Everytime I collect my thyroxine prescription the brand is different

[Spangle15]

Hi everyone

Everytime I get a new prescription of thyroxine the brand is different (all from the same pharmacy), as I’ve recently changed my dose, it means this month I’ve been given four different brands! It’s not something I’ve queried before but I’m sure I’ve now seen posts here recommending sticking to the same brand.

In which case, how can I ensure that happens? And what brand suits most people best.

(The 25mcg I took this morning are completely different from any I’ve had before, I dropped one on the floor and it disintegrated when I picked it up, usually they would stay solid so goodness knows how different that formula is to others!)

Thanks everyone.

[shaws Administrator]

Tell your pharmacist what you prefer to be sourced by them. Most get the one you want but at other times they may have to give you an alternative.

My pharmacist does his best.

[Spangle15 in reply to shaws]

Thank you.

[bantam12]

Your GP can specify the brand on your prescriptions and the pharmacy should have it logged on their computer so you aren’t issued different brands in the future.

The best brand is the one that suits you, we are all different so only you can decide on that one.

If you need to take a 25mcg and the brand doesn’t make a 25 then just split a 50 in half, this is what I do as Accord which is one I take only make 100 & 50s.

[Spangle15 in reply to bantam12]

Thank you.

[Sparklingsunshine]

Hi

I've found Accord suits me best, two others I've tried didn't suit me, I now get it named on my prescriptions. I think I've read Mercury and Accord are widely available and most easily tolerated. A lot of people don't get on with Teva, but if you're lactose intolerant then it's the best brand as its lactose free.

[Spangle15 in reply to Sparklingsunshine]

Thank you.

[helvella Administrator]

My medicines document shows you all the available products in the UK.

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...

My Vade Mecum has a section on how to write prescriptions for a specific brand.

helvella - Vade Mecum for Thyroid

The term vade mecum means:

1. A referential book such as a handbook or manual.

2. A useful object, constantly carried on one’s person.

Please don't get put off by the number of pages!

In particular, it is not intended that you sit and read the document. Just that you download it and know you can look things up.

Not everything is in this one document - my major medicines document is still separate!

From Dropbox:

dropbox.com/s/vp5ct1cwc03bl...

From Google Drive:

drive.google.com/file/d/1ZW...

Perhaps you would let us know which products you received?

[Spangle15 in reply to helvella]

Thank you Helvella.

The current brands are Glenmark 25mcg

And Mercury Pharma 50mcg

Prior to these I was given Wockhardt 25mcg

And Aristo 100 mcg

[helvella Administrator in reply to Spangle15]

Glenmark is new to the UK market, and we are only just starting to see mentions of it in posts.

When I first started taking levothyroxine, I tried to believe that I wouldn't notice any differences. Within a few months, I was certain it did make a difference.

The best first step would be to see how you get on with what you have got.

Then ask the pharmacy if they will make a note for you to have whichever you find best.

Only if that fails, ask your GP to prescribe by brand. (It can be a problem if a make is in short supply, for example.)

[Spangle15 in reply to helvella]

Thank you for all your help and advice.

[SlowDragon Administrator]

Aristo, Glenmark and Teva are lactose free

Teva contains mannitol, and this is possibly why it upsets so many people

List of different brands available in U.K.

thyroiduk.org/if-you-are-hy...

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.

New guidelines for GP if you find it difficult/impossible to change brands

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.

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)

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

Always test thyroid levels early morning, ideally before 9am and last dose levothyroxine 24 hours before test

[Spangle15]

Thank you so much SlowDragon. I really appreciate you taking the time to respond.