Different brands of Levo

[Yellow1955]

every month I seem to get different make of levothyroxine from my chemist usually have Accord or Activas 100mg or Wockhart or Teva 25mg is it better to stick to same brands ? And are any better than others filler wise for side effects ?

[helvella Administrator]

Many people find that they are intolerant of one (or more) products.

Even if they are tolerant, some people find they feel different makes feel as if they are slightly weaker or stronger than each other. There is good research which suggests there can be genuine differences in how much levothyroxine the various products deliver even if the tablets contain the exact same amount of levothyroxine.

I do support keeping to whatever you have found works best for you - so far as possible.

UK Levothyroxine Tablets

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Last updated 13/04/2020.

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.

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🔹 Accord – formerly Actavis (manufacturer)

50

100

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🔹 Advanz – branded both “Mercury Pharma Levothyroxine” and “Mercury Pharma Eltroxin” which are identical (manufacturer)

25

50

100

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🔸 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.

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🔹 Aristo – (manufacturer)

100

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🔸 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. ❗

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🔹 Teva – (manufacturer)

12.5

25

50

75

100

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🔹 Wockhardt – (manufacturer)

25

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🔹 – identifies manufacturers.

🔸 – identifies ‘own label supplier’ products.

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

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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...

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This document is available as a PDF here:

dropbox.com/s/6h3h0qi4eqwi6...

[Yellow1955 in reply to helvella]

Wish I could get one tablet of 125mg would make it so much easier

[helvella Administrator in reply to Yellow1955]

Until you want to try 100 or 150!

In the USA (and many other countries), they have maybe a dozen dosages. But it does make it more difficult to adjust the dose - which usually requires a new prescription. Whereas you could readily take 100, 100+25, or 100+25+25.

Also, most (possibly all) countries in which there are many doses add colouring agents to help with identification. And some people are intolerant of those very dyes. Hence, the 50 microgram dosage is usually undyed - white. So those people have to make their dose up from just one dosage tablet!

We already have enough issues with supply chain/stock level. I suspect there would be even more if the number of dosages were increased!

There are arguments in both directions.

[greygoose in reply to helvella]

Just a bit of trivia…

Here in France, we have - or had, I don't know about now - just one brand of levo (Levothyrox) which goes from 25 mcg to 200 mcg in 25 mcg steps. The pills are all the same colour - white - but the boxes are different colours. Unfortunately, sometimes not different enough! I was once given 75 mcg instead of 175 mcg - which made me pretty ill for a month! - and the colours were very similar (and the pharmacist had the nerve to say, 'well, it's not much of a difference'!!!). And, that's just one of the draw-backs. The other one is that all the doctors I've seen believe that you can't increase your dose above 200 mcg, because there isn't a pill with a higher dose, and any suggestion of adding a 25 mcg pill to a 200 mcg pill is greeted with looks of disbelief, as if you should be immediately incarcerated for suggesting such an insane idea! I guess there is no perfect system. Not many intelligent doctors, either!

[Yellow1955 in reply to greygoose]

A relative in Germany tells me that their Levothyroxine goes up in 25mg increments which makes sense and same brand

[helvella Administrator in reply to Yellow1955]

Yes, at least one make does (maybe they all do? I am not sure).

25 to 200 micrograms.

mein.sanofi.de/produkte/L-T...

[fuchsia-pink]

Many people fee better if they stick to the same brand. A few really struggle if their brands are constantly changed. Lots struggle with Teva - see poll - but others swear by it, because it's lactose-free. So it's not the same for everyone. If you struggle with different brands, ask your pharmacist for your preferred brand, or get t put on the prescription.

[helvella Administrator in reply to fuchsia-pink]

Aristo is also lactose-free.

[SeasideSusie Remembering]

Yellow1955

Accord and Actavis are the same. Accord is the new name for Actavis and they also produce Almus (for Boots) and Northstar (for Lloyds Pharmacy). They are all the same tablet, just with different branding. Actavis is gradually changing over to the Accord brand name, I dont know whether the others are.

One exception to this is Northstar 25mcg which is made by Teva, not Accord.

Accord don't make 25mcg tablets so if you need 25mcg and want to stick to the same brand you will have to quarter a 100mcg tablet or ask for 50mcg Actavis/Accord tablets to be added to your prescription and half one of those.

See helvella 's post in this thread which gives all Levo tablet information - 8th reply down.

healthunlocked.com/thyroidu...

Side effects from fillers vary from person to person, from none to severe, so what suits one wont necessarily suit another. If you are fine on Actavis, or any of the previous brands you were given, ask your pharmacy to only dispense this brand for you. If they say they can't then make sure you get a paper prescription from your surgery and ring round to find a pharmacy who has your preferred brand and take it there.

PS - I see Helvella posted whilst I was composing my reply

[Suzi_ in reply to SeasideSusie]

Hi

Do u have any recommendations for t 4/T3 combination names and ratio in USA. I am planning to switch from Armour thyroid, 30+ 15 mcg for 2 years. I been having reaction like out of breath, rash etc for the past few months.i think I posted my blood test before

Thanks

[SeasideSusie Remembering in reply to Suzi_]

No, I'm in the UK so not familiar with any US brands I'm afraid. Even if I did know brands, the same applies about one brand may suit one person but not another so it's a case of try a brand and see if it suits.

As for ratio of synthetic Levo/T3, that's individual too. If the ratio of T4:T3 in Armour suits you, start with that same ratio with synthetic hormone replacement and see how it goes.

Breathlessness can be low ferritin.

Rash can be a reaction to fillers in tablet.

[Suzi_ in reply to SeasideSusie]

Thanks

[helvella Administrator in reply to Suzi_]

You can find out all the products which are available in the USA by going to this FDA site:

dailymed.nlm.nih.gov/dailymed/

Sometimes products are listed still which are no longer available.

[SlowDragon Administrator]

academic.oup.com/jcem/artic...

Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).