Teva & Accord mixing them?

[PolyannaYorkshire]

My GP has just prescribed 25cg TEVA levo. to be taken with 100 mcg levo. Accor..is this OK?I thought people had problems mixing two brands?

[helvella Administrator Thyroid UK]

It isn't that any two makes interfere or interact with each other.

The problems are:

If you do not tolerate them together, which one is causing that? Or do you not tolerate both?

You could split some of the Accord 100, or take five Teva 25. By the time you have done that for a few days, then swapped round, you will likely be short of one or the other. Thus you'll need a new prescription earlier - which some surgeries seem to be very strict over.

(If you had some other makes and dosages around, that might give you other options. But many simply do not have any stock at all.)

A similar argument exists of you find one make seems more potent than another.

If you are getting this combination for this prescription, what will you get next time? Especially in this time of multiple shortages, I imagine you will be in line to get whatever they have. You might find a make you have never heard of next time you get them dispensed. Which is a difficult time to have to suddenly make a decision - accept or reject - and discuss why.

[PolyannaYorkshire in reply to helvella]

Thank you. Don't know what to do as I've not felt well for ages now. I am being referred to a neurologist so maybe not start the Teva 25s until I e been seen .. Ill keep on chopping the Accord !! Thank you for your help. 🤗

[SlowDragon Administrator]

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.

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

Teva, Glenmark or Aristo (100mcg only) are the only lactose free tablets

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

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

Accord only make 50mcg and 100mcg tablets

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

beware 25mcg Northstar is Teva

List of different brands available in U.K.

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

Posts that mention Teva

healthunlocked.com/search/p...

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.

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).

[PolyannaYorkshire in reply to SlowDragon]

Thank you for your help Slow Dragon

[App1]

You could request prescription for 50 Accord and split them?..

[PolyannaYorkshire in reply to App1]

HiUp to now I jave been splitting the 50s but my GP won't prescribe the 50s to me now insisting that I have a 25mcg. I said I was used to the 100mcg Accord but he wouldn't budge!!

[App1 in reply to PolyannaYorkshire]

doesnt trust that they will not be mixed up I suppose......

[Gingernut44 in reply to PolyannaYorkshire]

You could try another brand, ie Wockhardt, they don’t have mannitol in them. They only make 25’s, it doesn’t have to be Teva. I believe Mercury Pharma also makes 25 mcg.

[helvella Administrator Thyroid UK in reply to Gingernut44]

My medicines document has a table of lactose/mannitol/acacia UK products

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/wfhrlmb5983co...

From Google Drive:

drive.google.com/file/d/11z...

[PolyannaYorkshire in reply to helvella]

Thank yoiu Helvella

[PolyannaYorkshire in reply to Gingernut44]

Thank you Gingernut Very helpful!!