Dispensing when a brand is specified on the prescription.

[2pence]

Am I correct that when a brand is specified on the prescription that this must be the one prescribed?

It's my bi monthly trip/s to the pharmacy again and this time I asked the surgery to specify Morningside for my 20mcg Liothyronine. When I went to pick up my prescription everything was there in the correct brands except for the 20mcg which I was told is not available from AAH, Alliance or Phoenix. I am sure if I ring Morningside I will be told that all of those suppliers have their 20mcg Liothyronine. We do not get copies of our prescriptions so I took it from the desk and looked to see that Morningside is specified. I have taken the owing slip and will return next week.

If I am correct in thinking that they must now dispense Morningside is there a link to where it says this please?

[helvella Administrator Thyroid UK]

There is a section in my Vade Mecum about how prescriptions must be written for the brand name to be recognised. That is, on the first line.

There are onward links to NHS sites - so it is official advice.helvella's Vade Mecum document is available here:

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.

helvella.blogspot.com/p/hel...

[TiggerMe]

I had this issue.... Helvella sent me a great paragraph which explained how they should learn to correctly write prescriptions with the brand name first which then allows them to reclaim any extra cost, I sent this to my surgery but have yet to hear back... the brand requested had no extra cost to them as I found from the pharmacist who did supply they just had to make a call to order!

I hope they might look at their system and improve for all....

I wish I could send it to you but my history got wiped, it got the point across beautifully 🙃

[helvella Administrator Thyroid UK in reply to TiggerMe]

That information is in my reply above - it is in my Vade Mecum document!

[Aurealis in reply to helvella]

thank you helvella, I am looking really for evidence that changes to the brand of T3 should be avoided. Useful link to show how prescriptions should be written but I have to convince them to do it first - I did last month, but it’s been removed again 🙄 I despair really. It took years to get this stable and I’m expected to risk that to ‘prove’ I need the same brand - we have already established that changes to levothyroxine brand are problematic for me I know I’m fortunate to have t3 prescribed on nhs, but I spend a fortune on NDT, consultant appointments and private tests, and I’m very stressed about this all over again.

[Staffsgirl in reply to helvella]

Could you provide this information again, please, Helvella….it says it’s no longer available.

[helvella Administrator Thyroid UK in reply to Staffsgirl]

I have replaced the links with a link to my blog. That makes it easier for me to maintain things. Also provides things like QR codes which help if you are using a phone - as well as links to the document.

[posthinking01]

Yes they should - I have had trouble in the past and was told by the pharmacist that it didn't matter to my health that different brands were prescribed, this was after I had just told her that it is important for the thyroid patient to have the same brand. I went home and printed out a document from the internet that states how important it is for this to happen - and the pharmacist apologised.

I have also taken to telephoning manufacturers when I couldn't get a steroid that had been prescribed in hospital and it was critical I had the same brand as I am lactose intolerant (I had had Sepsis and was on high dose steroids when I came out) the company were so helpful and I managed to sort it out with their help. Good luck - pharmacists do seem to be trying to give us whatever they are being supplied from their distribution warehouses but this shouldn't be the case with a specified prescription.

[Aurealis in reply to posthinking01]

do you know which document you took to pharmacist please

[helvella Administrator Thyroid UK in reply to Aurealis]

Have a look in my Vade Mecum - it quotes the relevant part and links to the government site. See the first reply on this thread.

Find this bit:

Prescribing Levothyroxine by Brand

Levothyroxine: new prescribing advice for patients who experience symptoms on switching between different levothyroxine products

[Aurealis in reply to helvella]

thank you, sorry I replied to the wrong reply of yours

[dizzy864]

I know this is supposed to happen but in practice? I contacted several local pharmacies and asked them if they would supply me with a different brand of liquid levo as the one I m always given at Tesco burns the back of my throat sometimes. This causes soreness and sometimes vomiting. I said I could obtain a prescription from my gp naming a particular brand. Everyone told me they would not supply anything other than the brand their supplier gave them. All told me that they would not be able to supply a named brand. I wanted to have Wokhardt as its a different formulation to all other brands. I could not obtain it.

[helvella Administrator Thyroid UK in reply to dizzy864]

First, I hope you have filed a Yellow Card report (for each product you have tried which causes this issue)?

Second, if the pharmacy will not get the medicine as written (if done so properly), they need to be reported. As I understand, it is a primary requirement that they dispense what has been prescribed (so long as it has been done properly). Exceptions can be made under Severe Shortage Protocol rules but even then, I don't think they can change a specified make.

[dizzy864 in reply to helvella]

hi, Thanks for your reply. Firstly, I ve had to continue with Zentiva liquid levo. it does sometimes burn my throat - once quite badly as the affect lasted over 24 hours. it often makes me wretch and once actually very sick. But I also feel much better on it than I ever did on tablets. I ve even reduced lio by over 20%. I am a bit stressed about actually taking it. Its odd as mostly i dont have a problem. I think its when too much gets in my mouth. I contacted several local pharmacists and they all told me the same thing. That they would not be able to obtain any other brand of liquid levo other than their regular supply and there would be no point in my getting a named brand on a prescription as they would not be able to get it. Most offered Zentiva, one offered Teva and one said they randomly got Zentiva and Teva in stock and issued whichever came in but added it may be possible to supply the same brand!