I have booked a medication review for next Tuesday. This will be my first such review since May last year. As always the surgery has not sent me a blood test form so there will be no real discussion and nothing will be gained from the exercise, but I now have two questions for the pharmacist who will be conducting the review. Firstly I would like to know why, when I have been stable on the same dose of Levothyroxine since 2013, I am only allowed 28 days worth at a time. Can anyone point me to an NHS document which says that in this situation longer prescriptions can be issued?
Secondly, having been stable on the same brand of Levothyroxine since 2013, I started getting different brands last year, sometimes a different brand each time. With the exception of Teva, which made me feel awful, there seems little difference in how they make me feel, but I have put on over a stone in weight which I just cannot get off. Is it worth asking if a brand can be specified on my prescription, given that the pharmacy will tell me that 'my'brand (Mercury Pharma) is simply not available?
All assistance gratefully received. Thank you
Written by
AngelRain
To view profiles and participate in discussions please or .
Sounds like you might need dose levothyroxine adjusted
Obviously no point having a review without getting FULL thyroid and vitamin testing done FIRST
What vitamin supplements are you taking
When were vitamin levels last tested
Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine
For full Thyroid evaluation you need TSH, FT4 and FT3 tested
Also both TPO and TG thyroid antibodies tested at least once to see if your hypothyroidism is autoimmune
Very important to test vitamin D, folate, ferritin and B12 at least once year minimum
You can have a note added to all future prescription saying “No Teva”
Or you can have note added specifying a particular brand
It’s possible (but seems rarely done) to have a full years prescription at a time, once on stable dose. This gets sent to pharmacy of your choice and they can dispense 2 months worth of medications at a time
My surgery only offers 28 days worth as well. Its frustrating, time consuming for both patient and surgery and surely must cost the NHS more. Mine has always run like this. It does seem to vary depending on your practice.
Some of my meds I've been on for years and they aren't restricted or high risk, like say an opiate based painkiller would be. I really dont understand the reasoning behind it but have never summoned up the impetus to ask them.
As for your second question, there is certainly no harm in asking. I get Accord /Almus ( same tablet manufacturer) as a named brand. I had some digestive issues with others so quite early on after diagnosis I found I prefered Accord.
My old pharmacy, until then very reliable, starting sneaking Mercury into my repeats, which makes me itch. I make a point of checking my Levo before exiting the shop. It irritated me a bit as it seemed underhanded. So I switched to Superdrug, after first checking they could supply Accord. Never had any issues since.
If you have a preference and feel better on Mercury I would certainly request they name it on your prescriptions 😀. Just be prepared that some pharmacies can be a bit awkward about getting your preferred brand in and will make excuses. I've ended up getting the prescription back before and going elsewhere.
I'm VERY lucky and get 84 days (approx. three months). It saves NHS paying so many dispensing fees!
helvella - 28-day Prescribing
For many years now, there has in the UK been a near-universal imposition of 28-day prescribing.
There is, quite simply, no rational basis for this policy in relation to long term medicines on repeat. Worse, it can be to the detriment of patients, and cost more.
My GP practice has a practice policy of only 28 days prescriptions. I do believe this is due to them having their own pharmacy so they make more money that way from the dispensing fees. Grrr!
Oh, also I think my practice are one of the last to be using paper prescriptions. I've recently been told that in October they will be introducing electronic prescriptions. Turns out they've probably forced down this route but about time too!
I think, but am not certain, that electronic prescriptions are England-only at present. Definitely there are plans for the other nations but I don't think they have yet reached fruition. Scotland had announced implementation in 2024-25. But we all know these things often take forever to roll out completely even if the first few are on schedule.
The senior partner told me quite categorically, a few years ago that they would never introduce electronic prescribing, so it was a shock to be told that it was happening imminently. It must be quite an expensive undertaking with all the computer software and staff training.
May I respectfully suggest that the senior partner is a nincompoop?
It has been on the plans for many years. It was obvious that individual practices would not be allowed to duck out. And, now that they have introduced the systems for switching pharmacies, it is likely an advantage to most patients.
I suspect there are zero software costs because the GP systems used everywhere surely must include this as standard? (I suppose they might charge more if it is not already included. But essential components tend to be bundled.)
Training, yes. But I really can't believe that staff (medical and admin) who already use the GP systems will find it a major hurdle.
And think how much specially-printed FP10 (standard green prescriptions) stationery they will save!
Due to the fact I havent had the opportunity to experience electronic prescribing yet I'm almost completely in the dark as to how it works and any changes in being able to switch pharmacies etc.
I cant wait not to have to provide stamped addressed envelopes for my repeat prescriptions to be posted to me in or to have to drive 5 miles when unwell to collect a prescription.
Next time I'm there I'll try and find out why they havent done it before. I wonder why their hesitancy.
In the early days, there was a major hole in the system.
Basically, what happened if the pharmacy couldn't dispense what you need? There was no way for the pharmacy to give the patient their prescription so they could hunt round other pharmacies! This could very easily result in a patient requesting multiple re-issues of prescriptions in order for another pharmacy to dispense.
This issue was addressed by some token system (that I haven't used). More or less, the pharmacy can give a patient a reference. When they go to another pharmacy, they give that reference and it links up to their prescription. The pharmacy then grabs it and dispenses (you hope!).
Avoiding those issues might have been part of the reason.
Last time I was asked to make a review appointment, I phoned and asked the receptionist for a blood test - and she made that appointment immediately - with GP appointment a few days later. The way it was treated made that feel quite normal.
I think that it is simply they invite to review and don't think or look further to see if a blood test is appropriate.
My annual reviews are online, I answer a set of questions, fill in BP, weight etc, list that I still have all my symptoms, and they get filed away and next prescription issued. Seem to be linked to a review date on the prescription rather than my blood tests or even my health.
My number of pills depends on both what the GP asks for and how many they are allowed to prescribe based on supply issues. I was told 2 months for levothyroxine and hrt.
I only get one month if a medication is a one off prescription or a trial.
AngelRain, I get a 3 month prescription at a time from my doctors, so they can do it. I am also having the same trouble as you, our local Boots the chemist, it looks like a pound store now and they keep giving me different brands of T4 and T3. Even though I ask for my old brands. Someone went and got my prescription for me this time. I gave them a note to remind them no Teva, it is on their records, or was. They told the person who collected the prescription that I have to have Teva unless the doctor writes on the prescription. If you went into a cafe and said I am allergic to peanuts would they say you will have to have this peanut cake unless we get a letter from your doctor! I took Teva once before and I had laboured breathing. Thought something was wrong with my lungs. Doctor could not find anything, stop taking the Teva and it went.
I do wonder if they think patients make it up or are being difficult on purpose, my MIL can only use one brand of glaucoma drops, my mum could only tolerate one brand of low dose aspirin. So its not just thyroid medication.
So far l have been lucky in that I get three months worth of thyroxine at a time. I like Mercury ( it agrees with me) and requested my GP to name it on my prescription. He agreed but when he went into the system Mercury didn’t show as a brand (this was 2022). The GP had to select Eltroxin from the drop down menu which is Mercury under a different name and Mercury is written on the box. My prescriptions go electronically to the pharmacy and to date I have always received Eltroxin. Currently I’m getting texts from the surgery asking to go for a medication review if I haven’t had one in the last year. So far I have ignored the request but suspect I will have to bite not bullet and have a review when my next prescription is due. They have already made a change to one of my tablets without consultation but I’m ok with the change. I’m saving my ammunition in case they want to amend my prescription to generic thyroxine.
Well, I had the review yesterday. All my other medications continue, but I only get two months Levothyroxine now to take me up to a year from when I last had my levels tested, so need another "TSH test". I asked for co-factors and was told I couldn't have some of them because they were last tested in February. That was because my B12 and folate were low in November and I asked for 3 months to try to sort them out and then a re-test. It seems that being pro-active and involved with your own health stops you getting the testing you need *shrugs*
They can't, or won't, give me more than 28 days medication at a time or specify a brand of Levothyroxine on my prescription.
So there we are. As I suspected, pretty much a waste of time.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Best Levothyroine brands.
Pink Cheeks and Forehead
Problems with change of brand
PIP review help!!
Medication trial and errors.
