Has Brexit affected delivery of German Thybon Henning liothyronine to the NHS?

[dizzy864]

I get Thybon Henning liothyronine on an NHS prescription from my local Tesco. My prescription went to Tesco last week but I have not heard that they have it in yet. It usually only takes two or three days. Dose anyone know if deliveries for the NHS has been affected by Brexit?

[jimh111]

They were probably buying it cheaply from a German pharmacy and charging the NHS a fortune. This route is no longer available, they would have to import the drug under licence which they probably won't want to do as they can't profiteer.

[dizzy864 in reply to jimh111]

Hi, thanks for your reply. I rather expected that.Do you know of a vegetarian alternative to Thybon henning?

[helvella Administrator Thyroid UK in reply to dizzy864]

For what reason are you on Thybon Henning rather than any other product? Might be able to make some suggestions if we know what issues you need to avoid.

[dizzy864 in reply to helvella]

I had problems with uk pharma. I think it was more due to variations in strength than a problem with an ingredient but I can't be sure. I am vegetarian so insist on a vegetarian tablet. I was on Perigo until it was discontinued and then I switched to Thybon Henning as it was the only tablet available at the time that was vegetarian.

I have just contacted Tesco pharmacy about my current request. They told me that they do have it in and apologised for not contacting me - I just got missed apparently.

They also told me that they have had no problems with any medications due to Brexit. That might just be because their supplier had extra stocks and the problem hasn't shown up yet. So I'll have to wait and see.

[helvella Administrator Thyroid UK in reply to dizzy864]

Are you aware that Perrigo eventually became Mayne Pharma? Which is being manufactured - but whether you stand any chance of getting it imported on your behalf, I have no idea!

I couldn't see any obviously non-vegetarian ingredients in any of the three UK licensed liothyronine tablets.

[dizzy864 in reply to helvella]

The problem is that they list ingredients that sound vege or that could be vege. Often they don’t want people to know that they re not vege.I m happy with thybon henning for as long as I can get it. I ll research the U.K. ones again if it becomes a problem. But I prefer non U.K. tablets because every one else has stricter tolerances than here.

[helvella Administrator Thyroid UK in reply to dizzy864]

Really? I have never seen any evidence of that. (With the exception of USA levothyroxine having a 95-105% potency range against UK's 90-105%.)

That doesn't mean it isn't so, but without clear evidence, I'll put it in the "maybe/maybe not" pile.

[dizzy864 in reply to helvella]

Hi,I read that the UK tolerance is + or - 10% whilst the EU and America are + or - 5%. The aim with all manufacturers is to get the quantities spot on. I read that UK Pharma were unable to get it right whilst other manufacturers do manage it. This means that UK pharma could make a batch that is only 90% strength followed by a batch that is 110% strength. It's perfectly legal but I could not toleratate going from 90% one day to 110% the following day as I start a new batch. Uk pharma has a terrible record!

[helvella Administrator Thyroid UK in reply to dizzy864]

A number of years ago, the USA tightened their tolerance to 95 to 105% for levothyroxine tablets. Shortly after, the UK tightened ours to 90 to 105% (used to be 90 to 110%). So they are now identical at the top end. These tolerances apply from manufacture to expiry date.

If a product has a shelf-life of two years, and the deterioration is even, then at the very worst we would see a batch made today at 100%, deteriorating to 95% in January 2022, and 90% in January 2023. And that only if stored in the worst conditions that are allowed.

I suspect that few UK levothyroxine tablets actually fall below 95% at the time of dispensing but that would need to be verified - which is difficult.

Do bear in mind that the USA only tightened their specification for levothyroxine after many years of appallingly poor potency issues. Some makes were recalled many time towards the end of the 20th century. The FDA then demanded that every levothyroxine tablet in the USA had to apply for new licensing. At least one make ended up being withdrawn entirely because they could not conform to the standards despite trying repeatedly.

The USA also had a history of using "overage" - putting a bit extra levothyroxine into the tablets in the expectation that they would fall to be within standard by the time a patient actually took the tablet. Which didn't always happen so some ended up effectively over-dosed. This has been outlawed.

Yes - the UK had the Teva scandal but that was a specific single make issue. Even then, it was not about the amount of levothyroxine in the tablets.

I am not convinced that we can apply a blanket "every one else has stricter tolerances than here".

[dizzy864 in reply to helvella]

Hi,I was unaware that there had been a change. I have only ever had lio from the states. I have also only had a problem with lio here at least as far as strengths are concerned. I did have a problem with teva levo but I put that down to something in it's mixer. I have to admit that I am extremely sensitive to everything and problems with meds is very common for me.

[helvella Administrator Thyroid UK in reply to dizzy864]

The issue with "old" Teva, interestingly, was not with the amount of the levothyroxine in the tablets, but the unapproved substitution of an ingredient.

Unfortunately, however the specifications are written, we are individuals and makes can vary in effect even if they fully comply.

[jimh111 in reply to dizzy864]

Isn't all liothyronine vegetarian in the sense it is manufactured hormone?

[dizzy864 in reply to jimh111]

I wish!! No, its most annoying as liothyronine is synthetic and therefore vegetarian. Manufacturers use fillers and mixers that are from animals. Totally unnecessary. Some tablets are vegetarian and some change from batch to batch as they buy either a synthetic version of a filler or an animal one, and others always use animal fullers..

[helvella Administrator Thyroid UK in reply to jimh111]

A number of products are manufactured with things like gelatin. Not, so far as I am aware, any of the three UK licensed liothyronine tablets.

I believe all magnesium stearate in UK medicines is now vegetarian but, in the past, some has been animal-derived. (Quite likely true pretty much everywhere but I am not sure.)

[dizzy864 in reply to helvella]

Thanks for replying. I haven’t done any research for a while.Magnesium stearate was used in a number of different tablets. Manufacturers refused to use the vegetarian variety all of the time. Apparently the animal derivative could be a lot cheaper and was sometimes used instead. I thought that was not good for anyone as tablets need to be the same all the time. It makes it easier for me if it is now always vege.

[McPammy]

I have been on ThyBon Henning from Germany, which is no longer possible privately from Bennewitz in Germany. I also get T3 medication from the NHS. The hospital matched ingredients for me to ThyBon Henning. They came up with Mayne Pharma 5mcg. This works well for me. I initially tried a couple of others that didn’t suit me. Have you tried Mayne Pharma. It’s a US based company so no issues with supply and this was confirmed by my hospital pharmacist.

[dizzy864 in reply to McPammy]

NO, I've never tried Mayne Pharma although I've just been told it's the same as Perigo which I took for a couple of years until it was discontinued. Unfortunately, when Perigo was discontinued it did not become Mayne Pharma straight away or I would have switched to it. I did contact Perigo at the time it was discontinued and they were not able to say what was happening with it. So I switched to Thybon.

[McPammy in reply to dizzy864]

Mayne Pharma might be worth a try then

[dizzy864 in reply to McPammy]

I ll stick with thybon for as long as it’s available. Then I ll try and get Mayne pharma.Thank you