Mercury pharma help

[Loislincmum]

Hi all. Any advice given to me is greatly appreciated. I have had an under active thyroid for over 5 years. I’m on 75mg of levothyroxine. I’ve always had Mercury pharma brand of the 25s and the 50s. A few months ago I only got the 50s MP and today I’ve been given none. I have put on a stone in weight in the past few months, I’ve not changed my diet or anything. Was wondering if it could be the change in my meds. Thanks.

[SlowDragon Administrator]

Do you mean you have only been taking 50mcg daily instead of 75mcg

If so, then highly likely it’s linked and you are now hypothyroid

And what do you mean…..now you have none

Levothyroxine must be taken every day

If your normal pharmacy can’t supply Mercury Pharma brand levothyroxine

Either

Take prescription elsewhere

Or accept a different brand levothyroxine

Many members have reported problems recently getting Mercury Pharma brand

No one quite sure why, because there’s not a shortage

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

Eltroxin is identical

Both are made/boxed by Advanz

Pharmacies often list under Advanz rather than as Mercury Pharma

First step is to get 75mcg levothyroxine and take it everyday without fail

After minimum 6-8 weeks on constant unchanging dose and brand levothyroxine get FULL thyroid and vitamin testing done

Always test thyroid levels early morning, ideally around 9am and last dose levothyroxine 24 hours before test

Request GP test vitamin D, folate, ferritin and B12 levels now. Likely to be low if now hypothyroid again

[Loislincmum in reply to SlowDragon]

Thanks for getting in touch SlowDragon. I don’t think I got my point across correctly.

I religiously take my thyroid meds 1st thing and have been on 75mg of levothyroxine (Mercury Pharma brand) for over 5 years. A few months ago I was given 50mcg MP brand and 25mcg of the Teva brand. I have noticed a significant increase in my weight and was wondering if it could be down to the change in medication brand? I’ve received my medication today and have been sent 50s in accord brand and 25s in teva brand. Been in touch with the pharmacy ( I used to work there) and was informed that MP brand is unavailable at the moment. I really don’t feel as good as I was. Think it’s time for a doctors appointment. Thank again

[SlowDragon Administrator in reply to Loislincmum]

Generally we always say only change one thing at a time

Increase dose or change brand

Otherwise it’s impossible to know what is causing issues

That being said…..75mcg is only one step up from starter dose and you may simply be ready for next dose increase in levothyroxine to 100mcg daily

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)

Aristo (currently 100mcg only) is lactose free and mannitol free.

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.

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).

Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after

Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime

verywellhealth.com/best-tim...

No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.

Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away

(Time gap doesn't apply to Vitamin D mouth spray)

If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test

If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal

Similarly if normally splitting your levothyroxine, take whole daily dose 24 hours before test 

Increasing number of members find it smoother/more tolerable to split levothyroxine as two smaller doses, half dose waking, half dose at bedtime. 

REMEMBER.....very important....stop taking any supplements that contain biotin a week before ALL BLOOD TESTS as biotin can falsely affect test results - eg vitamin B complex

Mercury Pharma customer care phone number 

healthunlocked.com/thyroidu...

[1tuppence in reply to Loislincmum]

Yes, I found a great deal of difference in levothyroxine brands. Although SlowDragon has said many times to ensure we get the same brand I hadn't taken it fully on board, and thought, wrongly, that Accord and MercuryPharma were the same. If you look at my last few Posts you'll see I asked the question re differences in brands, because finally, the penny dropped for me, that MercuryPharma is the brand I'd been taking since 2015, and been doing pretty well with...then the brands had differed and I was going hypo again...weight gain,,,,creeping, and my diet was just the same, but my weight was going up, brain fog, clumsiness, light-headedness, deep inner cold etc etc.

After discussion with my GP, my repeat prescription now states levothyroxine dose MercuryPharma only. I hope this may be of some help to you?

Since being back on MercuryPharma my system is beginning to settle down, and I shall have blood tests in another 6 weeks when I hope I shall be stable again..

[Hidden in reply to SlowDragon]

Hi can I just ask please although I've not done well on Levo at all and having some rough times now I was having Eltroxin all this year the leaflet inside the box doesn't state the the same manufacturer as the one that just has the Name Mercury Pharma on the box I've thrown the leaflet away what was in Eltroxin box, MP manufacturer says Custom Pharmaceuticals in Hove East Sussex I know the Eltroxin said another manufacturer in the UK so how are they the same MP and Eltroxin

[SlowDragon Administrator in reply to Hidden]

Both Mercury Pharma and Eltroxin are made by Custom Pharmaceuticals

That’s the manufacturer

The owners of the brand are Advanz

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

[Hidden in reply to SlowDragon]

Wish I had saved the leaflet in the Eltroxin box it says the manufacturers wernt Custom Pharmaceuticals it said a different name different area ok Thank You SlowDragon

[Hidden in reply to SlowDragon]

Sorry I recall it said Something like Kline and India anyway when I got my new prescription Mercury Pharma back again 2 days ago since taking them heart was thumping like mad most of the night I didn't get that on Eltroxin same dose 100mcg so that's why I felt they wernt exactly the same

[helvella Administrator Thyroid UK in reply to Hidden]

May I check the background here?

Did you get the previous Eltroxin in the UK, supplied against an ordinary NHS prescription?

The company GlaxoSmithKline (GSK) operates in India (and other countries).

GSK India list Eltroxin:

india-pharma.gsk.com/en-in/...

GSK Inda list the prescribing information:

india-pharma.gsk.com/en-in/...

With the actual Prescribing Information PDF here:

india-pharma.gsk.com/media/...

The brand name Eltroxin is currently used for (at least) three different products.

UK - Advanz Pharma - Mercury Pharma

Aspen - Most of world (except India and UK)

GSK - India some other countries.

The three products have different ingredients, are made under different legal and production controls.

GSK Eltroxin should never be supplied within the UK.

I suggest you write a brand new post if you wish to continue discussing as this is talking over Loislincmum's post.

[Hidden in reply to helvella]

My apologies! I didn't mean to talk over the discussion