Sour/bitter taste on Teva 100mcg Levothyroxine. Any experience with asking Dr for different brand?

[LMorgan1]

Hi everyone. I recently had a thyroidectomy due to thyroid cancer and was put on 100mcg Levo. Within a couple of weeks I was feeling the best I’ve felt for years. But my repeated prescription was a different brand and for the last week this awful taste and dry mouth is making me feel sick. I can see Teva use mannitol instead of lactose and could that be the issue? I was wondering if anyone had any experience with asking doctor to switch the brand back as I’m worried I’ll be laughed off as all levothyroxine meds appear to be very similar. Many thanks!

[SlowDragon Administrator]

Teva brand upsets many people

Bloods should be retested 6-8 weeks after any dose change or brand change in levothyroxine

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

But for some people (usually if lactose intolerant, Teva is by far the best option)

Teva, Aristo and Glenmark are the only lactose free tablets

Most easily available (and often most easily tolerated) are Mercury Pharma or Accord

Accord is also boxed as Almus via Boots, and Northstar 50mcg and 100mcg via Lloyds ....but doesn’t make 25mcg tablets

beware 25mcg Northstar is Teva

List of different brands available in U.K.

thyroiduk.org/medications-f...

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

REMEMBER.....very important....stop taking any supplements that contain biotin a week before ALL BLOOD TESTS as biotin can falsely affect test results - eg vitamin B complex

[LMorgan1 in reply to SlowDragon]

Thank you! I feel frustrated after so much upset with thyroid cancer, I then settled brilliantly with my previous prescription, just to have more trouble now. I’m only 6 weeks post op and due more bloods this week. Really hope it won’t affect them. Thanks again.

[SlowDragon Administrator in reply to LMorgan1]

It almost certainly will

Which brand of levothyroxine were you on first?

[LMorgan1 in reply to SlowDragon]

To be honest I’ve been on a few! They gave me Mercury pharma 25mg initially, then I had activis 100mcg and then repeat prescription of wockhardt, but then they just gave me Teva, but only Teva has caused problems.

[SlowDragon Administrator in reply to LMorgan1]

That’s typical that it’s Teva that causes upset

Request that note added to all future prescriptions “No Teva”

Moving forward try to make sure you always get same brand at each prescription

Most widely available

....Mercury Pharma make 25mcg, 50mcg and 100mcg tablets

Or

Accord make 50mcg and 100mcg tablets (also as Northstar via Lloyds and Almus via Boots)

BEWARE Northstar 25mcg is Teva

[helvella Administrator Thyroid UK]

I encourage you to make a Yellow Card report to the MHRA about any medicine issue you experience - or even suspect.

This post says more.

🟨 Making Yellow Card Reports 🟨

healthunlocked.com/thyroidu...

[LMorgan1 in reply to helvella]

Thank you I will!

[elwins in reply to LMorgan1]

I had trouble with Teva due to fillers. Boots noted on my records for me no Teva and I went back to what I had always been on. Also contacted doctors surgery to note my records and filled in a yellow card.

[LMorgan1 in reply to elwins]

This gives me hope I won’t just be laughed at when I call the doctor! Thank you

[elwins in reply to LMorgan1]

You just have to be firm, Boots told me they had one other customer who had the same problems. You just have to find a chemist who can supply what brand you require that suits you and stick to it. Best of luck.