Liquid levothyroxine.

[Mugs19]

I'm supposed to change my medication from T3 0nly to combination T4 with T3. I picked up my prescription from the hospital last Wed and Endo has prescribed 5ml daily of liquid Levo(50 mcg) + 5mcg Lio x 3 daily. Went to pharmacy and had a long conversation with them about not switching brands and need Morningside Lio. Pharmacist didn't understand that these are two different things so explained that I have been on T3 only because every brand of Levo has upset me, and that them switching the T3 to Mercury Pharma has also resulted in a prescription I can't use and now I am trying the liquid thyroxine in the hope it won't upset me and that I must have Morningside Lio. They agreed to order what I want. I went to collect it on Saturday. I tried to check what was in the bag. this was difficult because of so many packets of pill and the bag had been tied. I untied it and found a bottle among the pill packets and asked if this was the only bottle I had been given. She took the bag back from me , found another pack if liquid which at first glance could have been the same and pointed to another one among the packets which I couldn't see properly, but I was assured I had got 3 bottles of 100 ml, and that the pills were Morningside, so I took it home. Only to find out that I have been given 3 different brands of Liquid thyroxine. I don't know if this matters as much as with pills, as the reason for it being prescribed was that it should be kinder to me without the usual excipients that are in pills. Looking at the ingredients quickly, I could see that there are 'E' numbers in them. One of them has 2 and another only 1. So there is a difference between them. My daughter thinks I should take them back and refuse to move out of the Pharmacy till they change it. When this happened last month they refused to exchange the Mercury Pharma for Morningside saying it is policy that once it has left the shop it cannot be returned and I have no appetite for a confrontation any more. I feel like I have spent most of my adult life jumping through hoops to get what I need and I would rather lie down and die at the moment than carry on like this. Would it be likely to be a disaster to take all 3 brands consecutively? That way I might find out whether one has more benefit than the others?

[Star13]

I’m a little confused with your post but I will try and reassure you.

First of all you mention that you were changed to 5ml of 50mcg oral solution T4 but later in your post you mention 100mcg. What is the dose of your liquid T4 is it 50 or 100mcg per 5ml? Can you list what your dose of T3 only was before And what your combination T3/T4 dose is now.

Secondly, don’t get yourself upset about what they have given you 1. They won’t change it because they are not allowed to once it’s left the pharmacy And 2. It really doesn’t matter about having different makes/brands of the oral solution.

I’m like you I had to switch to the oral because I couldn’t tolerate any tablets of T4 of any make. I started on the oral Teva, was very sceptical because it was Teva, then got MP, then got Ten Pharma, then Creo now back to Teva. I can honestly tell you it’s made no difference despite the E numbers and very slight difference in excipients. I’m Gluten, soy and lactose intolerant so believe me I react to everything and the oral solution has been a life saver. So if you have your normal T3 meds the only thing that you will need to get used to is the change over from the drop in T3, as you are now taking T4 too. You may notice some slight change but you may not but try not to assume it’s side effects from the oral solution and persevere for a while.

I think your Endo was very good to give you the liquid, I had to fight for over a year for mine!

[Mugs19 in reply to Star13]

Thankyou so much for your reply. It is reassuring. I have been given 3 bottles of 100 ml volume liquid Levo. 5 ml will deliver a 50 mcg dose. Endo has recommended taking 50mcg Levo and 15 mcg Liothyronine. I had been building up my dose of T3 only and am now at 40/45mcg daily. Advice on how to transition to the recommended dose of combined T3/T4 would be welcome. Yes he is a nice man but I have been hypo for two years now post RAI and have got iller. It hasn’t helped that he was put on ward duty and has had pneumonia/Covid so I haven’t been able to communicate with him for 8 months. I am glad he is back.

[Star13 in reply to Mugs19]

I’m not sure what you are saying is correct about your oral T4 dose.

5ml of 100mcg oral solution would be 100mcg not 50mcg. Please check both the bottle and the box of each that you have been given to see what it says and I think you will find it says “each 5ml of oral solution contains 100mcg of Levothyroxin solution”. Please do this straight away and then check the instructions you have been given on your label and if necessary call the pharmacy and ask them to check what dose you should be on.

If she wants you to take 50mcg daily then you would only be taking 2.5ml of the 100mcg. If the bottle is a 50mcg bottle then you would take 5ml daily so please check what the strength of this oral solution is as it could cause you to over dose on what he wants you to take.

[Mugs19 in reply to Star13]

Have just checked. All 3 brands Ten Pharma, zentiva, creo, say the same: Each 5 ml dose contains 50 mcg liothyronine. Contents of bottle=100 ml. I am ok with this. Thankyou for your kind concern.

[Star13 in reply to Mugs19]

Ah! Its a 5ml per 50mcg dose with 100ml of content! Boy they certainly gave you the full gambit of selection. Personally I liked Two Pharma best but see what you think. I do hope it works for you.

[Angel_of_the_North]

You need the brands stated on the prescription. They can't give out any meds that have left the shop to anyone else; they have to be destroyed