Generic Levothyroxine or Synthroid?

[THoa2022]

I've been on generic for a few years, but I've read enough recently that I am uneasy about it. From where it is manufactured and issues they have, to not having to be the exact same dosage as brand name. And I don't even know what fillers my generic has.

Synthroid may be a brand name option I can go to, but curious if anyone has experience. Should we stay away from generic levothyroxine and go brand name?

[SlowDragon Administrator]

How much levothyroxine are you currently taking

Do you always get same brand each prescription

Many people find Levothyroxine brands are not interchangeable.

Most easily available (and often most easily tolerated) are Mercury Pharma or Accord

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

Mercury Pharma also boxed as Eltroxin. Both often listed by company name on pharmacy database - Advanz 

Accord only make 50mcg and 100mcg tablets. Accord is also boxed as Almus via Boots, 

Wockhardt is very well tolerated, but only available in 25mcg tablets. Some people remain on Wockhardt, taking their daily dose as a number of tablets 

Lactose free brands

Teva makes 25mcg, 50mcg, 75mcg and 100mcg

Many patients do NOT get on well with Teva brand of Levothyroxine.

Teva is lactose free.But Teva contains mannitol as a filler instead of lactose, which seems to be possible cause of problems. Mannitol seems to upset many people, it changes gut biome 

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. 

March 2023 - Aristo now called Vencamil

healthunlocked.com/thyroidu...

 

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).

Discussed here too

healthunlocked.com/thyroidu...

[THoa2022 in reply to SlowDragon]

Thanks! Just 88 on generic levothyroxine for the past few years. It's switched manufacturers once, but that's all I know.

[HeartWoman]

I was on generic, but switched to Synthroid just so I know I get the same thing every time. I am not against generic and I know many people who do well on them.

Generics are to have a certain percentage of the active ingredient in each pill compared to the name brand. The fillers can vary though.

I crashed pretty hard a few years back and I believe it was because the generic brand was changed. If you are doing well on the generic you are on and can always get the same one, then you should be fine.