Lactose free brands of Levo

[sunnyside7]

Hello all: My Levo prescription specifies Teva lactose free and for a couple of years I've been stable on Teva: I know it doesn't agree with some people but I have liked it. However today I got a different brand, Aristo, which is lactose free but unknown to me. The pharmacist told me Teva doesn't exist anymore! I asked if I'll aways get this new brand now but they said they can't guarantee it, however they'll always order in a lactose free one. On the one hand I'm relieved the new brand is lactose free too, but I'm obviously a bit worried they will be chopping and changing things now, after so long with me being stable: I know the NICE guidelines say not to change brand? Does anyone know: is Teva now defunct or might I find it somewhere else? Has anyone had the Aristo? It's made in Germany so obviously I'm worried re: The upcoming B word too.... I'd hate to have to start taking Levo with Lactose in it.

[helvella Administrator]

I'd be absolutely amazed if the Teva product no longer exists.

Not just that Teva is a massive company and it would be very odd for one of their products to simply disappear. But also, although it is obviously a possibility, if it has gone why are you the first (and only, so far) person to quote your pharmacist saying that? (Yes - someone has to be the first. )

Aristo arrived a few months ago and there have been a few posts which discuss it. Aristo is also a significant company in Germany.

A very short time ago, I fell across some information about another lactose-free make - Glenmark. But absolutely no-one has yet said they have had it dispensed.

If I were you, I would contact Teva and ask.

Teva UK Limited

Address

Field House, Station Approach, Harlow, Essex, CM20 2FB

Telephone

[phone]

Medical Information e-mail

[e-mail]

Stock Availability

0800 590 502

WWW

tevauk.com

Medical Information Direct Line

[phone]

medicines.org.uk/emc/compan...

Half the time, we are saying how wonderful pharmacists are. That they are much better informed about medicines than GPs. The other half the time we are wondering how they ever qualified. And marvelling at their ability to use weasel words and misinform without so much as an um or err of hesitation.

UK Levothyroxine Tablets

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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....

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🔸 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.

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🔹 Aristo (marketing authorisation holder)

🏭 Aristo Pharma GmbH (manufacturer)

No lactose ingredient

  100 microgram  PL 40546-0159

🟢 PIL: mhraproducts4853.blob.core....

🟣 SPC: mhraproducts4853.blob.core....

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🔹 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....

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🔸 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....

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🔹 – 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...

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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.

[sunnyside7 in reply to helvella]

Thankyou so much, your post contains really helpful info.

When I queried how I'd had Teva last month, if they'd shut down (He implied it was the whole company!) I was told " using up old stock".

He was a bit grumpy to be honest, not dealt with him before, but I'd be astounded if he was making stuff up! It really is bizarre, and I will contact Teva with the details you've posted.

And I guess I'll try the new stuff and see how I get on...

[helvella Administrator in reply to sunnyside7]

Wiki, not always 100% reliable, says this:

Teva Pharmaceuticals

Teva Pharmaceutical Industries Ltd. (Hebrew: טבע תעשיות פרמצבטיות בע"מ‎), also known as Teva Pharmaceuticals, is an American Israeli pharmaceutical company with dual headquarters in Petah Tikva, Israel (global) and Parsippany, New Jersey, U.S. (commercial). It specializes primarily in generic drugs, but other business interests include active pharmaceutical ingredients and, to a lesser extent, proprietary pharmaceuticals. It is the largest generic drug manufacturer in the world and one of the 15 largest pharmaceutical companies worldwide.

en.wikipedia.org/wiki/Teva_...

I simply cannot believe that the largest generic drug manufacturer in the world could shut down yet it not be widely reported and discussed!

Of course, they could have sold off some products. But their UK company site still very clearly lists levothyroxine:

Levothyroxine

Teva markets Levothyroxine. The Patient Information Leaflet for Levothyroxine from Teva can be downloaded below, along with other information such as Frequently Asked Questions where applicable. For further information about Teva's medicine(s) you can contact Teva's Medical Information Service by email: [e-mail] or telephone: [phone].

products.tevauk.com/patient...

I can't think why your pharmacist appears to be suggesting otherwise? Is it possible that the distributor which supplies them no longer list Teva levothyroxine?

[2pence in reply to helvella]

Yesterday a Tesco pharmacist told me that Morningside Liothyronine 20 mcg was discontinued which was news to Morningside who still supply to one of Tesco’s suppliers.

[helvella Administrator in reply to 2pence]

Perhaps I should start to collect pharmacists' "fake news"?

It makes me want to be facetious towards (some) pharmacists and ask: Anyone been told that Mercury Pharma liothyronine has also been discontinued?

[jsy_girl in reply to helvella]

I’m sure this would also be news to boots pharmacy who when I rang them yesterday said my prescription order of Teva was on its way. Not only that but 3 different strengths because my doctor insists they don’t do a 12.5mg strength so I’m getting some 100s, some 50s and some 25s so I can take 125 and 150 alternately... pretty clearly they do a 12.5mg so who knows what that’s about.... but anyway should have Teva arriving today so not sure what this pharmacist is on about...

[helvella Administrator in reply to jsy_girl]

Absolutely agree that Teva do a 12.5 microgram levothyroxine - and have done since the brand returned to the levothyroxine market with their "New Formulation".

Is it possible that someone is looking at the prices?

12.5 microgram tablets are just over £12, then 75 microgram tablets at just over £3, the rest under £2.

bnf.nice.org.uk/medicinal-f...

Both 12.5 and 75 are unique to Teva.

[jsy_girl in reply to helvella]

Quite possibly but not sure the GP would have had them right in front of her. She was planning to put me to 125mg and it was me that asked to go to 137.5mg (as that’s the amount I need for my weight by the dosing calc of 1.6mg per kg). She agreed but said as above that she can’t prescribe that amount but was happy to do it across two amounts as it’s fairly stable in the blood. Nevermind eh!!! Just more complicated for me now as I’m having to plan them out with a pill box so I don’t accidentally take the same dose two days running...

[elsaldo]

Hi Sunnyside7,

Aristo is the only brand that I can take as I react badly to the fillers in other brands... i tried them all.

I seem to be good so far with Aristo though

I previously had a hard time getting this brand from Boots so I changed to a Pharmacy who had a supply of it.

When their supply ran out I gave them a contact name at Aristo (someone here gave me the name) and got some ordered directly. Just in case you have future problems getting it.

Sally x

[helvella Administrator in reply to elsaldo]

Contact details for most, possibly all, pharmaceutical companies in the UK are readily available here:

medicines.org.uk/emc/browse...

[vocalEK]

One possible explanation is that the parent company of your drug store has decided for some reason to not deal with Teva. To the individual pharmacist that situation might equate to "it doesn't exist any more."

[helvella Administrator in reply to vocalEK]

I do appreciate the logic. But I don't think that a pharmacy in the UK, which has to follow the NHS contract, would be able to avoid dealing with Teva or at least distributors of Teva products.

[Santori in reply to helvella]

Pharmacies in the UK are private companies, they don't have to provide a specific brand only the correct dose of a drug if generic available. Some will have it and some won't.

[helvella Administrator in reply to Santori]

You are right that they are private companies.

You are right that they do not, in general, have to provide a specific brand, only the correct dose.

However, they do have to provide any validly prescribed medicine. And it appears that Teva is the only company which supplies some medicines - for example:

TIAGABINE

CYPROHEPTADINE HYDROCHLORIDE

CAPSAICIN Cream

SIMETICONE Oral suspension

Therefore, directly or indirectly, they are bound to have to handle Teva UK products.

[Santori]

If the GP prescribes a propriety drug, the pharmacist will usually provide it. However, they don't have to.

The NHS prefers non propriety preps as its cheaper.

[helvella Administrator in reply to Santori]

Was that a response to me?

Yes, non proprietary medicines are usually less expensive.

But if Teva is the ONLY supplier of a particular medicine, there is no possibility of changing manufacturer. And I think three out of the four named products are technically non-proprietary but solely marketed by Teva.

[Santori in reply to helvella]

The medicines have various equivalents. E.g. panadol has many substitutes, just like Capsaicin cream, and no doubt the other medicines.

As I said the Pharmacy doesn't have to supply a particular brand. Though they would try to.

Your point was that Pharmacies can't avoid dealing with Teva. My response remains yes they can, its their decision. Whether any do, I don't know, that's their commercial decision.

[helvella Administrator in reply to Santori]

According to the British National Formulary, there is only one company that is listed for Capsaicin cream:

bnf.nice.org.uk/medicinal-f...

That appears to be confirmed by the MHRA Summary of Product Characteristics and Patient Information Leaflets library:

products.mhra.gov.uk/search...

Zacin and Axsain are the two products. Both from Teva. Only.

I didn't randomly think of a medicine - I did look before I replied.

I cannot see how a pharmacy can supply a capsaicin cream other than these Teva products unless they go down the far more expensive route of ordering in "specials".

[Santori in reply to helvella]

It's a brand name. Other products with the same or similar ingredients probably exist.

So I'm not sure what point you're now making. I replied to your initial point and have nothing further to add, as this is going around in circles.

[sunnyside7]

Hi: just an update from Teva:

"Levothyroxine 100mcg Tablets (PL 00289/0039) marketed by ourselves are in stock.

Should your pharmacy be experiencing any issues in sourcing the above product, they can contact our Customer Solutions team directly by emailing [e-mail] or calling 0800 590 502 for further guidance."

so that clears that up!

After a month in the other brand I'm now back with the Teva and have taken 4 weeks of that... However my TSH has gone up 2 points since my last tests in Feb so I'm being given a slightly increased dose. What I don't know if is the rise was due to the month on the other brand or if it's been building for a while... when I think back I have felt rubbish since the spring but what with the Pandemic, I put it down to stress. However this month I felt really awful hence the blood tests. I hope things stabilise because having lots of blood tests just now isn't ideal.

My prescription does say Teva only but the pharmacy can't guarantee they will be able to always have it. Finger's crossed!

[helvella Administrator in reply to sunnyside7]

Clears it up except why your pharmacy insisted Teva no longer exist!