T3 (liothyronine) UK OUT OF STOCK (manufacturin... - Thyroid UK

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T3 (liothyronine) UK OUT OF STOCK (manufacturing problems)

nobodysdriving profile image
59 Replies

I went to cash in my prescription of 160mcg T3 daily.....

the pharmacist told me it's out of stock and there is NONE available in the whole country until who knows when!

Sainsbury's pharmacy in a huge central London hospital told me the same.....they are trying to get me Cytomel from Pfizer instead, waiting for a phonecall....

I found this online where it says it's out of stock until June, I am now ringing the number supplied for more info.....

pjonline.com/supply_issues_0

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RedApple profile image
RedAppleAdministrator

OMG this is gobsmacking news. Still stunned and haven't quite taken it in yet :(

nobodysdriving profile image
nobodysdriving in reply toRedApple

tell me about it! still waiting on a phoncall from pharmacy! they said they might get me the injections...but they are IV only as far as I know and come in 20mcg I am on 160mcg!!!!

the number I rang I kept holding and holding and I gave up waiting.

lynmynott profile image
lynmynottPartnerThyroid UK

Please do let us know NBD what their response is. Very worrying. This kind of thing is getting too much of a habit! :-(

nobodysdriving profile image
nobodysdriving in reply tolynmynott

yes, it's NOT GOOD to run out of T3, people whose thyroid has packed up or don't have a thyroid anymore and don't tolerate T4 can go in a coma in a matter of days with no T3 :(

I know that at 3 days of no T3 I am indeed very very ill :(

I'll let you know, there is no reason why they cannot get the usa cytomel for me, they are capable of getting it as I have asked before (though have not had it), so yes, they should do it for me.

Kezzerb profile image
Kezzerb in reply tolynmynott

Lyn I am extremely worried about this news could you get this checked out Finchley clinic do a thyroid support formula. I must admit when I tried it two years ago I felt really well.

thefinchleyclinic.com/shop/...

The ingredients are One capsule typically provides: 12.5mg Vitamin C, 15mg, NE Niacin, 3.3mg Vitamin B6, 60µg Folic acid, 5µg Vitamin B12, 1.25mg Iron, 25mg Magnesium, 2.5mg Zinc, 30µg Iodine, 1.25mg Manganese, 250µg Copper, 30µg Selenium, 450mg Tyrosine.

That is awful news! I can hardly believe it! x

helvella profile image
helvellaAdministrator

If it were down to me, I would already have fitted a blue light to an aircraft to fly some in from wherever is appropriate! :-)

I suspect it is going to be an especially sudden and deep shortage as so many people report their pharmacies only get it in to order - so no buffer stock within pharmacies. And I can't imagine the standard "specials" importers such as IDIS have more than a few pots available.

But even if we got "foreign" liothyronine, we'd have the fact that "their" pills are 25mcg against ours being 20mcg to deal with - as well as the high degree of personal variation in how people take to different brands.

What a mess.

Rod

MaryMary profile image
MaryMary

Please keep us informed, this is seriously bad news, especially as I am only 'allowed' 28 days of T3 at a time!

Mary

SilkyJ profile image
SilkyJ

This seems to be a Mercury Pharma issue as their thyroxine is also out of stock so it will affect those on either!!...

"Eltroxin (levothyroxine sodium) tablets 25µg and 50µg are out of stock from Mercury Pharma. The company does not know when supply will resume. Generic levothyroxine tablets 25µg, 50µg and 100µg are available from Mercury Pharma."

So, no T3 until June! I hope this scare will encourage pharmacies to supply other brands so we have more choice but, I suppose, that's wishful thinking on my part! ;)

Silky x

RedApple profile image
RedAppleAdministrator in reply toSilkyJ

Yes indeed, info about the Eltroxin tablet shortage has been on the Thyroid UK website since early March.

thyroiduk.org.uk/tuk/news.h...

MercuryPharma are the onky UK suppliers of T3. There are no other UK brands or manufacturers of T3/liothyronine, and pharmacies can only supply what is written on the NHS prescription. So in order to offer a 'different brand', they need the prescription to state which brand they should get imported.

With regard to T4/levothyroxine, with the demise of Teva, there are now only two tablet manufacturers in the UK i.e. MercuryPharma and Actavis. So again, in order for a pharmacy to supply anything else, they will require a written prescription for the exact product to be imported.

RedApple profile image
RedAppleAdministrator in reply toRedApple

I probably should clarify that we do have a third supplier of levothyroxine here in the UK, which is Wockhardt. However, as Wockhardt only ever supply 25mcg tablets, I tend to discount them when I talk about UK levo products!

Zephyrbear profile image
Zephyrbear in reply toRedApple

There is also Wockhardt who operate from Wrexham. Granted they only do the 25mcg T4 tablets, but they are available. The news about the T3 is very worrying, however. I rely on that to keep me well same as, I am sure, quite a few people on here now. I can't believe that the medical establishment would even risk letting so many of us down with such potentially serious consequences. They wouldn't treat diabetics with such contempt, so why us? Or is this some back-door plot to get us all back on that little miracle pill Levothyroxine??? Perhaps a publicity campaign led by TUK to highlight this outrageous state of affairs is needed.

sandi profile image
sandi

I cannot imagine a situation where supplies of a necessary drug for any other group of patients would be allowed to run out.

There would be an outcry if diabetics were unable to get insulin or cancer patients their ongoing meds or transplant patients their anti-rejection drugs....but thyroid patients..well...expendable?

It makes you want to scream and shout.

nobodysdriving profile image
nobodysdriving

OK, summary:

no sainsbury's pharmacy cannot readily get cytomel USA for me, they 'could' but it'd take WEEKS they said. As it is an unlicensed medication they'd need first the GP to prescribe then it would have to go through the MHRA and get special 'import' status.

they can give some 'unknown' brand 5mcg tablets (I would imagine that is cytomel to be honest) but 100 tablets is £700!!!!!! needless to say, as I am on 160mcg daily I'd need THIRTYTWO of these tablets daily, it would cost the NHS £700 every THREE DAYS for these LOL :D

I have called around a few pharmacies, most have NO LIOTHYRONINE on their shelves, a couple had ONE POT (I need 16 LOL) and one pharmacy had THREE pots.

My gp gave me a prescription for 3 pots so I got the 3 pots which will last me 9 days, then she said she is going to talk to the 'PCT prescribing lead' in the week to organise something else! we'll see!

SilkyJ profile image
SilkyJ in reply tonobodysdriving

What an absolute fiasco! We've go through so much to get these damn pills of which there is only one supplier, and now we have to fight again when they run out of stock. The whole NHS system is mad!!

RedApple profile image
RedAppleAdministrator in reply tonobodysdriving

I'm somewhat surprised at the MHRA special import stuff Sainsbury have spouted at you. It sounds as though they are talking about importing directly themselves, rather than using an existing importer such as IDIS.

Might be worth finding a local pharmacy that has an account with IDIS, and ask them about getting Cytomel for you. I'm afraid my experience with Sainsbury's pharmacy is that they are less than helpful when it comes to supplying anything out of the ordinary. My local independent pharmacy was much more helpful (although that was for other thyroid meds such as desiccated and German lactose free T4, not 'foreign' T3 :) ).

RedApple profile image
RedAppleAdministrator in reply toRedApple

Surely the whole point of the 'named patient basis' thing is to allow for situations where a special medication needs to be imported for an individual patient. You are not asking Sainsbury to become a mass importer of Cytomel for the whole country forever, only for your personal needs whilst MercuryPharma T3 is unobtainable.

nobodysdriving profile image
nobodysdriving in reply toRedApple

I'll give the GP a few days to 'deal' with the prescribing lead and see what comes out of it I guess!

helvella profile image
helvellaAdministrator

I note that the PJonline link information was dated 13 April. That is 10 days ago.

We know that a number of people only get 28 day prescriptions, especially of liothyronine.

Therefore, perhaps in less than three weeks, we will see a true major crisis unless someone acts with appropriate urgency. (Not to say there is not already a crisis but the scale will grow.)

So far as I can see there are various organisations within the NHS and/or Department of Health who may be involved. One such is the Pharmaceutical Services Negotiating Committee who do have a role regarding shortages of branded and generic medicines and in authorising higher payments when necessary:

psnc.org.uk/

However, they refuse to have any contact with the public and advise anyone wishing to contact them to instead use PALS at their local hospital.

I urge everyone affected by this issue to contact their local PALS team as soon as possible.

The other obvious body that should be involved is the MHRA. However I cannot fully understand what they are able to do. Certainly they could speed a licence through for some other make - but I do not know enough about their processes. After all, in the usual case it is up to pharmaceutical companies to apply for licences - not for any other body to demand them.

Rod

Kezzerb profile image
Kezzerb

Could this be being done on purpose. I am due to pick up my script from the doctors on Thursday what to do if I can't get any I have only just started on them I have been on them a month now.

SilkyJ profile image
SilkyJ in reply toKezzerb

I would suggest you call all the pharmacies you know and ask them if they have any T3 in stock and if they can keep it for you for Thursday. I would also make an urgent appointment with your GP so that you can organise to get another brand on a named person basis urgently because you will be left without T3 the in May as well.

Silky x

Kezzerb profile image
Kezzerb in reply toSilkyJ

Thanks silkyj I will do tomorrow. Perhaps they cannot keep up with the demand now sufferers are switching.

Kerry X

SilkyJ profile image
SilkyJ in reply toKezzerb

Kerry I wish that were true but the NHS only source from one supplier and they are having manufacturing problems - we don't know exactly what but if they have problems we are pretty much stuffed. It's seems the NHS have little or no regard for thyroid sufferers unfortunately. :(

Silky x

Kezzerb profile image
Kezzerb in reply toSilkyJ

Well if it is being done on purpose it is time to take to the streets.

Willowluv profile image
Willowluv

I just picked up my repeat perscription for t3 this mornimg.!!

hh46 profile image
hh46

I'm due another prescription of liothyronine in three weeks should I ask for a repeat before then???

nobodysdriving profile image
nobodysdriving in reply tohh46

yes, call your GP and say you need it now as there is supply problems and they need to look around to get you some (the pharmacist will get you some)

janiebell profile image
janiebell

What is going on with Mercury pharma??? When you call and speak to their customer services they will not answer your questions other than to say " we have a manufacturing problem" . Why then can they produce the generic version if its exactly the same pill but in a different box? It all seems quite suspicious to me and rather worrying. I find it hard to believe they are having a problem producing the actual boxes so it must be the pills which then begs the question can we trust the pils? They don't seem to be a very transparent company.

Muffy profile image
Muffy

Would you write to your MP about this. This is happening far too often as the medication is often sold abroad first and then brought back!

I had this problem before Christmas when my anti-convulsants weren't available.

I had a letter from my MP saying the government were aware of problems with the supply of prescription meds. The more people who write, the better.

I'm due for a repeat of my T3 pres in a couple of weeks time, so looks as tho I may be out of luck again!

Very worrying for those affected and do hope that a solution is found. I really do despair with the NHS.

lynmynott profile image
lynmynottPartnerThyroid UK

Hi guys!! I've just spoken to one of my contacts. They have ordered some 5mcg generic liothyronine that they think may be coming in on Friday. I have to ring them back as she will know more this afternoon. I'll keep you informed....

nobodysdriving profile image
nobodysdriving in reply tolynmynott

Lyn, when you say 'they have ordered' who is 'they'?? and is this for the whole of the UK?

you know it will take me 32 5mcg tablets a day to survive, that is a whole lot of tablets until the end of june LOOOOL but whatever they give me so long that I get my T3 I don't care :)

lynmynott profile image
lynmynottPartnerThyroid UK in reply tonobodysdriving

I'd rather not say until they definitely are arriving - otherwise they will be inundated for no reason! :-) I'll be ringing them today....

I know - it's mad that we will have to take 5mcg tablets. However, I'm hoping to find another source....

nobodysdriving profile image
nobodysdriving in reply tolynmynott

anything will be good.

yesterday evening my pharmacist had 'no news' for me, so I'm popping down there on saturday :)

Kezzerb profile image
Kezzerb

I have just rang mercury pharma and they have confirmed that all T3 is out of stock and that they have a manufacturer problem. The woman I spoke to was a health advisor. She confirmed that mercury pharma are the only manufacturer in the UK and that they make it. She just kept insisting that I get in touch with my gp for an alternative as they do not know when it will be readily available can you believe that people rely on it. I swear it's bing done on purpose.

lynmynott profile image
lynmynottPartnerThyroid UK

Hi Everyone,

Ok. Just spoken to MercuryPharma. They tell me that there is a problem with the ASI of the product - the Active Pharmaceutical Ingredient (the actual T3 hormone). There is no date for stock but they are hoping to get some in by the end of June.

I then telephone the MHRA and they are going to investigate this and get straight back to me. I informed them that Thyroid UK is NOT happy and that they are going to have a lot of very UNHAPPPY and WORRIED patients who will have to go without their T3 which could cause very large health problems for them!!!

I think he got the picture! Will keep you informed....

helvella profile image
helvellaAdministrator in reply tolynmynott

The Active Pharmaceutical Ingredient could be this:

sandoz.com/our_products/ant...

The bigger issue is that if Sandoz (or whoever else makes the ingredient in Mercury Pharma's product) is having problems, that could affect many different manufacturers of liothyronine tablets.

Rod

nobodysdriving profile image
nobodysdriving in reply tolynmynott

thank you Lyn, it's not so much that we are unhappy, some of us will end up in hospital FOR SURE, especially those on T3 only like me :(

thank you for chasing this up for us all, we are very grateful xxx

Kezzerb profile image
Kezzerb in reply tolynmynott

Lyn this is very worrying if they are having problems with the active ingredient. What actualy is the problem? How can we be sure if and when they dispense the T3 whether they will alter the ingredients. It is the case that there have been recalls of other thryoid meds. Given the controversay concerning T4 Levo I wouldn't put it passed them giving us all a placebo when they rectfy the problem. I myself being put in this position has given me a loss of confidence in the way that Mercury Pharma is taking thyroid sufferers illnesses for granted it's just not acceptable.

hh46 profile image
hh46

Getting really worried around all this, just started T3 four weeks ago, just last few days feeling better,

marlathome profile image
marlathome

Picked up my repeat prescription for T3 this morning from Lloyds. Am going to go back in there shortly and find out how much stock they have.

marlathome profile image
marlathome in reply tomarlathome

Lloyds tell me I had the last tub of T3 but they are not aware of any shortages and will check. They said they only have 2 people currently who are prescribed T3 so they don't carry much stock anyway. What a fiasco.

lynmynott profile image
lynmynottPartnerThyroid UK

Just spoken to my contact and unfortunately, they have heard from their supplier that there is a stock problem and it may be a few weeks before they get it in stock. I asked them if it was the same problem as MercuryPharma and they said yes.

So, now, we are waiting to hear from the MHRA. :-(

lynmynott profile image
lynmynottPartnerThyroid UK

Just received this from the MHRA:

Dear Ms Mynott,

Thank you for your email and for bringing this to our attention.

We are currently working with colleagues at the Department of Health and with Mercury Pharma regarding this matter. Our intention is to come back to you shortly once we have an update on the position moving forward with regards to Liothyronine supplies.

If you have any further questions in the interim please do come back to us.

As soon as I hear more I will keep you informed... Lyn

nobodysdriving profile image
nobodysdriving in reply tolynmynott

thanks Lyn,

perhaps if and when you have some 'news' you will 'blog' about it?

thank you for trying

lynmynott profile image
lynmynottPartnerThyroid UK

Yes, will do. Not much point yet and I didn't want to cause mass hysteria! :-(

Totoro profile image
Totoro in reply tolynmynott

I put in my prescription at Boots yesterday (Thurs) and they said it would take "weeks" to get the 20mcg tablets and they had less than my prescription in stock. They would order it as a special order.

But this afternoon I went in and they had the whole prescription. They said it had unexpectedly come in. So maybe Boots have sorted out an alternative supply? Or maybe the Edinburgh/Scotland "warehouse" had enough in stock.

Derpington profile image
Derpington

I was unaware of this; I've been prescribed T3 for about two months now and I'd hate to see all progress in my recovery tarnished by what may very well be a concerted attempt at the top to botch the entire supply chain. I'm meant to collect my prescription again today from the local Boots (they didn't have any yesterday when I placed it), God knows if they'll have any in stock. If Totoro is right in her hunch about the Scottish supply backlog though, I may just be in luck.

Redditch profile image
Redditch

The issues continue, apparently... I am in Worcestershire and my Pharmacy say they can't get my T3... I rang all the pharmacies in the phone book and found one that had one pot.. so I have it.. but we're in a bit of trouble here... suggest we all contact the big pharmacies.. Boots, lloyds etc and tell them we need it... Lloyds are part of Celesio so they have fingers in Pies and international partners.. they surely can get this from somewhere else, they just need telling that there is a genuine demand... Email lloyds pharmacy if you are looking for T3... tell them what the demand is

cybersheel profile image
cybersheel

Hi! I use Lloyds pharmacy and they have no T3. Get their supplies from - guess who? - Century Pharma.

LouiseRoberts profile image
LouiseRoberts

Hi

This thread is about T3 - Liothyronine. We are not aware of any general levothyroxine shortage, only a problem with the branded Eltroxin.

More info here:

thyroiduk.org.uk/tuk/news.h...

Louise

x

sandywandy1 profile image
sandywandy1

I have tried most pharmacies within a 5 mile radius of home (Essex) large and small. Managed to get one pot of 28, but my prescription is for 126. Couldn't obtain them in London either.

Does anyone know if it is possible to buy them over the counter in Spain or do you need to see a doctor? I take T4 as well, but don't feel human without the T3. I will speak to my GP this week to see if he has any suggestions.

Indigokiwi1 profile image
Indigokiwi1

My GP ended up prescribing me a special prescription of unlicensed 5mcg T3 tablets, after ringing all the local pharmacies. As a parting message, she said that they dont even know how much active ingredients are in the unlicensed versions... Something is better than nothing i guess.

Gold pharmacy online does 20mcg at £17 for a months supply... If pharmacies charge a tenner per tablet, then the gold pharmacy version is probably not authentic.

I wonder what we have all really been ingesting instead of T3!!!

Good news!

Mercury pharma confirmed today (31.05.2013) that their liothyronine tablets are already back in stock. Pharmacies can order Mercury liothyronine tables from either of 2 wholesalers: AAH and Alliance Healthcare. All pharmacies have an account with Alliance Healthcare (a proportion also use AAH). As a result, your pharmacy should be able to obtain Mercury liothyronine tablets very soon, if they haven't already.

Just to clarify a few points which have been raised...

1. The shortage of liothyronine in the UK was not caused by exporting, or quotas. Given that the UK version of liothyronine is unusually expensive, foreign pharmaceutical wholesalers would not wish to purchase UK stock. Exporting occurs only when UK branded medicines are substantially less expensive than the same brand in other EU countries. The current wholesale price of Mercury liothyronine tablets is high (net price, £52.46 per pack of 28). As far as I know, the shortage was caused by a delay in obtaining the active ingredient, resulting in a delay in tablet production.

2. Mercury pharma are able to charge a high price for their liothyronine tablets because no other manufacturer currently sells this drug in the UK; there is therefore no price competition to keep the price low. Bear in mind, however, that Mercury are not preventing other companies from launching their own liothyronine (this product is not patent protected). The Department of Health are not able to force any other manufacturers to obtain a license and start producing this product. As a result, other competing manufacturers may or may not start to sell liothyronine in the UK over the coming years. This is not something that the NHS can control.

Because liothyronine is naturally present in the body (and blood), it is difficult for companies to demonstrate that their tablets are equivalent to the reference brand (which is performed by measuring blood levels after a tablet has been taken). This may be the reason for the absence of other suppliers. Another reason could be difficulties in sourcing the active ingredient.

3. There is no reason to think that Mercury would deliberately create a shortage of liothyronine, as was suggested above, this would simply reduce sales. Due to the fact that they are the UK's sole supplier, they *already* have control over the price (which they have increased dramatically over the last few years).

4. Mercury pharma have an unusually large number of out-of-stock situations. This is by no means unique to liothyronine - far from it. I have seldom known a company to have so many out-of-stocks. It is therefore rather unfortunate in my opinion that the sole supplier of this important medicine happens to be Mercury!

5. Unlicensed liothyronine products imported from the EU are licensed products in the country where they are normally sold. There is no reason to doubt the quality of these imports, they are regulated medicines in the country of origin, it's just that they are not regulated by the UK authorities. They will contain exactly the dose of liothyronine specified on the label eg. 20mcg. The issue is that there are other ingredients in the tablets apart from the active drug. These ingredients may be slightly different between Mercury liothyronine and the European versions. This could result in a very slight difference in the amount of liothyronine which is actually absorbed from the tablet (ie. the bioavailability may be different). This is only a potential problem. I do not think it is likely to be a problem in the majority of patients. Fortunately, few patients will now need to use the imports, unless the UK product becomes unavailable once again, which is quite possible.

I hope that this information is useful.

Oh, and just to clarify one more point. If a doctor prescribes a product which is only available as an unlicensed medicine in the UK (eg. liothyronine 5mcg tabs), they do not need to mention the unlicensed nature of the product on the prescription. For example, they could simply write...

Liothyronine 5mcg tabs, Take XXX daily, 56 tabs.

On the other hand, for products which are normally available as a licensed product in the UK (eg. liothyronine 20mcg tabs), the pharmacist will/should not order an unlicensed import unless the doctor has requested it on the prescription (which they may need to do if the UK product is temporarily unavailable).

In order to permit the pharmacist to dispense the unlicensed version, and to ensure that the pharmacy can claim for correct payment, the doctor needs to write....

Liothyronine 20mcg tabs (to be dispensed as an unlicensed import) - or words to that effect. 56 tabs, or whatever quantity is required.

edwardsk72 profile image
edwardsk72

My pharmacy had the lio back in stock on 31st May for me. According to him he says it is caused by them changing their name, and the legalities, as he had lots of their products out of stock.

>According to him he says it is caused by them changing their name, and the legalities, as he had lots of their products out of stock.

This company always has a lot of out of stocks! They have several at the moment. The issue with liothyronine was apparently due to a delay in obtaining the active ingredient for the tablets.

Quasarlis profile image
Quasarlis

Are we allowed to post links here? I know where we can get Cytomel T3 25mcg tablets from ... delivered to your door!!

RedApple profile image
RedAppleAdministrator in reply toQuasarlis

Quasarlis, Absoluetly do not post links for this on this forum. Please read the forum's posting guidelines, in particular this one

24. Do not post advertisements, links or information of any sort whatsoever, on where or how to obtain UK prescription only medications without prescription. This includes online pharmacies who issue 'prescriptions' on the basis of the completion of a simple health questionnaire.

healthunlocked.com/thyroidu...

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