My pharmacist is now on board with this Aristo/Vencamil 100mcg supply nonsense and keen to get to the bottom of it.
Paul at Aristo confirms no problem with supply.
Pharmacist confirms no problem with placing an order, can see it in the system. However it’s showing as ‘red’ which means no stock at depot.
Alliance the wholesaler have 12 depots and it seems Hinckley and Cardiff are out of 100mcg Aristo. All other sizes available. With no forwards visibility on when they will get stock.
I’ll be asking my MP to follow up his previous good work and tackle Alliance on this. Soooo irritating 😠
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I've just put in for a repeat prescription but wont be taking it to chemist until mid next week. Fingers crossed this is ironed out by then, as so far I've not had any issues getting hold of the 100mcgs.
I hope you don't mind me asking which online pharmacy you are using? Sadly my last online pharmacy is now using an automated system, which means they cannot guarantee to dispatch my brand (100 mcg Accord), even if it is specifically written on the prescription 🙄. Its very tedious to ring around all the pharmacies to see if they have it in, so if you have a reliable online pharmacy suggestion, that would be very helpful. You can pm me, in case it is not allowed? Thanks.
In general, it is often worth considering Boots or former Lloyds pharmacies for Accord. Boots often supply Almus. Former Lloyds often supply AAH Hillcross. In 50 and 100 microgram dosages they are Accord product.
However, for online pharmacies, I really do not know if any do what you'd hope for.
Thanks for that, although our Lloyds pharmacy has closed and so will the Boots pharmacy at the end of the year, they have already reduced their medicines substantially 😢. It is quite tricky to get hold of a specific brand it seems, as they always change it around. Will look out for the AAH Hillcross, thanks for the tip.
Our Lloyds closed but was taken over as an independent. (And a much more pleasant place to go!) However, I think they are contractually required to continue ordering through AAH (Lloyds' distributor) - at least under some circumstances.
Therefore they do tend to get what Lloyds would once have offered - which includes AAH Hillcross.
(Just warning for anyone passing by, the 25 microgram AAH Hillcross levothyroxine is Teva product.)
I've had the same issue after having 25mcg increase so needing 100mcg and 25mcg of Vencamil / Aristo.I had a right runaround first I went to local chemist's who could only offer me Teva or Accord which I can't take as need to be lactose free and mannitol doesn't agree with me. I was told by my usual chemist that Teva and Accord cost less than Vencamil and that they wouldn't get paid the full amount for purchasing it.
I rang supermarket pharmacies Tesco etc no joy as they only got what came from warehouse.
I rang the local hospital pharmacy and explained the situation stating that I only have the option of having Teva or Accord both of which make me feel awful and surely this was not correct, or do i have to feel awful every day, as I have no option and must take levothyroxine daily as had thyroid removed surgically in 2018.
They looked into it and found out that Vencamil was ordereable from Alliance wholesalers not from the specialist supplier. 100mcg had a new order code. I took the email I'd received to my usual chemist who seemed not too pleased and didn't want the new code. I also took it to my Dr's surgery and gave them a copy of the email.
The only other option was to have liquid levothyroxine if the chemist couldn't/wouldn't get Vencamil and they'd given me a list of lactose and mannitol free brands.
I've been trying to get an increase in levothyroxine for sometime as I feel better on 125mcg but they keep reducing it back to 100mcg...always seems to be a fight.
I also have get chemist to open the prescription packet each time to check it's Vencamil this was before when only on 100mcg and asked them to change if it was Accord or Teva.
The Dr has now put on my prescription that I'm to have lactose and mannitol free levothyroxine. He told me that he couldn't write a specific brand on the prescription. I wonder if it's to do with budgets especially as the chemist told me that they don't get paid the full amount that Vencamil costs.
Hopefully, I will get the correct brand going forward.
Appendix F of my UK medicines document explains how prescriptions need to be written is a specific product needs to be dispensed. It includes an example for Vencamil. Your prescription should not say "Levothyroxine" but "Vencamil".
"The only other option was to have liquid levothyroxine if the chemist couldn't/wouldn't get Vencamil and they'd given me a list of lactose and mannitol free brands."
Not sure if the pharmacist is ignorant or what there! None of the UK levothyroxine oral solutions contain lactose or mannitol. My my UK medicines document has all such products listed. The document also contains the PIP codes for several products - specifically it includes them for Vencamil products. These might help the pharmacy.
The cost of one 100mL bottle of levothyroxine oral solutions is something like FORTY (yes, 40) times the cost of Vencamil tablets.
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).
● The approved (or ‘generic’) name of the medicine. To prevent misinterpretation, the name should be written clearly and unabbreviated e.g. isosorbide mononitrate (not “ISMN”), ferrous sulphate (not “FeSO4”)
● The exception to the above rule is where there is a clinically significant variance in bioavailability of the same preparation between each manufacturer, in which case, the brand name should be written
Health Education England - LEGAL ASPECTS OF PRESCRIPTION WRITING
The Dr has now put on my prescription that I'm to have lactose and mannitol free levothyroxine. He told me that he couldn't write a specific brand on the prescription.
That’s rubbish
Government guidelines state clearly that GP can/should write named brand on prescription
Yes some brands will cost more than others, and may even cost more than NHS will pay pharmacies
In order that pharmacy gets full reimbursement of cost of prescription the prescription needs to state the brand
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.
If symptoms or poor control of thyroid function persist (despite adhering to a specific product), consider prescribing levothyroxine in an oral solution formulation.
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).
We probably need to clarify what is actually possible. My GP surgery told me they have no way of writing the brand name in the first line of the prescription for instance.
If Vencamil is prescribed then this circumvents the above problem as its already singled down to one product and written in a different way that doesnt even mention Levothyroxine.
Another update from Paul at Aristo; his contact at Alliance says… orders are due in in the next few days and they are upping the quantities they forecast and also upping their top up orders.
Paul is going to keep an eye on stocks at the South Normanton master depot.
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