Change in Brand of levothyroxine

[Syrupafigs]

I have had my levothyroxine increase to 75 micrograms, I was previously taking the band name accord 50 micrograms daily, which i have tolerated well.

I went to pick my prescription today and they wanted to give me the brand name Teva 75micrograms which I declined,

Please can any suggest a brand to take because accord only supply 50mrg or 100mcgs

Thanks

[helvella Administrator Thyroid UK]

Teva is the ONLY make in the UK that produces a 75 microgram tablet.

You could ask for a prescription that specifies a 50 and a 25 - there are several possibilities.

Have you ever taken Teva? While a disappointingly large number of people do not tolerate it well, some find it their preferred make. It might be worth at least dipping your toe. (I don't get on with it. )

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.

From Dropbox:

dropbox.com/s/shcwdwpedzr93...

From Google Drive:

drive.google.com/file/d/12N...

[Syrupafigs in reply to helvella]

thank you for your reply ,I have not yet tried Teva but I have read a few posts saying fellow members do not tolerate Teva, therefore I would prefer to try a different brand even if i have to take two tablets

[helvella Administrator Thyroid UK in reply to Syrupafigs]

I understand that. Unfortunately, there seems no way of predicting the response of one individual to Teva levothyroxine.

[Syrupafigs in reply to helvella]

Thanks

[Tintin0202 in reply to Syrupafigs]

I asked for just 50mcgs and took one and a half tablets - easy enough to cut one in half. I don't advise taking 25mcgs of any brand as they have more fillers in them and I found in the end that I was intolerant to all the brands the dispensary gave me, so I am now on liquid thyroxine. I couldn't tolerate Teva - was worse than others.

[Haynton in reply to Tintin0202]

Hi regarding your comment on 25mcg,what side effects did you get?

[Tintin0202 in reply to Haynton]

Side effects were brain fog, joint pains, heavy eyes, fatigue etc - similar to hypo symptoms. They stopped within a few days of coming off 25 mcg thyroxine.

[Haynton in reply to Tintin0202]

Thanks,this is interesting, I have been really tired and eyes feel heavy

[SeasideSusie Remembering]

Syrupafigs

If you like Accord then you could stick to that. You could have all 50mcg tablets and just cut one in half, take one and a half tablets to give 75mcg daily. Or you could have 100mcg and 50mcg tablets and alternate them to average 75mcg daily.

[Syrupafigs in reply to SeasideSusie]

thanks

[SlowDragon Administrator in reply to Syrupafigs]

Either way ….you need new prescription from GP

If staying on Accord brand…..request GP prescribe increased number of 50mcg tablets per month

You can then cut 50mcg in half to get 25mcg extra per day

Get a weekly pill dispenser, so you have safe place for remaining half

If GP is difficult give them these guidelines

gov.uk/drug-safety-update/l...

If a patient reports persistent symptoms when switching between different levothyroxine tablet formulations, consider consistently prescribing a specific product known to be well tolerated by the patient.

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

[Syrupafigs in reply to SlowDragon]

Thank you

[Horsey07]

I was concerned when my latest order of Levothyroxine turned out to be Teva, but decided to try it and it hasn’t caused me any problems at all. I could just be lucky, but perhaps it’s worth a try?

[Syrupafigs in reply to Horsey07]

Thanks

[Jules0001]

Hi Syrupafigs,

I’ve just been faced with this exact problem. I have been taking the brand Almus for the last 5 years. Finally referred by my GP to an endocrinologist as my TSH levels were “in range” but I was feeling awful. He took one look at my broader blood test results (that I paid for privately) and said I needed to increase my dose to 75mcg. The Almus brand does not come in 75mcg. The pharmacy tried to give me Teva. I spoke to the endo again and he said stick with my current brand and to split a tablet. I’ve had the pharmacist and the prescriptions clerk at the Doctors telling me not to split a tablet as it’s unlicensed. I didn’t want to add a change of brand into the mix when I’ve pushed so hard to get my dose increased. The prescriptions clerk said she’d never heard of people only sticking to one specific brand and that they are interchangeable. I’ve never tried Teva but why would I want to add a brand change into the equation that I am still trying to balance?

[Sparklingsunshine in reply to Jules0001]

Hi

That sounds like bunkum, I spoke to the pharmacy team at my surgery and when I was on 75mcg I was told I could use 50mcg and split one, no problem. I have Accord as a named brand on my prescription. I'm very drug sensitive. No one ever suggested it was unlicenced.

[helvella Administrator Thyroid UK in reply to Sparklingsunshine]

I think it true that the product has not been tested and approved for splittting.

The official line is that tablets which can safely be split will say so in the Patient Information Leaflet. (Just having a break line or scoring does not mean splitting is approved.)

Levothyroxine tablets don't have gastro-resistant coatings or other physical reasons not to split.

However, as they could prescribe 50 one day, and 50+25 the next, which would be far more uneven than splitting tablets!

The only significant issue in my view is losing crumbs as you split the tablets.

[Sparklingsunshine in reply to helvella]

Hi

I can see that, you would need to make sure you got every bit, it begs the question though if switching brands during dose changes isn't generally recommended and as Levo comes in 25mcg as its smallest tablet dose, why don't the manufacturers make them all in the range of doses required.

Why don't Accord, my brand, make 25mcg? Or 75mcg? It would make life easier all round if all UK Levo brands came in 25mcg for example.and I agree I never liked alternating doses.

Perhaps I'm being anal but I never felt OK doing it. Not physically so much but my OCD kicked in lol. I like to take the same dose daily.

[helvella Administrator Thyroid UK in reply to Sparklingsunshine]

Well, Teva make 12.5!

A lot of it seems to be down to history. I posted an overview of historic products just yesterday:

healthunlocked.com/thyroidu...

I think 25 became more widely available due to the changes to specification in 1980. At least one was introduced then to make it easier to make an adjustment to long-term stable doses.

I can imagine that a company launched with one product, but then couldn't see a financial advantage in adding other dosages.

And I suspect that we have Teva 12.5 and 75 simply because the company already made those dosages for other markets (the factory is in Europe).

I found I could dose alternate days for a while, then start to feel something wasn't quite right. Changing back to the same dose every day seemed better.

[SlowDragon Administrator in reply to Sparklingsunshine]

Teva brand upsets many people

Aside from Teva being the only brand that makes 12.5mcg its significantly more expensive

Teva brand only

12.5 mcg is £12.49 per pack 28 tablets

25mcg tablets are 98p per 28 tablets

50mcg tablets are 90p per 28 tablets

Teva brand only

75mcg tablets are £2.58 per 28 tablets

[SlowDragon Administrator in reply to Jules0001]

Almus is Accord brand boxed by Boots. Also boxed as Northstar by Lloyds

Of course you can cut 50mcg tablets in half

Doctors and pharmacies have been gaslighting thyroid patients for decades over the different brand issues

Government stepped in recently and issued guidelines …here

gov.uk/drug-safety-update/l...

If a patient reports persistent symptoms when switching between different levothyroxine tablet formulations, consider consistently prescribing a specific product known to be well tolerated by the patient. If symptoms or poor control of thyroid function persist (despite adhering to a specific product), consider prescribing levothyroxine in an oral solution formulation.

[Jules0001 in reply to SlowDragon]

Thank you SlowDragon for your reply.

[Sparklingsunshine]

Hi

I take Accord as a named brand, I'm currently on 125mcg, when I was on 75mcg I was given 42x 50mcg tablets each month and told to half one every day. Or you could try alternating 100mcg one day, 50mcg another, averaging 75mcg. Some people are sensitive to dose changes however and it might not work for you. You might need to ask your GP surgery to state Accord on the prescription.

[Hafa]

This is a general comment about the difficulty of splitting tablets to achieve a correct higher dosage. I take 50 mcg (2 - 25 mcg tablets) and have been told by my doctor to slowly increase the dosage. During this transition period, I take the 2 tablets and 1 drop of SERB thyroxine (liquid form) in a glass of water. Each drop is 5 mcg. I live in France SERB is available in a 30-day supply bottle. I've tried to find info for SERB availability in other countries: ndrugs.com/?s=l-thyroxine%2...

[Starmen]

I had a problem with Teva however my pharmacy agree to dispense the medication in 25mcg tablets of Wockhart brand. This has worked for me .

[elwins]

They tried to give me Teva when they put me up to 75mcg found the fillers did not agree with me so asked to go back to my old brand of 50mcg and 25mcg tablet works well for me and boots are very good at prescribing the correct make. My records at both boots and the doctors surgery have on my records no Teva. It was the mannitol which was causing the problems it is used as a filller.