I have been given two different brands of levot... - Thyroid UK

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I have been given two different brands of levothyroxine to take at same time

42 Replies

Is it ok to take 25mcg of one brand and 50mcg of different brand at same time?I did question with pharmacist who said they just give what's available, after my dose was increased to 75mcg from 50mcg I have trouble every 56days getting my medication of each dose as prescribed weeks apart .Suggested to my gp to prescribe 75mcg but hasn't. Just wondered also do they make more money prescribing twice on two prescriptions and do the pharmacy charge nhs twice also?

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42 Replies
SlowDragon profile image
SlowDragonAdministrator

which brand of levothyroxine were you taking before

The only brand that makes 75mcg tablets is Teva

Teva brand upsets many people

As to cost

It’s cheaper for NHS to prescribe 25mcg (90p per 28 tablets) and 50mcg tablets (85p per 28 tablets)

75mcg tablets are £2.58 per 28 tablets

Ideally only change dose or brand at any one time or you don’t know what might cause an issue

How long have you been on 50mcg

Bloods should be retested 6-8 weeks after any dose change or brand change in levothyroxine

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).

Netherlands (and Germany?) guidelines are for thyroid patients to always get same brand levothyroxine at each prescription 

healthunlocked.com/thyroidu...

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...

markvanderpump.co.uk/blog/p...

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

in reply to SlowDragon

Thankyou for detailed information. I have been prescribed 75mcg for 3 months.Previously 50mcg Accord.

I have just been given 25mcg Wockhardt and 50mcg Accord tablets.

Previously given 25mcg Teva and 50mcg Accord tablets

Problem trying to get both tablet prescription at same date since increased, gp giving repeat prescription weeks apart for each tablet and pharmacy dispensing weeks apart must cost more than just price of tablets in doing this.

SlowDragon profile image
SlowDragonAdministrator in reply to

if you wanted to only take Accord you would need to cut a 50mcg tablet in half to get 25mcg and get GP to increase number of 50mcg tablets prescribed per month

But many people find Wockhardt is well tolerated

Request admin at GP surgery combine prescriptions on to same repeat date

Bloods should be retested 6-8 weeks after any dose change or brand change in levothyroxine

How long have you been on just 75mcg

Important to test vitamin D, folate, ferritin and B12 at least once a year too

in reply to SlowDragon

Thankyou for useful information and advice

Thankyou for your information and helpful advice will try again to get my surgery to combine my prescription. Not sure I can have blood checked yet

Auders profile image
Auders

I’m on 75mcg and take Accord 50mcg and 25mcg Wockhardt at same time. For me there has been no problems taking these two together. Also been given MP and Wockhardt together which has been fine too. Good luck x

in reply to Auders

Thankyou

Seagull23 profile image
Seagull23

I think the brand is immaterial, as long as the ingredients are identical I see no reason not to take them simultaneously. Also remember to take it a good hour before eating in the morning.

in reply to Seagull23

Thankyou for help

Jerseyliz profile image
Jerseyliz

I'm sorry but am unable to reply on this query, I dont have the expertise. It would imagine a local pharmacist might help.

Whiskers3 profile image
Whiskers3

Hello, I’m really sorry, yes I do take Levothyroxine, 100mcg daily, but it’s always the same brand. I was put on 75mcg for a few weeks, but it was the same brand. I haven’t had any trouble getting it, but I order it well in advance, just in case there is any delay. So I never run out. I have been on 100 mcg for 25 years.

in reply to Whiskers3

Thankyou

Bobstanton profile image
Bobstanton

I'm currently using two different brands and have had no issues. It's been a month now. 100mcg and 25mcg.However I did have an issue with a change from my regular brand last year as it made me feel sluggish and moody after taking them for a few days, almost like I hadn't taken then at all. I can't remember what make this was sadly.

The pharmacy changed them as this is known problem and can be quite common.

in reply to Bobstanton

Good to hear you were able to recognise symptoms and get a change made also very helpful information

anglobike profile image
anglobike

To my knowledge, the reason for this is that no company makes 75mcg tablets in the UK. My younger daughter also takes 75mcg of levothyroxine daily, using two tablets like you, also probably made by different companies and, to my knowledge, she hasn't had any problems with the medication.

in reply to anglobike

Thankyou that's good to hear

CAK1 profile image
CAK1

Was taking different brands with no obvious effect. Reduced dose now means only one kind

in reply to CAK1

Good to hear thankyou

Agatha1977 profile image
Agatha1977

hi there. I’m in the same position as you, on 75mcg dose but with separate prescriptions out of synch. I have been taking separate 25/50 doses from two different brands for the past 6 months and haven’t noticed any adverse effect so far. Hope this helps?

in reply to Agatha1977

Very helpful thank you

Saturn64 profile image
Saturn64

hi, I’m on 150mg levothyroxine, the brands that I have been prescribed have changed from time to time, I have never been aware of any difference.

in reply to Saturn64

Thankyou good to know

SJT73 profile image
SJT73

Hi

If hope you're not paying, you can apply for free NHS prescriptions as you have underactive thyroid, the only benefit to it!! Also the doctors can chnage the date of when prescriptions are due to be reauthorised.

in reply to SJT73

Thank you

Quinc profile image
Quinc

I take 25 in the morning and 25 last thing at night … you could save the 25 for evening and so split them up?

in reply to Quinc

Thankyou

Astralhaze profile image
Astralhaze

Yes it's OK to take different brands of levothyroxine

in reply to Astralhaze

Thankyou

Marianne0915 profile image
Marianne0915

I have only taken Levothyroxine (Teva) 75microgram so unable to discuss.

singuk profile image
singuk

good evening Levotatate

In my experience (of 15 years ) of Levothyroxine I have found it to be fine mixing 2 different manufacturers

Hope this helps

in reply to singuk

Thankyou

Roxy1939 profile image
Roxy1939

Hi am not really sure they uped my dose from 100mg to 125mg I have to take 2 tablets 1 100mg and 2nd 25mg both same brand but I have to take 2 different pack each time to make up dose in December doing my bloods again for my thyroid to see if it's controlled mine really hasn't ever been controlled I got underactive thyroid if controlled I should really lose weight when it keeps on increasing when am taking this medication also i told gp I wasn't happy not been controlled for years and to refer me to a thyroid specialist at hospital so gunna wait till December blood test see what it says

in reply to Roxy1939

Thankyou for information zyour seeing specialist to help you hope you are OK.

Roxy1939 profile image
Roxy1939 in reply to

Your welcome hope that If they refer Me to a specialist that's if hopefully 🙏 hope your okay too

Nantygirl60 profile image
Nantygirl60

hello. I am regularly given two different brands of thyroxine. There doesn’t seem to be an option. It doesn’t seem to adversely affect me.

Hope this helps.

in reply to Nantygirl60

Thankyou helpful information

Redvee profile image
Redvee

have to take two tabs to get the optimum dosage. Some times they are two different brands, Never any problems. I was advised they just don't 'do' the tabs in the the required dosage size form me. Presently on Accord 50mg & Mercury 25mg

in reply to Redvee

Thankyou

Thankyou for information.

clarityforest profile image
clarityforest

Hi

I don't have experience of this I'm afraid, I can't advice.

Thankyou

SeasideSusie profile image
SeasideSusieRemembering

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