I have been in direct communication with Aristo in the UK and can pass on the following news/information:
If you have difficulty in getting Aristo levothyroxine:
It is distributed by Alliance. The pharmacy needs an account with Alliance.
However, it is handled by Alcura - Alliance's specialist medicines branch. Letting the pharmacy know that might help.
Identifying the product by PIP code might help: 123-4418
Aristo will be launching additional tablet dosages - 25, 50 and 75 micrograms. These might arrive in the middle of 2023.
Aristo will be launching a branded version alongside their existing generic product. The reason for this is to make it easier to prescribe. Apart from branding, it will be absolutely identical to their generic product. It will be available in all four dosages - 25, 50, 75 and 100. The branded 100 might arrive early 2023.
I do not know the brand name they will use.
In time, they will also launch a 12.5 microgram dosage.
None of the tablets will be splittable.
Just adding, for anyone who does not know, Aristo levothyroxine contains neither lactose nor mannitol.
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helvella
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Apparently this is one of the things that happens when they move away from lactose!
I'd consider alternate day dosing (though I personally do not like doing so) or accepting the crumbling and unevenness as still being being better than the alternatives - while understanding the company cannot support/advise/recommend doing so.
This is why a 12.5mcg dose tablet is so very important. So many in the medical profession still have not grasped the notion that (possibly very small) percentage of people needing to take levothyroxine absolutely cannot tolerate big 'lumps' at a time.
Alternate day dosing (e.g. 100mcg / 75mcg ) works for some. Others find the only way they can dose levothyroxine is by splitting their dose, taking it two or more times throughout the day.
'Aristo will be launching a branded version'
I just hope that the Aristo branded version doesn't end up being another cost issue. e.g. No we won't specify this brand on your prescription because it's more expensive. We've been here before many years ago with Eltroxin!
(Do you realise that 25 microgram tablets only became widely available in 1980 when the specification of levothyroxine tablets changed. Companies were encouraged to introduce them to help as the new formulation were a little more potent so some patients would need a small dose reduction.)
I'm hoping that the supply lines are better than for Advanz Pharma!
The switching between branded Eltroxin and generic Mercury Pharma Levothyroxine have been a major issue, I'm sure. Not knowing which is available and when.
There is a bit in my Vade Mecum about writing prescriptions for specific brands/makes.
Yes, the manufacturer/brand must be on the first line in order for the pharmacy to claim whatever extra cost they incur. (Reading between the lines, this is because the system they use only looks at that first line and treats the rest pretty much as comments!)
The prescriber needs to go on a course in order to learn how to use their system for writing prescriptions! It could well be that they do not have this already set up as an option. (I assume they only see the available dosages without any manufacturer/brand.) But they (or the practice manager, or their technical support people) must be able to add products!
Well done for pushing on with it! And for letting us know.
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!
Nor by the fact it is targeted at people interested in thyroid issues. Much of its contents could be of use to many involved in health issues. Things like abbreviations, lists, general reference information, an Appendix of links to many useful websites.
And do keep up to date. I edit it frequently- sometimes trivially, sometimes extensively. If your copy is more than a few weeks old, please download it again.
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.
If there is anything you'd like me to add, let me know.
Do bear in mind, everything I know has been picked up from official sources, posts here, and various websites, and the odd conversation (email or phone) with people who have some relevant job.
Yet these health professionals surely have a support contract with their software suppliers?
And this is levothyroxine products in the British National Formulary (Accord, Aristo and Teva if you click in the right places) which shows Accord (50) costing 60 pennies (NHS Drug Tariff) or 90 pennies (Indicative Price), Aristo costing 89 pennies (NHS Drug Tariff) or 177 pennies (Indicative Price), Teva costing 95 pennies (NHS Drug Tariff) or 80 pennies (Indicative Price):
No - I can't explain the variations but they could simply be a matter of time - changes made to dm+d take time to get to BNF. And all of them are towards the lower end of costs!
Teva 75 and 12.5 are significantly more expensive. I wonder if they are using memory rather than checking? Maybe confusing the price of Teva 12.5 with other dosages of Teva? Or the sources I've quoted are out of date?
I think the Drug Tariff price is how much the NHS will pay if supplied as a generic medicine. And the Indicative Price is what it is being sold for. Goodness knows what happens when Indicative Price is lower than Drug Tariff price? Do they end up making more profit?
But this whole area is beyond confusing. Even experts have to stop and think and maybe ask some extra questions.
(I keep wondering whether a flat price of £1 for the very cheap medicines would actually save money by simplifying everything and reducing the overheads of working out all these confusions.)
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