Levo: Just opened my repeat prescription pack and... - Thyroid UK

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Lulla profile image
11 Replies

Just opened my repeat prescription pack and I see they have changed my 25mg dose’s brand. From mercury to teva

Do chemists just do that without saying anything?

Also my 100 mg supply has been a different make from the outset.

How can one tell if a particular brand does not agree with you if you have 3 different ones?

Just wondering if this is common. Thanks

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Lulla profile image
Lulla
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11 Replies
Lalatoot profile image
Lalatoot

They change according to the availability. 25mcg tablets seem particularly prone to change.

It is best to stick to the same manufacturer where possible.

If there is a brand you don't want you can ask the surgery to write NOT TEVA on the prescription.

Lulla profile image
Lulla in reply to Lalatoot

Thank you. Will do

helvella profile image
helvellaAdministratorThyroid UK

Yes - brands do get switched.

If/when you know what does, or does not, suit you, get your pharmacy to note that on their records for you.

I have long taken two different makes - but I do care what they are!

I find that 100 microgram Accord plus 25 microgram Mercury Pharma are acceptable. But definitiely not Teva and preferably not Wockhardt.

UK Levothyroxine Tablets

➖➖➖➖➖➖➖➖➖➖➖➖➖➖

Last updated 15/09/2020.

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.

Lulla profile image
Lulla in reply to helvella

Thank you. I wish I had opened the package there and then and told the pharmacy that I would like to avoid testing a new brand for 6 weeks to then have to maybe find out that they don’t suit me. I guess that’s everyone else’s situation too when brands are substituted. Thank you very much for the file on brands.

SlowDragon profile image
SlowDragonAdministrator in reply to Lulla

ALWAYS double check what's in the bag before leaving the pharmacy

Even if it says specific brand required on prescription it's often completely ignored by pharmacy

helvella profile image
helvellaAdministratorThyroid UK in reply to SlowDragon

Preferably before leaving the counter. That way, they cannot suggest you have even touched the product. So exchange, if needed, is simple.

A couple or so times, the pharmacy staff have asked what I am doing. I explain that I always check (product and expiry) and one even said it is a good idea.

SeasideSusie profile image
SeasideSusieRemembering

Lulla

You should retest 6-8 weeks after a brand change. I think SlowDragon has a link to something in the NICE guidelines about this.

SlowDragon profile image
SlowDragonAdministrator

Many people find Levothyroxine brands are not interchangeable.

Once you find a brand that suits you, best to make sure to only get that one at each prescription.

You can request GP add brand to prescription

Watch out for brand change when dose is increased or at repeat prescription.

Many patients do NOT get on well with Teva brand of Levothyroxine. Teva contains mannitol as a filler, which seems to be possible cause of problems. Teva is the only brand that makes 75mcg tablet. So if avoiding Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half

Teva, Aristo and Glenmark are the only lactose free tablets

healthunlocked.com/thyroidu...

Teva poll

healthunlocked.com/thyroidu...

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).

Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after

Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime

verywellhealth.com/best-tim...

No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap. Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away

(Time gap doesn't apply to Vitamin D mouth spray)

MissGrace profile image
MissGrace

Almus (Activas) who do your 100s don’t do a 25mcg tablet so you inevitably have to mix brands unless you alternate doses in some way to add up to the same overall amount, e.g 150 one day, 100 next day = 125 a day. Or get half the amount of Activas 50mcg prescribed instead of the 25s and use a tablet splitter - which is what I do so I only have one brand of tablets. I have been told some GPs don’t like you splitting tablets, but they do have the splitting line on them to help. 🤸🏿‍♀️🥛

Lulla profile image
Lulla

Thank you all. Lots of good advice. For 6 years since my thyrodectomy I was on the same brand that I could get in Europe and elsewhere over the counter. Since returning to the Uk a year ago I’ve had to switch so I’m trying to get used to these new brands

MissGrace profile image
MissGrace

For what it’s worth, my specialist insists I stick to one brand and likes Actavis (Almus) best but if you can’t get that, Mercury Pharma. 🤸🏿‍♀️🥛

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