Is it ok to dose with mixed brands of levothyroxine?

[DizzyD]

Hi all am looking for some advice please as to what I could say to pharmacist regarding dosing with mixed brands of levothyroxine that I have been dosing with for the past seven weeks in preparation for private TFT next week. Dose of levo for that period was: 50mcg of one brand 25mcg of another brand.(can't recall each brand names...get my meds in a blister pack)

In most recent blister pack, one of the levo had been changed to another different brand and have no idea if this change of brand, a week before TFT could effect the results. Really Would appreciate some feedback on this issue to assist me as I intend to go confront the pharmacist.

Thank you all most kindly

[SlowDragon Administrator]

Depends which brands

For example 50mcg Northstar, Almus and Accord are all same levothyroxine inside the box - ie Accord

25mcg Northstar is Teva

Many people find Levothyroxine brands are not interchangeable.

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

List of different brands available in U.K.

dropbox.com/s/6h3h0qi4eqwi6...

Teva poll

healthunlocked.com/thyroidu...

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

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

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)

If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test

If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal

[DizzyD in reply to SlowDragon]

Thank you slow dragon.....armed with info you so kindly pointed me to, off to see pharmacist now. Have a rewarding day