Hi I picked up my t3 prescription this week and I just opened it now. I am prescribed Morningside 5mcg tablets. It states this on my prescription. I have been given bottles with labels on them applied by the pharmacy that says "Morningside brand". The actual bottles and the PIL clearly say Sigmapharm. Can the pharmacy do this? I have explained to the endo and gp that I can't take alternative brands. Last time I tried Sigmapharm for any length of time it made me unwell!
Does anyone know if there's any guidance I can point to to show the pharmacy?
Thanks
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BiscuitBaby
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I can't help with the guidance, but just to say a similar thing has happened to me before, when the Pharmacy is low on stock.
I've been given a generic brown bottle with say 12 Levo tablets, with no indication as to brand, a data leaflet scrunched in (which turned out to be for a different brand of Levo), and an IOU for the missing 18. It's very concerning, but I'd rather have that than go without any medication for x number of days.
Why they have no stock when they get the prescription 4 days prior is beyond me.
HiThanks. I've been given the whole 2 months of sigmapharm. I've had half a prescription before and I'd prefer that to feeling unwell on a brand I don't tolerate. I tried Sigmapharm before and short term it was OK but more than a few weeks and I just don't feel right! It's so frustrating. I sometimes just think things are going well, then they're not!! I've got some Morningside spare thankfully but it's a hassle I could do without!
Lack of appropriate Patient Information Leaflet is very poor. Indeed, I think it counts as a prescribing mistake but would have to check.
We have had so many stories about people suffering allergic reactions to food which were not properly labelled. And the food industry has been forced to make major improvements. (Though issues do still occur.) Why on earth don't they see that the same serious outcomes can occur with medicines?
I had meant to come back and add more or less what I have put below! Thanks for the reminder.
The first sentence of this government guidance is absolutely critical.
But quite clearly the "own leaflet" requirement implies that the included PIL must be its own and some random other product. This is especially important when the product varies such as own-label levothyroxine where the same company name (Hillcross) is used for two very different formulations (Teva and Accord products).
Patient information leaflets (PILs)
Unless all the information is on the pack, all medicines must include a PIL, regardless of how patients get them. PILs must:
be easy to understand
not contain personal information that can identify an individual, including names of staff members or digital signatures
Each product authorised under a marketing authorisation must have its own leaflet as explained in our best practice guidance on patient information leaflets. Also see MHRA guidance document always read the leaflet - getting the best information with every medicine (PDF, 588 KB, 173 pages).
HiThanks for your reply. I saw a couple of bits of guidance around labelling but it seemed to relate more to insulin and a few other medications. As usual nothing much about lio. I always get the same levo and I've not had this problem for quite a long time. It seems like very poor practice to me. And....did they think I'd not notice???
Any specification of brand MUST be on the top line. Not below the patient "How to take" information.
In financial terms, the pharmacy can only get paid the standard NHS Drug Tariff price for the tablets if that line does not specific the actual product.
You are not the first - by a long chalk - to have this issue. And it is a very poor system. But if the prescriber doesn't understand how to prescribe, we really do have a problem. And that is how it appears to me.
My UK medicines document Appendix F is my attempt to explain further.
helvella - Thyroid Hormone Medicines - UK
The UK document contains up-to-date versions of the Summary Matrixes for levothyroxine tablets, oral solutions and also liothyronine available in the UK. Includes injectables and descriptions of tablet markings which allow identification. Latest updates include all declared ingredients for all UK products and links to Patient Information Leaflets, Dictionary of Medicines and Devices (dm+d), etc. PLUS how to write prescriptions in Appendix F.
Also includes links for anti-thyroid medicines (but not product details).
Thank you for this. When you say about the brand name being on the top line, is that on the label or the actual prescription? I also found some prescriber info from nhs Bristol that says basically if a prescription is specified then it shoukd be prescribed. I'm in scotland and not found similar for here but I would suspect the same applies. I always reorder my medication when I have 2 weeks left to give them time and I normally check before I leave but I was at work and in a hurry! It baffles me as to why they would state one thing on the label!!! And then think I wouldn't notice??
I've had a quick peek at your document but I'm on my phone and it's a big document so I think it'll be better looked at on my laptop.
I don't understand why the prescriber has put "KEEP AS TABLET". It rather suggests that they are trying to avoid it being dispensed as ROMA Hard Capsules. But if they wrote it properly, that wouldn't happen. (Except in the extraordinarily unlikely case that Morningside suddenly launched a capsule product. But, even then, they state TABLETS in the top line and that should be definitive.)
And the pharmacy likely didn't even read lines two to four! They read line one, printed the label, grabbed the pot of 28 LIOTHYRONINE 5MICROGRAM TABLETS which matched line one, slapped the label on. Job done.
Note: I am not trained in pharmacy or medicine. But this is what has been said in various places, in various forms of words, and I've never seen anything that contradicts it.
There are official examples in Appendix F of my UK medicines document.
Thanks helvella. They tried a while back to change to capsules and I had to get the surgery to state Morningside tablets. They've probably put tablets then Morningside! I'll have to take them back and get it sorted. This is the first time I've had this issue for a long time. I'm wondering if there's a change of pharmacist as well. Thanks.
I went to the pharmacy this morning and spoke to a staff member who's worked there for years. She said she could see that I should get Morningside and she's not sure what happened. The pharmacist and the team there change a lot but its still poor practice to say one thing on a label and a different thing in the bottle. Luckily I have spare. Thanks for your help. As always on here everyone's help is invaluable!
Hi yes the government are stating that brands should not be changed . Go on gov.uk . Helvella helped me with this . This is shocking that the pharmacy has done this , putting a label on and it's clearly not the same brand
I've been to the pharmacy this morning and the lady I spoke to was very helpful and said she could see that I should be on Morningside. And she wasn't sure how that happened! I did have a look on the government site and saw info about brands but nothing specifically related to liothyronine. Hopefully that'll be it sorted.
I'm so glad that your pharmacy was understanding and have been able to help . The info about levothyroxine is gov.uk drug safety levothyroxine. Sorry I can't for some reason share the link but hope this helps . Good luck for keep getting the right meds in the future.
Awwwww that's good to hear . I'm going into my pharmacy tomorrow to see if they have managed to get vencamil aristo for me and I think I'm going to have to ask my gp to state this on my prescription and I will be showing them the gov info about levothyroxine and changing brands . You really think the pharmacists would be aware that swapping brands could affect patients health but this clearly doesn't seem the case .
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