Bad Reaction to TEVA

[Cat___]

I just had a bad reaction to TEVA Levo 50mg due to the Acacia Powder filler, GP changed prescription to Accord, but I also take Liothyronine (Morningside), I don't believe there is a brand of Lio (tablets) in the UK that doesn't contain Acacia, but that there is an oral solution. Does anyone have experience of the oral solution?

[SlowDragon Administrator]

Teva upsets many people…..usually due to the mannitol it has instead of lactose

But it could be the acacia

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 - currently Teva or Vencamil only

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 levothyroxine and T3 including ingredients 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...

[helvella Administrator]

Why do you think there is no make without acacia? There are three!

(That is a genuine question. We have had numerous members ask similar questions. And I don't know why they had the impression they did.)

helvella's medicines documents (UK and Rest of the World) can be found here:

helvella - Thyroid Hormone Medicines

helvella has created, and tries to maintain, documents containing details of all thyroid hormone medicines in the UK and, in less detail, many others around the world.

This link takes you to a page which has direct links to the documents from Dropbox and Google Drive, and QR codes to make it easy to access from phones.

The UK document contains up-to-date versions of the Summary Matrix for tablets, oral solutions and liothyronine available in the UK.

helvella.blogspot.com/p/hel...

[tcpace in reply to helvella]

Which are the 3 brands that don't contain acacia powder?

[helvella Administrator in reply to tcpace]

There is a nice little matrix/table/chart in my document which shows which ones contain lactose, mannitol or acacia.

(I don't post it here because I keep updating it. If I post the matrix here, it could be out of date within a day. If you look at the actual document, you always get the latest version. - Assuming you download it afresh! Whereas there are some old versions still posted on old replies here which are now grossly wrong.)

My awareness might change within hours! But at present I am aware of Roma, Teva and SigmaPharm as not containing acacia.

[TiggerMe Ambassador in reply to tcpace]

T3 - Accord, Sigmapharm and Teva in tablets.... Roma in capsules

T4 - Accord, Aristo and Wockhardt

[CocoBaloo]

Hi CatSorry to hear about your reaction ... I take TEVA Liquid Thyroxine ... over the years I've tried tablets & other brands of liquid Thyroxine, but this the only one that suits me ... I'd say give it a try ... Good luck 🍀

[Cebla]

Hi Cat,

I had problems with my Levothyroxine brands when Actavis was sold and became Accord brand. I had been taking Actavis for years and accord was supposed to be some ingredients. I completed a yellow card form.

I eventually took liquid TEVA thyroxine thinking that it would solve everything but I still didn’t feel right and I didn’t actually like like taking the liquid. It was a performance for me to get rid of the taste.

As I recall there are different strengths and if the pharmacy can’t get hold of the right strength - you have to take twice amount of the liquid which happened to me.

I now take Wockhardt brand Levothyroxine tablets and I feel more balanced.

My dose is 50mcg but I have lowered my dose by splitting the tablets and taking 37.5 mcg.I also take 3 grains of Armour thyroid.

Hope that you find something that works for you.

Best wishes to get better, Jane

[helvella Administrator]

I'm not aware of any liothyronine solution available in the UK.

Liotir is available in Italy.

For example, this is a page containing information about it - in Italian.

torrinomedica.it/schede-far...

YOUR experience on LIOTIR T3?

healthunlocked.com/thyroidu...

[Paws21]

I don’t have any knowledge of oral solutions. Most brands of tablet contain acacia so you are going to have to do some research. I can’t take Teva either but mine is because it contains mannitol as a filler, the only manufacturer that uses it. Took some time to determine that was the cause of my reaction. Good luck. Hope you get it sorted soon.

[Tintin0202]

Hi Cat

I too had a bad reaction to Teva tablets and deduced it was from the Acacia. I am now lactose intolerant too and have been on Liquid thyroxine for over a year now which has helped my symptoms stabilise and I generally feel much better most of the time. But it was a battle to get the GP to prescribe it (at around £140 a month) and the pharmacies seem to have difficulty with the supply. So far I have managed to get it when I need it by stocking up when it is available.