thyroid medicine: Hi please can someone advise... - Thyroid UK

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thyroid medicine

Sally1253 profile image
20 Replies

Hi please can someone advise?

I am finally stable on a dose of 100 liquid levothyroxine from taking TEVA for past year and now my local chemists are unable to get this brand in or another ZENTIVA which I can tolerate. my level last check was 1.27 tsh

They have said that as the stock is so low that I will just have to accept whatever they can source every ten days and maybe changing brands every 10 days because of the stock issues so I have been given zentiva to last for next week and next weeks is brillpharma for week after might have to consider alliance healthcare but doesnt changing brands constantly affect your levels? they wont allow me to come off and tablets arent an option as I am allergic to a lot of fillers since adverse reaction to covid v

I would be grateful of any advice

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Sally1253
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20 Replies
Sally1253 profile image
Sally1253

im also worried every time changing that I could be allergic to ingredients and not be able to continue with medication

SlowDragon profile image
SlowDragonAdministrator

Try ringing around/visiting all the local pharmacies

Alternatively try these online ones

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

Is this an NHS or private prescription?

Danielj1 profile image
Danielj1 in reply to SlowDragon

I am intrigued about this thread - I always assumed that the brands followed a standard approach and won’t differ much. I have always had to take what brand was offered at the time - never thought about these variations to consider ? Interesting indeed ...

SlowDragon profile image
SlowDragonAdministrator in reply to Danielj1

Government Guidelines are to stick to one brand (or to avoid any that upset you )

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)

Glenmark or Aristo (100mcg only) are lactose free and mannitol free. May be difficult to track down Glenmark, not been available very long

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).

Sally1253 profile image
Sally1253 in reply to SlowDragon

yes teva tablets are the ones i reacted to and other tablet fillers i take liquid teva because of it or try to but cant as that brand isnt there or zentiva that i have had twice

Sally1253 profile image
Sally1253 in reply to SlowDragon

its a nhs prescription I will have a look at the link thank you

Sally1253 profile image
Sally1253 in reply to SlowDragon

i have called a number of local ones but they order in from prescriptions for the liquid levothyroxine and takes 4 days to know what is coming in

Jaydee1507 profile image
Jaydee1507Administrator in reply to Sally1253

My liquid levo is usually in next day. Maybe try a different pharmacy if you have that option.

Also, why a 10 day prescription? Mine is for a month.

Sally1253 profile image
Sally1253 in reply to Jaydee1507

I dont know sometimes they give me two bottles-20 days but alot of times when I collect they give me slip to owe one I could take to another pharmacy but they are all saying they wont know what brand will come inI called TEVA myself in the end they went out of stock two weeks ago apparently and not due back in until end of september/ beg of oct the lady was lovely and said get the pharmacy to call her and she will try to locate at whole salers but now the chemist not answering to phone or email . the last phone call they told me they cant provide one to one service, moved mountains to get the other brand in and should just take what im given no acknowledgement that other medicines have caused me allergy symptoms and that shouldnt be changing brands constantly. ive called all the local pharmacies they have to order in and cant confirm brand until its in

Jaydee1507 profile image
Jaydee1507Administrator in reply to Sally1253

I've been on liquid for years now and never been given an 'owing' slip for the odd bottle, just have to wait 24 hours for the 3 bottles to come in. Something isn't right here.

I also recently talked to the pharmacist about getting one brand, as like you keep getting different ones. He explained how my GP surgery would have to write the prescription with the named brand in the first line and told me that probably Teva would be the best to ask for as far as availability goes.

Personally I would try switching pharmacy, perhaps to one that uses a different wholesaler. I quit using Boots years ago as they were so bad for various issues and now just use one on the corner of my road and haven't looked back.

Sally1253 profile image
Sally1253 in reply to Jaydee1507

I know definitely sounds that way doesnt it the one next to the actual doctors are shocking so I use one the other end of town that until now have managed to get the teva but i guess this out of stock issue is teva rather than them just dont know what to do personally as dont want to be switching brands constantly until they are back in stock

Jaydee1507 profile image
Jaydee1507Administrator in reply to Sally1253

I've actually just got another prescription for Levo which I'll drop in the chemists later. Am now curious to see what I get back. Will let you know!

Sally1253 profile image
Sally1253 in reply to Jaydee1507

yes please keep everything crossed for you!

helvella profile image
helvellaAdministratorThyroid UK

There are several levothyroxine oral solutions. Teva is made by Delpharm - and I think some of the others are also. Whether they are 100% identical is more difficult to assess.

Delpharm acquired several Famar manufacturing sites - which makes it even more confusing:

famar-group.com/new/delphar...

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...

Sally1253 profile image
Sally1253 in reply to helvella

thats very helpful thank you

McPammy profile image
McPammy

I’ve been in liquid Levothyroxine now for about 3 years after being in tablet form prior. I phoned my surgery medication manager and requested that they put the brand I much prefer on my prescription and also requested minimum 2 months supply (I did want 3 months but they said no). I much prefer Wockhardt brand. They can’t guarantee this brand from their usual supplier. So what I did was call Wockhardt customer service in Wrexham and ask them if they could deliver direct to my village pharmacy. They said of course they could at no delivery charge either. I then gave my pharmacist Wockhardt’s tel number. They now phone Wockhardt each time rather than going through their usual supplier for my liquid Levothyroxine. It usually takes 4 days for the medication to arrive once I’ve submitted my prescription. So, call you surgery medication manager first. Request the brand you want to be hilighted on your prescription then the pharmacy must supply that brand every time. If you’d like to try Wockhardt the pharmacy can obtain it for you direct from Wockhardt in Wrexham with no delivery charge to them.

I hope it works out for you. Sometimes you just have to get in front and pull the people together as our NHS supply chain is very poor.

Sally1253 profile image
Sally1253 in reply to McPammy

thanks pammy thats what i did yesterday got a contact from teva who said she would arrange and sent all of her contact details over to chemist they are just ignoring me now phone call and email. The guy at chemist said to me yesterday we cant give everyone a one to one service feeling stressed. It does say Teva or zentiva on mine but they couldnt get either in due to being out of stock, the teva lady confirmed that it is but said she would help them find some

McPammy profile image
McPammy in reply to Sally1253

Another solution could be for the medication manager at your surgery to increase your order and also for you to place your order earlier. That way you’ll have more supply at home incase there’s a shortage and give the pharmacy a bit more time to resolve it. I place my order a month ahead of when I’m going to run out. I use to be a supply chain manager so I do my best to plan ahead my medications. 👍😀

Triciatextiles profile image
Triciatextiles in reply to Sally1253

Hi I have had a problem with getting zentiva from my pharmacy. I cannot tolerate other brands. Zentiva has the least number of fillers. Apparently there is a supply problem at the moment. I managed to get 2 x50mg instead if 1 x 100mg. Why don’t you change your pharmacy? It really isn’t acceptable for them to treat you in this way.

Sally1253 profile image
Sally1253 in reply to Triciatextiles

Its so annoying isnt it? i have been trying to get zentiva too the gp pharmacy team admitted that all the local chemists were as bad as one another unfortunately but then Im wondering is it really the chemists fault there is this shortage after time to think today. Im hoping they have called teva to try and get it but I doubt it . The other chemists I spoke to said they wont know whats coming in until it comes in, I will drive round a few on Monday when the kids are back at school and beg lol

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