Advice needed please as my chemist cannot get my usual levothyroxine

[Benjipuss]

Thank you all for the valued info I glean from this group. After being diagnosed with an underactive thyroid last December I was initially given teva oral levo and I had some awful symptoms which I put down to my thyroid issue. After a few prescriptions I was given Mercury levo and felt so much better. I was then given Teva again and all the symptoms returned. I now have it on my prescription and noted at the chemist to give me Mercury. However, last week Mercury was unavailable and I was offered Teva!! I refused and have been unable to source Mercury locally. Does anyone know what the problem is and what can I do? Thank you for any advice given

[Regenallotment Ambassador]

You are going to have to educate them.

The GP needs to name the brand that suits you on the prescription.

The pharmacy need to order the brand that you are well in and that the GP names.

Governments own guidelines here gov.uk/drug-safety-update/l...

You are quite within your rights to ask for and receive the Levothyroxine that suits you best. I have a letter from a (now former) Health Minister to confirm this.

What happens is pharmacies receive bulk supplies of random brands in random dosages of Levothyroxine and put them all on the shelf and then dole them out what appears to be willy nilly according to each prescription. With my favoured brand listed I still check my bag at the counter every single time and take to me out and hand them back and got through this rigmarole every so often. 8 months is a record for not having to politely explain… again!

More info in this post too: healthunlocked.com/thyroidu...

It’s a common issue, the more we educate the better or will be for everyone 🌱

[Benjipuss in reply to Regenallotment]

thank you! The chemist said they had been unable to source it and did make me aware that they’d given me Teva. I have rung them today and shall continue . I tried to contact the supplier but on Google it said permanently closed?! I’m hoping that’s just that particular office? My Mercury is named on my prescription and the chemist has also noted it. Not a problem till now. But what do I do if it can’t be sourced? Another chemist mentioned Wockhardt, but I don’t know anything about this brand

[Regenallotment Ambassador in reply to Benjipuss]

I’ll tag helvella he will know about Mercury supply and suitable alternatives 👍

[FallingInReverse in reply to Regenallotment]

helvella tagged… wasn’t blue in your reply so not sure he would have gotten a notification?

[Regenallotment Ambassador in reply to FallingInReverse]

Thanks so much not sure what happened there 🙏

[Benjipuss in reply to Regenallotment]

Thank you!

[helvella Administrator in reply to Benjipuss]

Is Mercury Pharma named on the top line? Appendix F of my document has examples of how to write prescriptions. (No - we shouldn't need to inform our prescribers how to write prescriptions...)

Who did you try to contact?

UK (Corporate Headquarters)

Dashwood House, 2nd Floor, 69 Old Broad Street, London, EC2M 1QS

The following entities are all trading divisions of ADVANZ PHARMA Corp.

Mercury Pharmaceuticals Ltd

Amdipharm Ltd

Advanz Pharma Generics (UK) Ltd

Advanz Pharma Services (UK) Ltd

Direct: [phone]

[e-mail]

advanzpharma.com/contact

I'm afraid I do not know why we keep having issues!

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), British National Formulary, etc. PLUS how to write prescriptions in Appendix F.

Also includes links for anti-thyroid medicines (but not product details).

📄 dropbox.com/s/bo2jzxucgp9hl...

Matrix of UK levothyroxine

[Benjipuss in reply to helvella]

Thank you! It does say only Mercury on my prescription and the chemist also made their own note on my record when it became apparent that Teva gave me problems. I have oral levo . Is there a chart please for oral additives? Medication and me do not generally get on too well so I would be interested to know about any additives, especially as this is a lifetime hormone. Thanks for the contact details which are different to what is on my box! I shall try and contact tomorrow.

[helvella Administrator in reply to Benjipuss]

Sorry - not quite sure what you mean there?

The chart has ALL the listed excipients in UK levothyroxine tablets. And my document has ALL the listed excipients in all UK thyroid hormone medicines.

[Benjipuss in reply to helvella]

Thank you. It’s me…for some reason I didn’t load it properly. I wonder why an oral solution can’t be made without all these additions. Is there nothing that’s natural and additive free that works as well?

[helvella Administrator in reply to Benjipuss]

The oral solutions need the glycerol both to keep the levothyroxine in solution (it isn't soluble in just water) and to give it some body.

But if they stopped there, it would allow bacteria and fungus to grow - so they add some preservatives. And they might need to use something to achieve the right pH - so acid/alkali to do that.

Everything has a reason to be there!

Not everyone tolerates the relatively large amounts of glycerol you get in all the oral solutions.

[Benjipuss in reply to helvella]

Thank you! So there are no natural alternatives then!

[SlowDragon Administrator]

Ring round all your local pharmacies

Has GP written prescription specifying named brand

Mercury Pharma is identical to Eltroxin

Both made/distributed by Advanz

Often listed on pharmacy databases as Advanz rather than as Mercury Pharma

lots of members use online specialist pharmacies

thyroiduk.org/get-support/t...

What dose are you currently taking

You might try Wockhardt - 25mcg only

Vencamil - should have all doses available

How to get named brand levothyroxine

[Benjipuss in reply to SlowDragon]

Thank you. I do have named brand on my prescription and have rung round. Most only have Teva, there is a huge Teva factory nearby. I’ve not heard Eltroxin mentioned. Why has the same product got two names? I shall let my local chemist know about Advanz database. Thank you for the specialist pharmacy link which I shall pursue if no joy with my local one tomorrow. ( they have said they will continue to try). I am on oral 50 mcg still but my results still are moving in a positive direction.

[SlowDragon Administrator in reply to Benjipuss]

Likely to be ready to increase to 75mcg soon

So then would need 25mcg plus 50mcg

[Benjipuss in reply to SlowDragon]

Thank you! I am keeping a close eye on my figures when tested and currently they are all moving, albeit slowly, in the right direction. I don’t feel a 100% but have lingering issues from Long Covid and just had operation . I am surprised that numerically at least that my small dose appears to be working but only time will tell. I was diagnosed after only one test and from a scan.

[Pmb57]

I too feel well Mercury levothyroxine. When my GP tried to add the name Mercury to my prescription Mercury didn’t appear in the drop down list on his system, he had to use the Eltroxin option. Last week I had a meds review with the GP’s in house pharmacist. He tried to change my prescription to a generic levothyroxine (to save costs). I said I would accept Mercury or even Advanz on my prescription but he told me a pharmacist would take this as being a generic option as it’s a makers name on the prescription and not a brand name. 🤷‍♀️. Thankfully I managed to convince him to continue with the Eltroxin. I still check my meds when I receive them while in the pharmacy. If you return meds after you have left the pharmacy the meds have to be destroyed.

[Benjipuss in reply to Pmb57]

Thank you! I’ve read here that Teva is much cheaper, but boy, did it really cause me some horrendous symptoms! I think I’m the only person that uses my chemist that has Mercury. It looks like I might need to ask them to try Advanz/ Eltroxin route for my latest prescription. They are a good chemist and did make me aware that it was Teva this time so I gave it straight back as I’m not prepared to be made so unwell again.

[SlowDragon Administrator in reply to Benjipuss]

Mercury Pharma customer care phone number

healthunlocked.com/thyroidu...

Teva contains mannitol instead of lactose

Mannitol changes gut biome and seems to upset many people

Alternative Levo that’s lactose and mannitol free is Vencamil. originally only available as 100mcg only, but 25mcg, 50mcg and 75mcg tablets became available Sept 2024

Prior to March 2023 Vencamil was called Aristo

How to get Vencamil stocked at your local pharmacy

healthunlocked.com/thyroidu...

[Benjipuss in reply to SlowDragon]

Thank you! I take oral levo. Vencamil sounds maybe better re additives, it’s the first time I’ve heard it mentioned. Am reluctant to change brand after awful experience with Teva, which oddly no one appears to have trouble stocking! I shall try and follow the info up that you have given . Many thanks 😊

[SlowDragon Administrator in reply to Benjipuss]

Government pays a fixed fee to pharmacies

Teva is often cheapest one for pharmacies to get

[Benjipuss in reply to SlowDragon]

Thank you! That explains a lot….but is it the chemist or the Drs surgery that is out of pocket if I can’t have Teva?

[SlowDragon Administrator in reply to Benjipuss]

Pharmacy

Different brands might give smaller profit

So brands can cost more to supply than current reimbursement Government will pay

Dispensing the cheapest brand will maximise profit

But if the brand is named on prescription then pharmacy will get reimbursed full amount even if price they need to pay wholesalers is higher than Government is paying ……

but they still won’t make any profit

see page 10

Point 2.18

assets.publishing.service.g...

[Benjipuss in reply to SlowDragon]

Thank you! I’m pleased to say my chemist has now managed to source my Mercury and I am picking up tomorrow! We are only a village and I think I am the only person having Mercury! I shall keep the welcome details above though just in case and will ask my Dr for an extra prescription I think to create a good safety net!

[SlowDragon Administrator in reply to Benjipuss]

will ask my Dr for an extra prescription I think to create a good safety net!

Excellent plan

[Benjipuss in reply to SlowDragon]

😊