceutical Ingredient.)

In the UK, and many other countries, all levothyroxine tablets are white.

[Capri71]

Does anyone know if Accord have changed anything to the ingredients? I started Accord from the usual Actavis a month ago and have started to have palpitations and slight dizziness since?

[helvella Administrator Thyroid UK in reply to Capri71]

I have not heard or seen anything to suggest that the formulation has changed.

I assume you have compared the Patient Information Leaflet of your last pack and this current pack. Can you see any differences?

[Capri71 in reply to helvella]

I have and can’t see anything obvious. Just seems strange and is the only change I’ve made 🤷🏼‍♀️

[helvella Administrator Thyroid UK in reply to Capri71]

I was rather hoping others who have now received Accord-branded levothyroxine would dive in and let us know their experiences.

(I do always bear in mind that the old formulation of Teva levothyroxine, the one that got withdrawn from the market back in 2012/2013, also had no evidence of any change of formulation.)

I suggest you should consider making a Yellow Card report:

yellowcard.mhra.gov.uk/

Any issue can be reported - however slight, or serious.

[Capri71 in reply to helvella]

I found an old pack of actavis and took that on my last dose. So far no palpitations or dizziness 🤔 gonna give it a few days then try the other pack if it happens again then I’ll know and yellow card it.

[Angieruss01 in reply to Capri71]

How did you get on with the Accord after a few days back on Actavis?

[Capri71]

Whilst on old actavis I was fine with the new accord have ended up increasing my dose by 50mcg which has stopped all symptoms. Strength difference 🤷🏼‍♀️ ?

[bantam12 in reply to Capri71]

They are exactly the same tablet just a different name on the packet.

[Darktide]

Heya I’m here as I’m having the same issues , since the change from activas to accord despite many saying it’s just a rebrand , unfortunately I’ve felt a change , it could be the change of source ingredients or something but definitely a change , any suggestions?

[helvella Administrator Thyroid UK in reply to Darktide]

Have you made a Yellow Card report? (And everyone else who feels they are affected by this issue.)

I suspect that is our only route to get a clear explanation - if enough reports are made and the MHRA investigate.

[Darktide in reply to helvella]

No not yet , I only found out about it now , also I came across this -

gov.uk/drug-safety-update/l...

Seems they are aware at least of the issues between changing brands.

Can you link where to do the yellow card ,cheers

[helvella Administrator Thyroid UK in reply to Darktide]

This post explains:

healthunlocked.com/thyroidu...