My new GP (I moved home recently) told me that he can only prescribe unbranded levothyroxine. My previous GP, also in Westminster, prescribed my preferred Eltroxin. This is the brand that works best for me.Is my new GP being difficult, following old rules, or are there restrictions in place at present?
He told me I have to pay whatever extra the pharmacist quotes to get the brand which works best for me.
I find this very distressing.
GP is being obtuse
Print out these Government guidelines and highlight relevant sentence
Government guidelines for GP in support of patients 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.
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).
Eltroxin and Mercury Pharma brands by Advanz are identical to each other
Both often listed in pharmacy database as Advanz
SlowDragon, where can I find a listing of the ingredients in the different brands of levothyroxine? I think I was on Eltroxin because of allergies to ingredients in other brands. Many thanks for your help.
Links to all the information from my medicines document.
Including pointing our that Mercury Pharma Eltroxin is identical to Mercury Pharma Levothyroxine.
If you look at the UK Levothyroxine Matrix, image attached, you'll see a summary of the products and whether they contain acacia, lactose or mannitol.
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. It is sectioned by UK - rest of the world, and by T4, T3, desiccated thyroid, etc.
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. (You must download - not just view in a browser - for the Table of Contents to work.)
From Dropbox:
dropbox.com/s/wfhrlmb5983co...
From Google Drive:
drive.google.com/file/d/11z...
Thank you. I am constantly amazed at the extraordinary research, knowledge and assistance the Administrators of the site provide. I very much appreciate it.
That is some document helvella !
Thank you for this. He is following an edict for GPs within Westminster. He said they are not allowed to specify a brand.
I wonder if this rule was another established by the 'No Liothyronine' endocrinologist who has no background in thyroid disorders in adults.
I told the new GP that I had had many problems before Eltroxin was specified. That's when he said I would have to pay.
I will print these documents and read them more carefully. It's worth a try.
At least he is including both the FT4 and FT3 tests for me.
Government guidelines were written to give patients power to stand up to gaslighting GP’s and endocrinologists
All levothyroxine costs the NHS exactly the same regardless of brand…..
I would question whether there is any legitimacy in requiring a patient to pay extra for any specific make/brand under any circumstances.
I am not aware of any mechanism that allows for a charge other than standard prescription charges in England.
The only way the could be done is for the doctor to issue a private prescription. Which itself would be a seriously questionable approach for an NHS GP for an NHS patient for a medicine that is recognised as being life-sustaining.
I think a pharmacy would have no way of charging for a prescription which would usually be exempt from charges! (Assuming medical exemption certificate or other basis for no charge.)
If GP ever says anything like this, ask them how much?
Hi Fifteen,
Another option which has worked for me is to find an helpful pharmacist. My prescription says Levothyroxine but does not specify a particular brand but the pharmacist knows which brand suits me and she makes sure it's the same each time. Though I have only recently been prescribed levo but the pharmacist said she'll make sure I have a little stock pile of my own. She has been brilliant. So I highly recommend finding a good pharmacist. You may find an independent chemist more helpful than a big chain one.
Best wishes.
bnf.nice.org.uk/drugs/levot...
My pharmacist is well aware if you don’t get on with a brand of medication you should be allowed to stipulate one that suits you or be given liquid form that is obviously more expensive and most pharmacies prefer to give the brand you want if in stock.
Apologies if this is already posted and repeating what has already been said.
I’m aware that pharmacist have had this memo so your GP may not know but Pharmacist should help.
Thank you. I have realised that I went through all the problems with mixed brands which is why I was able to stipulate the brand that worked. I need to let this new GP know this. Will hope he accepts and prescribes correctly.
Maybe it’s time ‘we’ had a knowledgable solicitor on some sort of retainer to write replies (a set of pro-forma letters which could be copied intelligently) to these ‘people’ with the information and subtly threatening legal action. The ‘hypothyroid’ equivalent of ‘ambulance chasers’. I know - not ideal. However a united front would be better than piecemeal. Whilst I am more than happy (ecstatic) with the information and support we receive individually on this forum, perhaps the incredible fount of knowledge our administrators supply could be more widely used. Off course I understand that would not ideally be everyone’s cup of tea. Could it be more damaging to our situation?
the problem with litigation is it leads to more litigation .. and the lawyers win .
As soon as you go down the route of producing anything official from a named source )like a thyroid charity) you have to make sure it's bulletproof for all case and all circumstances , so it inevitably has to become watered down ... but by keeping advice flexible , individual ,and most importantly .. 'peer to peer' and therefore anonymous .. much more 'useful' help can be given to the individual without anyone risking getting sued for offering it .
Yes I thought as much tattybogle . I am just awfully angry at the moment. I am grateful this forum exists. I just want to stamp my foot and shout “It’s not fair” like a four year old having a tantrum. Whilst experience proves different, I still have an idealised vision of those we are primed to think would be helpful. Naive, I know.
totally understand .. i was there once .... life is much more pleasant now i've let it go and got on with it myself .
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