GP Changed my Brand of Liothyronine : Hi can... - Thyroid UK

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GP Changed my Brand of Liothyronine

Beautifuldreamer profile image

Hi can anyone advise please ?

I have been prescribed Morningside T3 successfully for 3 years no side effects.

My GP practice / NHS has changed the brand to Roma which is making me feel nauseous and tummy trouble (Roma is cheaper apparently).

Can my GP / Pharmacy insist this is the brand I have to take even with the side effects ?

I have tried taking the contents only in water but it makes no difference.

Advice please on how to deal with this as I am finding it very stressful.

Thank you

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Beautifuldreamer profile image
Beautifuldreamer
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24 Replies
radd profile image
radd

Beautifuldreamer,

The pharmacy can give you any brand if there isn't a specified one on your prescription.

Have you asked your GP why your T3 brand has been changed, and advised that you are feeling unwell on the new one? If not, just ask for Morningside to be specified.

The only danger with this is if the pharmacy don't have it in stock, then they can't dispense it.

notatortoise profile image
notatortoise

I recently had the exact same experience. On Morningside for2 years with no side effects.

Then GP changed to Roma capsules, which resulted in the same side effects as yourself, I felt awful the side effects were nasty, I raised a yellow card and asked GP and pharmacy if my prescription could specify Morningside. I was told by pharmacy Morningside were ‘out of stock’ and eventually told by pharmacy that they were too expensive!

The 10mcg Morningside cost £155 a pack and Roma are £55 per pack.

Thankfully Helvella , one of the thyroid UK admin team, advised me the 20 mcg of Morningside are the same price as Roma.

So my pharmacy have agreed to provide 20mcg Morningside that I pill cut in half - result!

All I can say us persevere. The more people that experience bad side effects with Roma that raise a yellow card the better. Cost should not be a driver for good health.

Insist on a change back to Morningside.

Good luck

Lalatoot profile image
Lalatoot

Roma can be cheaper depending on the doses prescribed which is why many GPS have changed prescriptions.My GP tried to do the same to me. What they do is write liothyronine CAPSULES on the prescription which means that the pharmacy has to provide capsules which are Roma.

If the GP wrote liothyronine TABLETS then the pharmacy could supply Morningside or any other lio tablet it could get.

You need to contact your GP surgery and ask them to write tablets on the lio prescription. Explain that you need to split the tablets to make the smaller doses you take throughout the day and that this is not possible with capsules.

Beautifuldreamer profile image
Beautifuldreamer in reply to Lalatoot

Hi as I did get 5mg tablets and now 5 mg capsules there isn’t an sue with splitting them, Slow Dragon has broken down the costs and savings for the GP and it is much cheaper for them to give me 20mg tablets to split than Roma by miles. I don’t know why the Surgery hasn’t worked it out.

Lalatoot profile image
Lalatoot in reply to Beautifuldreamer

My prescription is for lio 2 x 5mcg daily so my surgery won't issue 10mcg tablets even though I told them it was cheaper.

To stay on Morningside I told them that as suggested by the endo I split one tablet to give me 2.5mcg doses to take throughout the day. They accepted this.

Buddy195 profile image
Buddy195Administrator

I too have had an adverse reaction to Roma, so spoke with my GP and now have ‘Morningside only’ on my prescription. Pharmacist said that many patients are being transferred to Roma as it’s significantly cheaper. As the 5mcg Morningside are difficult to source (according to my pharmacy) my GP agreed to prescribe 10mcg tablets for me to cut myself.

helvella profile image
helvellaAdministratorThyroid UK

If you have problems with Roma, there are two things to do:

Put in a Yellow Card report.

Try using the approach described in the Patient Information Leaflet of opening the capsule and dispersing/dissolving the contents in water. This avoids you taking the actual capsule which could be the source of your issues,

Batty1 profile image
Batty1 in reply to helvella

Why would the capsule cause issues? Could the contents be transferred to a vegetable based capsule that you can usually purchase from health food store?

Beautifuldreamer profile image
Beautifuldreamer in reply to Batty1

Hi as my original email said I have tried the contents in water without the capsule therefore it’s the contents that’s causing my problems

Batty1 profile image
Batty1 in reply to Beautifuldreamer

I think u meant to reply to hellvella

helvella profile image
helvellaAdministratorThyroid UK in reply to Beautifuldreamer

Have you done the other thing, put in a Yellow Card report?

Beautifuldreamer profile image
Beautifuldreamer in reply to helvella

Hi yes I have reported it on yellow card.

Thank you all for your help, it has been so helpful.

helvella profile image
helvellaAdministratorThyroid UK in reply to Batty1

Why wouldn't the capsule cause the issues?

The product consist of about six ingredients (varies a bit by dosage). Three form the capsule, and three the contents.

By avoiding the capsule you avoid about three ingredients. If that helps, you have identified what causes the issue, and a possible (if somewhat unsatisfactory) way round it.

I can't see why you would even try to put the powder into another capsule. Far too easy to lose some powder and end up under-dosing. Or maybe sneezing and seeing it fly around with unpredictable effects.

SlowDragon profile image
SlowDragonAdministrator

It’s price driven

Which size morningside tablets were you getting

Different prices listed here

healthunlocked.com/thyroidu...

Request you are changed back to Morningside tablets

Summer64 profile image
Summer64

I have Mercury Pharma and am OK with that. When it was stopped and I had to source from abroad I had some Thybon Henning and that made me feel ill. Thank goodness I got it back on prescription. I dread finding it's been changed. I would yellow card it and the more people that do hopefully it will be looked into.

Quasarlis profile image
Quasarlis

May I ask how you got a GP to prescribe you T3??

Lalatoot profile image
Lalatoot in reply to Quasarlis

Quasarlis To get NHS T3 you need to be referred by your GP to an NHS endocrinologist. The Endo has to supervise and prescribe T3 liothyroinine for a trial. Once the trial has been deemed a success the endo returns you to the care of your GP and tells them to continue prescribing liothyronine.

In reality it is difficult to get the endo referral. Not all endos are T3 friendly and it depends on where you live as to whether they can prescribe lio. Having said that there are those of us who have been through the process and do get liothyronine on the NHS so it can be done. It is slightly easier in Scotland as liothyronine has to be prescribed if there is a clinical need. Establishing that clinical need is the big one up here!

Quasarlis profile image
Quasarlis in reply to Lalatoot

I have had a endo referral years ago .. He fed me so much BS it was literally a struggle to stop myself knocking him on his lieing bottom!! .. I did a private blood test that showed I was loaded with RT3, my TSH was high and above range AS WELL AS my T4 and I was loaded with Hashi’s anti-bodies and he blatantly ignored it, started accusing me of miss-dosing and so on, his so called ‘physical examination’ was an absolute JOKE!! So as far as the NHS are concerned regarding my Hashi’s I have made it clear that I think they are completely incompetent, have told my GP that I will get my bloods done as required, I will self medicate on my self sourced T3 and prescription T4 and I just want my results … I’m not interested in your absolute nonsense regarding my condition in the the slightest, so save your advice until you some idea at least of what your talking about.

Good for you though Lala .. You got someone who actually cares about how you feel and function .. There are very few and far between of us on this forum that can say that. Hope it’s all going well for you. 👊🏻👊🏻

Wattsea profile image
Wattsea

Just to say that I’ve had the same problem this week with being given Roma rather than the usual Morningside. After refusing the capsules and speaking to my gp surgery it has now been specified as tablets rather than capsules on the prescription. I noticed that Roma contains titanium dioxide which is a known irritant/genotixic substance and as of October 2022 it has been banned in food and drugs produced in the EU. I can only assume that the new Roma capsules do not have to comply with EU safety regulation since we are no longer in the EU.

TiggerMe profile image
TiggerMe in reply to Wattsea

I think the titanium dioxide is only in the 20mcg Roma? But I'd have to go and check  helvella Vade Mecum

Edit... Ingredients are Maize starch, Magnesium Stearate and gelatine capsule. The 10 and 20 also contain titanium dioxide, and the 20 also contains yellow iron oxide. (These additional ingredients appear to be used to change the look of the capsules.)

helvella profile image
helvellaAdministratorThyroid UK in reply to Wattsea

Titanium dioxide has NOT been banned from drugs produced in the EU. This link helpfully covers the EU and Switzerland.

Use of titanium dioxide in medicinal products

The pharmaceutical excipient titanium dioxide remains permissible in Switzerland until further notice

01.01.2022

In October 2021, the EU Member States approved the proposal of the European Commission to ban titanium dioxide in all food products in the European Union (EU) (European Commission's FAQ on titanium dioxide). This ban is expected to enter into force in the EU in early 2022, with a transitional period of six months. Similarly, a ban on titanium dioxide in food products is also envisaged in Switzerland (see Q&A of the Federal Food Safety and Veterinary Office: What measures is the FSVO now taking?).

In contrast to the rule on food products, titanium dioxide is still permitted as an excipient in medicinal products in the EU; this is based on the analysis published in September 2021 European Medicines Agency (EMA) on the use of titanium dioxide in medicinal products. However, the European Commission intends to re-evaluate the situation concerning the use of titanium dioxide in medicinal products in three years' time.

Swissmedic has noted the EMA's analysis and considers a coordinated international approach to be appropriate. The use of titanium dioxide in medicinal products will therefore also continue to be permitted in Switzerland. Swissmedic will closely monitor international evaluations and reassess the situation on an ongoing basis.

swissmedic.ch/swissmedic/en...

Abby2003 profile image
Abby2003

Hi Beautifuldreamer. I had exactly this situation only a few weeks ago. My local pharmacy dispensed me a different brand. I spoke to the pharmacist, quietly, politely but firmly and advised him that while the active ingredient may be the same, the fillers or binding agents were different and because of this I always needed the same brand, and they were obliged to dispense it. I left my prescription with them. Three days later I received a telephone call from the pharmacy advising that my preferred prescription was ready for collection. Perhaps I was just lucky but it’s worth a try. One thing I will advise is what I have done over time is I have managed to bring my repeats forward so that I always have at least three weeks meds in reserve when I put the repeat in so that I’m never desperate if this happens.

Good luck 😊

Locky1971 profile image
Locky1971

They did the same to me. I came out in a dry scaley dermatitis rash all over my body. Roma capsules are apparently £4 cheaper so they don't care that the fillers are going to mess us up if they can save money. Ironically it cost more with creams and bath stuff to calm the rash. It took 12 + weeks before it faded. The capsules contain titanium dioxide that can cause a dermatitis rash and other problems as a side effect. I had to email and phone the Integrated Care Board to ask them to reverse the decision to give me capsules, GP said they couldn't change it. The ICB eventually changed my prescription back to tablets but it took a month with no T3 medication and made me feel rubbish.

Don't you hate it when people make changes that affect your health without consulting you.

Now the tablets are cheaper and most of us are stuck with capsules.

Hope you get yours changed. I did actually beg in the email to ICB.

Catseyes235 profile image
Catseyes235

my T3 is now Roma too in capsule form only but not having any particular side effects. My problem is I only take one 5mcg but divided in two which was easy with a tablet but is such a pain to open, divide, take half with water then rest of capsule next day. The cost of T3 though it’s come down, is still exorbitant so any savings which can be made will be.

My GP practice won’t pay for the T3 so hospital does and it’s their chemist that has to have Roma. Unlike T4 which I have an hour at least before eating, T3 can be taken with food and I do ...with breakfast and dinner so maybe that prevents any other symptoms.

You don’t say when stomach probs began and for how long so may be coincidence and something else to check out? Good luck.

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