Levothyorine 75mcg?: So I've been prescribed... - Thyroid UK

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Levothyorine 75mcg?

luthien profile image
21 Replies

So I've been prescribed 50mcg and a top up of 25mcg by a separate GP, this was about 6 months ago. That means two items on my prescription every three months, which of course (in the UK) costs £9.35 per item.

I've just checked with my GP and they're saying they cannot prescribe Levothyroxine 75mcg as this isn't manufactured as one single dose. Is this correct? Where do I find this out?

I'm currently on two different brands so it would be good to switch to one.

Update - All good - GP has prescribed 75mcg

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luthien profile image
luthien
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21 Replies
helvella profile image
helvellaAdministrator

Your GP really is hopeless in this regard.

First, you must be in England (the rest of the UK does not impose prescription charges at all). That means almost everyone prescribed levothyroxine will be eligible for a Medex - Prescription Charge Exemption certificate.

The eligibility is under this:

myxoedema (that is, hypothyroidism which needs thyroid hormone replacement)

nhsbsa.nhs.uk/exemption-cer...

(There is one exception - when levothyroxine is used as part of a block-and-replace regime for hyperthyroidism.)

Lots more information by following the link.

There is one make, Teva, which is produced in 75 microgram tablets. Your GP is just plain ignorant to say otherwise. It takes a few seconds to check that.

Follow this link:

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

However, some people find they cannot tolerate the Teva make of levothyroxine. We suspect it is might be due to it containing mannitol and/or acacia.

helvella - Thyroid Hormone Medicines

I have created, and try to maintain, a document containing details of all thyroid hormone medicines in the UK and, in less detail, many others around the world.

dropbox.com/s/shcwdwpedzr93...

helvella profile image
helvellaAdministrator in reply tohelvella

Just to note, if you need another prescription dispensed before you get your Medex sorted...

If you need to pay prescription charges before your medical exemption certificate arrives, you can get a refund as long as:

you ask for an FP57 refund receipt when you pay (you can’t get one later)

the start date of your medical exemption certificate is the same or earlier than the date you pay for your prescription (certificates are backdated one month from the date that we receive your application - they can’t be backdated any further)

You must claim your refund within three months of paying.

The FP57 refund receipt tells you what to do.

Hi as you get Levo you are entitled to a medical exemption,which also means your other meds if you take any, will be free. I applied and now carry a little card with my details on it to show at the pharmacy. Mine lasts for 5 years and then I will need to renew it. I think your GP has to sign it to confirm you are taking Levo.

Hi

I was on 75mcg a while ago. I take Accord brand only due to problems with other brands. Accord comes in 100mcg and 50mcg, making 75mcg awkward. I spoke to the pharmacist who works at my surgery, you can either take 100mcg one day, 50mcg the next, making an average dose of 75mcg.

Or your GP can prescribe 42x 50mcg tablets a month so you half one tablet daily to make 75mcg. There is only Teva which comes as a 75mcg tablet. It's lactose free so suits some people but not everyone gets on with it.

Guidelines usually state its best to stay on one brand of Levo for continuity of dose and to avoid side effects. Hope that helps.

luthien profile image
luthien

Hey all, GP had to check, prescribed 75mcg, all good.

He hadn't prescribed that dose for years so forgot to check if it's still manufactured, just assumed it wasn't.

Mistakes and oversights happen, that's why we have to check and investigate.

helvella profile image
helvellaAdministrator in reply toluthien

That response, what the doctor said, is somewhat disingenuous.

Teva was re-launched after a gap of a few years in, from memory 2016.

It is the only 75 microrgam tablet that has ever been available.

Making it sound as if he hasn't prescribed it since he was in shorts is an excuse. It could not possibly have been more than five years ago!

The Product Assessment Report for the 75 micogram Teva levothyroxine is dated 15th September 2016:

mhraproducts4853.blob.core....

But, you are right, mistakes do happen and I certainly make my share!

greygoose profile image
greygoose in reply toluthien

Yes, but, as Sparklingsunshine has said, you shouldn't be paying for your levo anyway! You have hypothyroidism, so prescriptions are free.

I'm afraid that on this fourm, if you wish to reply to someone's comment, you must click on the blue 'Reply' button under that comment. Otherwise, the person will not be notified that you have replied. :)

luthien profile image
luthien in reply togreygoose

I wasn't replying to a particular comment hence I didn't hit the reply button! I do know how the forums work!

greygoose profile image
greygoose in reply toluthien

OK, sorry to have interferred, but it's unlikely the two people that have taken the trouble to reply to you will see what you've written.

luthien profile image
luthien in reply togreygoose

One person has!

People don't always reply expecting a response, well for the three years I've been on here I don't expect responses, I just help others out :)

tattybogle profile image
tattybogle in reply toluthien

Hi again luthien. I remember your earlier posts ...

"Mistakes and oversights happen, that's why we have to check and investigate."

Well, ..... if this is the same GP that told you to wait for another blood test before taking the levo he'd already prescribed for your TSH of 13 (!).... despite knowing you were seeing a fertility expert about TTC (!)... (who fortunately told you to ignore the Doctor and hurry up and take it )

and who now fails to mention to you that no one diagnosed with hypothyroidism ever has to pay for Levo (!), when you ask about sorting out your prescription costs. ... Mmm ... if it IS the same bloke, you'd better keep a very close eye on him indeed .... cos he makes a heck of a lot of mistakes.

(i might let him off with forgetting that 75mcg tablets exist ... but the rest of it is firmly in the ' could do better ' camp )

has you TSH come down to good levels for TTC yet ? .... hope so .

luthien profile image
luthien in reply totattybogle

This GP is a different one; I wasn't happy with the one which didn't acknowledge needing to reduce my TSH levels. I've not actually seen this one as he's just covering at the moment. So as far as competency it's just the 75mcg he hasn't prescribed in a while, he did call me personally to apologise. He's so far when it's been dose adjustments up or down so from 50 to 75 or 150 down to 125 has prescribed double (two 50s) or one plus a lower one (100 plus 50) for a period of time; so two lots of 50 etc, and the patient can dose adjust the remainder as they feel, i.e. 50 with half a 50, then if the patient feels okay keep it at that or take it up to 50 plus 50. Much like some people on here do. I think he works on patients adjusting it themselves so he was happy with prescribing two 50s for me to see what works but I'm happy with what I'm on.

No one apart from on here has ever mention that I can get my thyroid prescriptions free, actually Boots have. But I don't know how it works if I'm in-between GPs at the moment. I'm moving over to a private GP (this one) so don't know if they'll sign a prescription exemption, I shall ask.

It's fine as it's all sorted, new prescription on it's way for one 75mcg tablet. I'll work out the exemption in a bit.

tattybogle profile image
tattybogle in reply toluthien

Oh good. He sounds better . i actually prefer to have the ability to split / slightly adjust dose by myself . so i would rather have, say 50mcg's and 25mcg tablets than a 75mcg. (and also i don't feel so well on Teva tablets and they are the only place who make the 75mcg size )

luthien profile image
luthien in reply totattybogle

I've contacted the GP surgery to keep the same 50 and 25 split as I'm going through IVF therefore don't want additional side effects from changing this brand

luthien profile image
luthien in reply totattybogle

Levels for TSH came down in July to 0.96. Specialist is happy.

fibrolinda profile image
fibrolinda

Mention to GP that you have just found out that due to hypothyroidism you are entitled to free prescriptions. I was entitled for years and didn't know... My GP assumed I already did. He did the form there and then.

luthien profile image
luthien in reply tofibrolinda

I shall call up and ask, they're doing over the phone consultations or book weeks in advance . .

Workingitout profile image
Workingitout

I take 3 x 25mg Mercury Pharma brand Levo per day as I found this brand suited me better.

luthien profile image
luthien in reply toWorkingitout

interesting.

luthien profile image
luthien in reply toluthien

maybe I'll keep to the same split for now and look into it in the future.

Wetsuiter profile image
Wetsuiter

I m surprised dispensing pharmacist didnt pick up on the fact you shouldn't be paying.

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