I am out of stock of my oral (liquid) levothyroxine medication. My prescription is brand specific to Wockhardt. I’ve been phoning Wockhardt for the past 2 months asking when their next batch will be delivered as their current stock expired yesterday 30 Nov 22. The next delivery is now January 23 they say. Prior they were saying it’ll be in before yesterday. So, I’ve rang and visited numerous pharmacies and even phoned my hospital pharmacy where I get my liothyronine from. No one has any stock or can order liquid levothyroxine except Teva which I cannot tolerate.
Today I phoned the Pinewood site in Ireland where Wockhardt liquid levothyroxine is manufactured. Then it’s transferred to Wockhardt in Wrexham. They were very helpful and informed me it has been produced but is held up in ‘testing’. This cannot be hurried. I do know that is true as I worked in pharmaceutical for some time as a materials manager. They said they would email me once testing has been completed. My only alternative is to switch to tablet form. This is not good I feel as I failed miserably on tablets before. Anyway I’ll give it a trial as I’ve no alternative. It might just work out as I was not on liothyronine when last on levothyroxine T4 tablets. I’m a very poor converter of T4 to T3.
I just don’t understand why there is such a stock out everywhere of liquid levothyroxine?? With the exception of Teva. Maybe lots of Teva in stock as lots don’t do well on it??
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You are confusing Teva liquid with the tablets. The liquid doesn’t contain mannitol which is what people do not tolerate in the tablets. They are two completely different products, just manufactured by the same company. You would likely be fine with Teva liquid Levo.
I don’t know why I can’t tolerate Teva liquid. I’ve never had Teva tablets, only their liquid. I get bad headaches and feel sick with their liquid. Any other liquid I’ve tried it’s been ok but Wockhardt for myself suits me best. I don’t think it’s anything to do with mannitol in my case.
Yes, my thoughts too. I requested same brand as liquid Wockhardt. Just collected 25mcg size tablets. Only 28 thought as they’ve messed up the prescription and put 50’s on it too. So will need to call GP again to alter it to all 25’s as was agreed earlier today. I’ll start on the tablets tomorrow 🙄
i cannot get zentiva my usual brand only brillpharma. I dont know what the problem is with the availability of oral solution. I cannot tolerate any Levothyroxine in pill form even though I took them for 10 years then deveoped an allegy/intolerance and still not well on oral solution. The pills also give me severe headache nausea and many other side effects.
I have managed to get Brillpharma liquid 75 mcg from Boots. As far as I can tell it is very like Zentiva which I normally have. Just about to start on Brillpharma and hope it will suit me. I can't tolerate the Teva liquid thyroxine either. It is much cheaper than the others so I suspect the ingredients are not as good.
I’ve now been prescribed Wockhardt in tablet form. Just taken my first dose this morning. Not sure how I’ll go with it. It might be ok ? I much prefer liquid form. But like you can’t tolerate Teva.
Many thank you’s for letting me know about Brillpharma. Not heard of that brand. I need 50mcg strength normally. Xxx I hope you get on alright with the Brillpharma I’ve never tried Zentiva either
I went to Boots yesterday. Unfortunately no 50mcg liquid at all available. They said next availability is showing as Jan 23. No brands at all available 🙄. Thanks for sharing your experience though. Much appreciated 👍 I started on my tablet’s yesterday. I hope they’ll be ok for me.
I am sorry to hear that. I got 4 bottles of 75mcg Brillpharma about 5 weeks ago and Boots told me they could get it for me if I put my next prescription in with them. I had better find out if they can still do that. I am sure it is all about the cost and the pharmacies do not want to be out of pocket so they won't order it. Will be interesting to hear how you get on with the tablets as we may all have to go down that road in the end. Good luck
have been on tablets before. I got really bad. Found out I’m a very poor converter. Then put on liquid levothyroxine about 4 years ago. Then I was prescribed liothyronine T3 which was my game changer. Never felt better in years. Maybe it might be ok as now I’m on the liothyronine too. I do feel liquid is much better to target the correct amount for you. I normally have 68mcg of 50mg liquid which I split into two doses a day. So cutting tiny tablets isn’t great. But better than the alternative. Second day on tablets and so far so good! I’ve bloods booked already for 13th Dec. I know it’s a bit soon to check how the tablets are doing but it’ll be an indication.
I hope some arrives soon as I’m doing quite badly on tablet form. My TSH has risen from 0.89 in Nov to 5.96 last week (0.35-5.50 range). I feel off balance and dizzy, low mood and generally feeling unwell. My T4 has gone under range 6.0 (7.85-14.40). This has never happened before. I’m trying to mimic my liquid dose with the tablets. Maybe an absorption issue.
that’s brilliant information Helvella. Thank you. I took 25mcg extra last night going to bed. So that’s 100mcg taken yesterday and I normally take 68mcg of liquid which I split 34 +34. I’m waiting for yesterdays blood draw results. I’d normally not have taken any medication prior but I was phoned by my GP after my morning dose to come in at 11.40 and use a cancellation slot. So my figures won’t be reflective of my usual regimen. I haven’t been abnormally low with T4 for years. And my TSH is usually around 1.00. I’m hoping that also taking liothyronine is helping but I’m very much off balance and dizzy. I had it all off to a T then the bombshell that no liquid whatsoever is available in England pharmacies nor my local hospitals. I’m going to call my medication manager at my surgery in a few minutes to see what can be done. Maybe a ‘special’ request. Never done that before or knew about it either until a lovely member suggested it to me yesterday.
Do you know the reason why there is no liquid levothyroxine available in England presently please? I’m suspecting Brexit as it’s manufactured in the EU but I’m not 100% sure or if so why it would cause this stock out
I do not know why there have been the liquid problems.
The product from Ten Pharma is manufactured in the UK (they are part of BCM who used to be Boots the Chemist Manufacturing until they were sold off a few years ago).
Have a look at the details in my Thyroid Hormone Medicines document available from here:
Thank you. I’ve called Boots again this morning to see if there’s any chance of supply anywhere of any brand. But no they say. I’ve had Ten Pharma in the past and that was ok but no stock anywhere of it I can find.
I’m in Chester. I’ve been in touch with Boots and there is none available anywhere in the country they say. I’ve called all my local pharmacies and my partner who lives in Southport has called many pharmacies over there too. Just nothing available.
It seems to depend where you are in the country as to what Boots can access. Boots in Scotland can get no liquid levo , since 20/9/22. After 2 months of repeatedly going to Boots they located a 100mcg teva liquid bottle which they brought up from England. It took a week to arrive. Boots in Scotland could not get Brillpharma , though English forum members were being supplied it by Boots, at this time.
LLoyds in Scotland have been accessing 50mcg Teva liquid when Boots can't, even though Boots said that they would try to locate it from LLoyds' suppliers, and the suppliers independent pharmacies usually use.
I was forced to accept a bottle of Wockhardt liquid levo from Boots 20/9/22, which I had refused in July, and they still held as a stock item.
It did not agree with me. I have not been trying to get hold of Wockhardt liquid at any time, so don't know if Scotland would have any access to it from July onwards, to date.
Teva liquid and Brillpharma liquid seem to be fine for me, though you know that Teva liquid does not agree with you.
Brillpharma liquid has one less ingredient than the Teva liquid. Otherwise, they are the same. You may be lucky, in that Brillpharma might agree with you, if the ingredient they omit is the ingredient in Teva that does not agree with you????
I think it depends how hard the pharmacist is prepared to try to locate a bottle for you.
In your case, because you are in England ?, there may be Brillpharma available from Boots, that could be ordered from another location in England, if the pharmacist tries hard enough.
sorry for delayed reply. I couldn’t get any liquid levo anywhere except Teva which I’ve tried in the past and it made me unwell. So, I have switched to tablet form levothyroxine until liquid Wockhardt is back in stock, hopefully in Jan. I didn’t know how I was going to be on tablet form. To my pleasant surprise I’ve been fine so far. It’s good to know I can switch to tablets without any issues. I’ve kept it to my original brand Wockhardt too. I normally split my liquid dose to twice a day. I’ve also managed to do that with the tablet form too. I already had a blood test set up for next week. I know it’s a bit soon but it’ll be interesting to see if the Levo tablets have made any changes to my bloods at that point.
Boots told me 20/9/22 there was no, and wouldn't be anymore ,Teva liquid until end of January 2023.
There is liquid Teva liquid out there, now , and since 20/9/22!
The advantage you have is that you are normally supplied , more or less, directly from Wockhardt for your liquid. You have special arrangements via them and your pharmacist . In consequence, you may actually be getting the truth from the company.
So glad you seem to be doing all right with the tablets, although I have seen mentioned on the forum that you may be getting 100% absorbency from the liquid , but maybe 80% or less from a tablet?? Can't remember exactly what was quoted.
You had your dose, I think at 68mcg liquid levo, so really had finely tuned your dose. You felt marvellous on the dose. It is a real bummer that you've now had to accept tablets.
Marvellous that you seem to be tolerating the change so far. I'll keep my fingers crossed that this continues without any ill effects.
thank you. My GP has agreed I can return to the liquid as soon as it becomes available. But good to know I could be ok on Wockhardt tablets too. But only blood tests and how I feel in a few weeks would prove one way or the other.
a few weeks on tablet form levothyroxine now and not doing good. Had bloods taken on Friday and my TSH has risen from 0.89 to 5.96! ( range is 0.35-5.50). I’m in hypo mode. Also my T4 has plummeted to below range. Not sure why exactly. I’ve mimicked my normal levo liquid doses and times I take it. I feel quite unwell too. Mainly balance issues and dizzy. I’m also starving a lot even though I have eaten. Maybe a false feeling and probably my energy levels are low. My mood is low. I’m normally feeling brilliant on my liquid levo and liothyronine. I’ve phoned Boots, my local hospital pharmacy and Wockhardt again. Still no joy of when ‘any’ liquid will be available. They’ve all said it’s Brexit causing supply issues. Not only to liquid levothyroxine but many other medications too.
Oh McPammy, so sorry to hear that. I was afraid that that would happen- your readings would go way off, and your wellbeing with it.
I have noted that Helvella has previously estimated in a past post that liquid levo may give someone 10-40% higher absorbed dose than tablets. Wockhardt tablets might agree with you, but you really have no idea how big a dose you need if absorbed less well than liquid.
You agreed to go on tablets in the absence of availability of liquid levo. You now have proof both from your readings and lack of wellbeing that substituting tablets for liquid has made you ill.
The only thing you can really do is ask for a "special" liquid, which will be much more expensive .
I'm running out of liquid levo too, now. I'm doing my damndest to work something out. My local pharmacist was "turning water into wine" lately , getting me Teva liquid when supposedly none. I discovered last week that she is off work for a couple of months. She slipped on ice before Xmas. Now, being told there is none.
A specialist pharmacy from the Thyroid Uk list supply them. I assume G.P. needs to authorise. I don't know the full procedure you need to go through.
I would urge you to try for a "special" and tell them the brand you would like replicated, as much as possible, is Wockhardt liquid.
what a brilliant reply and idea. Can’t thank you enough! I’ve been recalled to my GP surgery today for another full thyroid blood test as they forgot to do my T3 at the hospital lab last week. So, as soon as I get those results , it now might be worse than last weeks. I’m going to approach them for a special request as you suggest. I’m going to try and take the levo tablets going to bed also to avoid food as much as possible. It’s just a minefield.
I phoned Wockhardt and they informed me that the medication has been produced at the supplying factory in Southern Ireland. But it’s held up in ‘testing’ and has been since December. Not sure why it’s taking so long. Maybe just an excuse. It could be Brexit related. It’s really odd there is absolutely no stock of any brand available anywhere in England, even hospitals have no stock and are waiting for stock they told me.
I hope the stocks arrive before you run out The first couple of weeks on tablets I was fine Then I started to lose my balance now dizziness Yesterday I went on a walk I started to struggle and I had to hold onto my partner until we got home now I know why
I’m definitely going to approach the special order route tomorrow thank you so much xxx
Hope it works out for you! May take a week or two even if successful. If there is an excipient you know or strongly suspect does not agree with you, advise them of this if you are successful with the "special route", to avoid a potential problem.
For example, tell them Wockhardt liquid suits you, but Teva liquid doesn't, and you suspect "xyz" ingredient or excipient may be the problem.
Will do. Thank you so very much. I’ll let you know how I got on. I’m not sure which excipient I may have an issue with. I’ll request they copy ingredients in Wockhardt brand ✔️
I’ve phoned Boots pharmacy and my own independent pharmacy this morning. They both said that liquid levothyroxine was not available as a ‘special’. I’m waiting for my consultant to call me. Left a message with his secretary this morning. This is clearly ridiculous. How can the entire country be out of stock of liquid levothyroxine. Doesn’t make sense. I’ve also called the plant at Pinewood in Ireland. The batch of Wockhardt has been made and still held in backlog in testing. Been there for 2 months nearly now. 🙄. Thanks for all your help and support. It is a damn nightmare.
Have you contacted Roseway labs regarding a 'special'? They actually mention 'suspension', which might mean they can do liquid. Look under personalised thyroid medication on this page rosewaylabs.com/specialisms...
hi. Yes, I’ve called Roseway. They can’t get any brand of liquid levothyroxine either. I’m waiting for a call back from their pharmacy to see what they could do, if anything. Will let you know what they say.
made a few calls this morning. Pharmacies have explain liquid levothyroxine is not an option on a special prescription. Oh dear. Not sure what’ll happen now.
that’s a lovely message, thank you. Yes, I was flying high and feeling on top. I’ve learnt that I really do struggle on tablet form levothyroxine. Can’t Adam n Eve there’s no stock of any brand anywhere! 😔
Tollesbury Pharmacy can have made, liquid levothyroxine, in any strength. It is a suspension, and need to give it a good shake. It is a fridge line and they need to send it under cold pack conditions, and it needs to be signed for when comes by courier.
I enquired last week re. liquid levo, saying I had a paper prescription I could not get filled. They ended the email saying if the above is acceptable to forward my prescription to them.
I didn't forward my prescription as in the above narrative they are offering a "special", though not making it clear if the NHS prescription would cover it. I am sure it will not. "Specials" are much more expensive, and I assume the G.P. would need to issue a prescription for a "special". I don't know the procedure. Maybe , if approved, the G.P. surgery deals with it all?
I believe Roseway Labs would also supply a "special", but I think you would need a private prescription for this.
Discovered on internet tonight that Unipharma, Athens, Greece seem to have got their approval for Liquid LT4 ( T4 drops) which is a 100ug/ml concentration available in a 30ml bottle, and has an 18 month life span. Use within 30 days of opening.
It is Levothyroxine Sodium Anhydrous 100ug per 1ml, and excipients are:
thank you so much. All this information is so important. I have no idea how I could get hold of it from Greece as the EU, now we’ve left the EU, cannot accept a UK Drs prescription. I use to get my Thybon Henning from Germany but that wasn’t allowed once Britain left the EU. Luckily Roseway stock it now but it is twice the price. You’ve given me so much information I’m so grateful. Thank you so very much. What would we all do without this extremely valuable forum.
I’m still waiting for my NHS consultant to call me! I’m hoping he might just be able to check various hospitals in England to see if there’s any in their shelves
Hi. Yesterday I rang around several hospitals in my area. Liverpool, Chester, Warrington, Aintree then finally Arrowe Park in Birkenhead. Each time no stock and no idea when stock would arrive. Except on the last call to Arrowe Park! They had 5 bottles of 50mcg Brill Pharma!!! Oh my goodness. Then I thought how could I get them. I called my NHS consultants secretary at Halton Hospital who I’d also tried the day before again. The secretary said she’d get a prescription for me by lunch time. I then phoned Halton pharmacy as a consultant can’t write a prescription for just any hospital I was told. So, a lovely pharmacist at Halton explained she could get Arrowe Parks Brillpharma for me as they could purchase it from them. But by the time this could happen the Halton Pharmacy would be closed for the weekend. So the lovely pharmacist arranged to send it to Warrington hospital for me to collect today as they are open on Saturday’s. What a nightmare this has been. So I’m going to collect it this morning from Warrington after making a call to them to make sure the logistics has gone to plan. I’ve learnt so much from this situation and how poorly the NHS supply network operates. My job was supply chain manager in various high profile businesses. If any of those businesses was run as the NHS run theirs they would have collapsed. I’m so delighted and relived I’ve managed to find some stock I cannot explain properly. Oh boy am I relived. But will feel completely at ease once it’s in my hands. I cannot thank you enough for your help and support with this issue. You’ve been absolutely fantastic. What would we do without one another on here. Bless you and a great big hug.
Fabulous, so pleased it has worked out for you. Big Hug!
Totally confused, will need to read your email a good few times, preferably when brain engaging, which is usually around midnight!
Okay, had another go. One English hospital pharmacy can buy from another English hospital pharmacy!!!!!I ???? If you didn't have a private, high profile Endo in the mix even though you are NHS now, I doubt they would have entertained you.
Just goes to show, there is stock out there, but very much dependent on whether someone prepared to go the extra mile for you, and rare that they will.
Well done you! Consider yourself cheered on as you go to collect it!
Without this forum, I too would not have got as far as I have, and would feel totally helpless. Delighted that you feel I've been of help.
Hope you can get on an even keel soon. Disgraceful that the system has made you ill through want of appropriate medication , and will take time to rectify. You were such a success story.
You've cheered me up no end knowing that things seem to be working out for you now. Hope you feel better soon.
Sorry my message was a bit confusing to grasp. The whole saga has been unbelievably long winded down a winding road. No wonder the NHS is in a mess. Tracking the liquid down was just down to tenacity and determination really. I think what sealed me being able to get stock from one hospital area to another was down to the caring pharmacist. She told me she has autoimmune thyroid disease and completely understood how I felt. She had to go away and call me back on how she could obtain the medication by purchasing it. And then sent one bottle to a different hospital that had a pharmacy open on a Saturday. I’m convinced it’s all about who picks up the phone sometimes. Anyways I have it now and started taking it yesterday.
I shall be writing a ‘clear’ email to my GP next week on this. They asked me to do so last week when and if I managed to resolve anything. They said it could help them understand and may be useful in the future for other patients. It’s like their hands are tied or they just haven’t got the time to resolve issues. My liquid levothyroxine is normally supplied via my GP not a hospital.
Your welcome. You've summed up the situation perfectly. But for your tenacity and determination, and a sympathetic sufferer in a position in the NHS willing and capable of helping, you would still be up ****creek. Hope you feel better soon. x
Have just checked and the usual approval/product documents (PAR, SPC and PIL) are not on the MHRA's products site. This search is for all Uni-Pharma products (20989 is the company number within MHRA systems):
However, I am still utterly confused by how manufacturing authorisations from the EU apply or don't apply in the UK and specifically Northern Ireland. I cannot rule out some mutual recognition procedure applying. Even so, I'd expect the Patient Information Leaflets to be available. (Though it can take a few days for them to appear even after they have been agreed.)
There are two other liquid products: Nassington – Izifet and Galenica A.Ε. – Accu-Thyrox.
A little more information is in my medicines document:
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.
As Helvella states, it is listed on the Unipharma website as a product in existence. Unipharma site, in general , says they supply Non EU countries: Russia, Uk, ex CIS countries.
I don't know who they supply in UK, but their website implies that supplying the UK is possible , or is actually happening. I would assume if they need Greek authority to supply the UK, it is in place. If products not available in UK, maybe UK blocking?
Greece is in the EU, wheras Uk no longer is.
Was reading an Irish Pharmacy site and it mentioned hoping soon to get to grips with problem of Northern Ireland and Uk where there is still a problem (Brexit) to do with pharmaceuticals having to be treated differently. Think to do with North Sea divide protocol thing.
Can't help thinking that the Wockhardt factory making the liquid levo in Southern Ireland is in the EU, whereas UK no longer is. Product is made in EU and they are quoting a delay in ability to get testing done as responsible for shortages. Must be bureaucracy and paper work problem caused by exit from EU?
Theoretically, if NHS are supplying Greek Roma T3 capsules, it seems to be possible for Greek Pharmaceuticals to enter UK.
In short, I don't know the answer to your question.
Funnily enough though, I believe that I read that the "special" liquid levothyroxine that Roseway Labs are able to supply is basically T4 with glycerol and purified water.
This is the same as Unipharma T4, except that Unipharma T4 also has Trisodium Citrate .
Wua13262348, As I understand it, Uni-Pharma need to apply to the MHRA for a license to supply their product in the UK. If they haven't done so, then they cannot supply it here. Roma (a different Greek company) supply us with their T3 capsules because they applied for and were granted license to do so by the MHRA. helvella is more clued up on all this than I am, so I'm quite sure he will let us know if anything changes.
Absolutely, RedApple . Without such a licence (marketing authorisation), it cannot be supplied and sold in the UK as a regular product.
Even if it were approved as a product under some sort of mutual recognition with the EU, a British Patient Information Leaflet needs to be produced, approved and packed with it. And that should show up on the MHRA site.
(None of that precludes it being supplied as a 'Special'. But that has a significant extra cost to it and is not accepted as a way to avoid being licensed.)
Roma T3 capsules were approved in the UK. This is the Product Approval Report:
Also, the Greek connection for Roma capsules is that it is contract manufactured in Greece by a third-party company. In principle, Roma could shift the manufacturing contract anywhere they like (so long as the factory is properly approved, has the equipment, and wants the contract). There is nothing inherently Greek about T3 hard capsules.
Most of the levothyroxine oral solutions are primarily water and glycerol. There is a range of approaches to achieving and maintaining the right acidity/alkalinity and preservation.
In the last month or so , I think it may have been" Birkie" that eventually got a "special" liquid levo from her hospital, though I don't think it agreed with her, and I don't think they listed the ingredients on the bottle. It was supplied via her hospital. I think, though delayed for weeks?
I just wanted to wrap up my post and give some more information that might help others going forward.
I was told by my Halton hospital pharmacy that they would purchase the x5 bottles of 50mcg levo liquid that I found at Arrowe Park Hospital Pharmacy last week, after weeks on end phoning multiple community pharmacies and hospital pharmacies. I was then informed yesterday by Halton Hospital Pharmacy that they won’t be doing that now! You can imagine how my bubble burst. 😔. They said they could get me one bottle of 125mcg strength Zentiva and as they could do that my case was not critical. One bottle 125mcg versus five bottle of my correct 50mcg strength. They wouldn’t budge on it. 😔.
I phoned Arrowe Park Hospital Pharmacy to see what I could do. The manager was extremely helpful and completely understood my situation. She asked did I have a white or green prescription. I said I had both. She said well if Halton won’t raise the paperwork to facilitate them sending my 5 bottles to them, then I could call their onsite LLoyds pharmacy she could take the liquid to them and I could use my green (GP) prescription. I’ve learnt so much with this situation. So it was done. Arrowe Park Hospital pharmacy transferred my medication to a community LLoyds pharmacy on site and I collected the liquid medication last night as they were open until 9pm. Hurrah 😁 finally I have the right strength and can start taking my normal medication regimen this morning. What upset me the most is my hospital pharmacy (Halton) saying it wasn’t critical. All they needed to do was raise a requisition to ensure the money side of things was paid.
I did it. I got it. By determination and not giving up. You have to jump through hoops of fire 🔥 to get anywhere it seems. Once again thyroid patients not seen as critical by some health professionals. Thank the Lord for the very professional and understanding manager at Arrowe Park Hospital Pharmacy. I shall call her this morning to thank her and let her know the transaction went smoothly. And as a patient I’m so relieved
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