Thyroid Hormone Replacements

Click on the purple bars to see information for each type of thyroid medication

UK Manufactured
Prescription Thyroid Medications

UK - Synthetic Levothyroxine (T4) Tablets

 

UK - Synthetic Levothyroxine (T4) Tablets
currently available with an NHS or private prescription are:

Wockhardt (www.wockhardt.co.uk)

Information below taken from PIL dated April 2008

Marketing Authorisation Holder:
Wockhardt Ltd, Ash Road North, Wrexham LL13 9UF
Manufacturer:
CP Pharmaceuticals, Ash Road North, Wrexham LL13 9UF

Levothyroxine 25mcg tablets
Ingredients:
Levothyroxine Sodium
Lactose, Sucrose (fine powder), Maize Starch, Magnesium Stearate

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Actavis (www.actavis.co.uk)

Information below taken from PIL dated March 2011

Marketing Authorisation Holder and Manufacturer:
Actavis, Barnstaple, EX32 8NS

Levothyroxine 50mcg and 100mcg tablets
Ingredients:
Anhydrous Levothyroxine Sodium
Lactose, Magnesium Stearate, Maize Starch, Stearic Acid, Pregelatinised Maize Starch

The PIL (Patient Information Leaflet) for Activis Levothyroxine 50micrograms and 100micrograms tablets can be viewed online here:
http://xpil.medicines.org.uk/ViewPil.aspx?DocID=18104

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*Eltroxin www.mercurypharma.com
(The Marketing Authorisation Holder of this levothyroxine product changed their name from Goldshield to Mercury Pharma in early 2012)

12-16 Addiscombe Roa,d Croydon, Surrey CR0 0XT
Tel: 020-8649 8500
email: info@mercurypharma.com

Information below taken from PIL dated August 2006

Marketing Authorisation Holder:
Goldshield Pharmaceuticals Ltd., NLA Tower, 12-16 Addiscombe Road, Croydon, Surrey, CR0 0XT, UK.
Manufacturer: Custom Pharmaceuticals Ltd., Tecore House, Conway Street, Hove, East Sussex, BN3 3LW, UK.

Levothyroxine 25mcg, 50mcg and 100 mcg tablets
Ingredients:
Levothyroxine Sodium
Sodium Citrate, Lactose, Maize Starch, Acacia Powder, Magnesium Stearate, Purified Water

*Goldshield www.mercurypharma.com
(The Marketing Authorisation Holder of this levothyroxine product changed their name from Goldshield to Mercury Pharma in early 2012)

12-16 Addiscombe Roa,d Croydon, Surrey CR0 0XT
Tel: 020-8649 8500

This is the same company that distributes Eltroxin, but they also distribute a 25mcg levothyroxine tablet under their own name of Goldshield.
The ingredients are the same as their Eltroxin branded tablets.

*Forley Generics www.mercurypharma.com
(The Marketing Authorisation Holder of this levothyroxine product changed their name from Forley Generics to Mercury Pharma in early 2012)

12-16 Addiscombe Roa,d Croydon, Surrey CR0 0XT
Tel: 020-8649 8500

Information below taken from PIL dated April 2004

Marketing Authorisation Holder:
Forley Generics Ltd., NLA Tower, 12-16 Addiscombe Road, Croydon, Surrey, CR0 0XT, UK.
Manufacturer: Custom Pharmaceuticals Ltd., Conway Street, Hove, East Sussex, BN3 3LW, UK.

Levothyroxine 50mcg and 100 mcg tablets
Ingredients:
Levothyroxine Sodium
Sodium Citrate, Lactose, Maize Starch, Acacia Powder, Magnesium Stearate, Purified Water

*NB
It has been confirmed by Mercury Pharma (formerly Goldshield), that all tablets in boxes marked either Eltroxin, Goldshield or Forley are in fact exactly the same product.
This means that if you are one of the people who have found they feel better when taking the Eltroxin tablets, you should not notice any difference at all if your pharmacy supplies you with a box marked 'Goldshield' or a box marked 'Forley' instead of the box marked 'Eltroxin'.

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Almus (www.almus.co.uk)

Almus Medical Information Line
Telephone: 0800 917 7983
Email: medinfo@almus.co.uk

Almus distribute generic levothyroxine, (Almus labelled products are frequently obtained through Boots Pharmacies).
According to their Spring / Summer 2010 (issue 11) product information list, the thyroid medications that they supply are:

Levothyroxine Tablets 100mcg
Levothyroxine Tablets 50mcg

Levothyroxine Oral Solution 25mcg/5ml
Levothyroxine Oral Solution 50mcg/5ml
Levothyroxine Oral Solution 100mcg/5ml

NB
Almus is simply the name of a distributer of generic medications, not a manufacturer.
You need to check the PIL (patient information leaflet) that comes inside the box to find out the details of the actual manufacturer, and the ingredients of the particular medication that you have been given.

 

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Teva (www.tevauk.com)

Teva UK Limited - Head Office
Ridings Point , Whistler Drive, Castleford WF10 5HX

Teva Medical Information Service:
Telephone 0207 540 7117
Email: medinfo@tevauk.com

NB
In September 2012, Thyroid UK obtained confirmation from Teva UK Ltd. that they are no longer producing their own levothyroxine in any doses.

Teva are however, distributing all doses (25mcg, 50mcg, 100mcg) of Mercury Pharma levothyroxine products instead.
So, if your pharmacist gives you levothyroxine tablets in Teva packaging, details on the PIL (Patient Information Leaflet) inside the box should confirm that the tablets are manufactured by Mercury Pharma.

Imortant Update about Teva 100mcg Levothyroxine 16/02/2012

MHRA Press release Date: Thursday 16 February 2012
MHRA suspends licence for Teva levothyroxine 100 microgram tablets

Click here to:
Download the MHRA Press Release in PDF format

Click here to:
Download the MHRA Questions and Answers document about Teva 100mcg

 

The information below is for reference only as it refers to products previously , but no longer manufactered by Teva. Details taken from PIL dated August 2010

Marketing Authorisation Holder and Company Responsible for Manufacture:
Teva UK Limited, Eastbourne, BN22 9AG

Levothyroxine 50mcg and 100 mcg tablets
Ingredients:
Levothyroxine Sodium
Lactose Monohydrate, Dextrin, Maize Starch, Magnesium Stearate

Teva also distribute 25mcg tablets under the Teva packaging name, but these are actually manufactured by Custom Pharmaceuticals under the marketing authorisation of Goldshield Pharmaceuticals Ltd.
The ingredients in these 25mcg tablets as stated on the PIL are: Anhydrous Levothyroxine Sodium, Sodium Citrate, Lactose, Maize Starch, Acacia Powder, Magnesium Stearate.

 

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UK - Liquid Synthetic Levothyroxine (T4)

 

Teva Oral Solution

Product launched 19/02/2013

Marketing Authorisation Holder: Teva UK Limited, Eastbourne, BN22 9AG, UK
Telephone: 01977 628500
www.tevauk.com

Manufacturer

Farmar Netherlands BV, 5531 AD Bladel, The Netherlands

Ingredients:

Each 5ml of oral solution contains Levothyroxine equivalent to Levothyroxine Sodium Anhydrous 25 micrograms, 50micrograms or 100 micrograms

Other Ingredients:
Glycerol
Citric acid, Monohydrate
Sodium Methyl Parahydroxybenzoate (E219)
Sodium Hydroxide
Purified Water

Information taken from PIL with a revision date of 05/2012, which can be downloaded from here: www.tevauk.com/mediafile/id/6008.pdf

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Eltroxin® Oral Solution (Lactose Free)

Marketing Authorisation Holder: Mercury Pharmaceuticals Ltd.,

No. 1 Croydon, 12 - 16 Addiscombe Road, Croydon, Surrey, CR0 0XT, UK
Telephone: +44 (0)208 588 9100
Fax: +44 (0)208 686 0807
www.mercurypharma.com
Medical Information Direct Line: 08700 70 30 33
Medical Information e-mail: medicalinformation@mercurypharma.com
Customer Care direct line: +44 (0)208 588 9273

Manufacturer
FAMAR NETHERLANDS BV, Bladel Production Site, Industrieweg 1, 5531 AD BLADEL, The Netherlands

Ingredients:

For the 25mcg dose: Each 5ml of oral solution contains 25microgramsLevothyroxine Sodium

For the 50mcg dose: Each 5ml of oral solution contains 50micrograms Levothyroxine Sodium

Other Ingredients:
Glycerol
Citric acid, Monohydrate
Sodium Methyl Parahydroxybenzoate (E219)
Sodium Hydroxide
Purified Water

NB: It is advised that patients switching from the oral solution to the tablet form or from the tablet form to the oral solution should be monitored closely.

Information taken from Patient Information Leaflet (PIL) with a revision date of March 2012 which can be downloaded from here:
www.medicines.org.uk/EMC/pdfviewer.aspx?isAttachment=true&documentid=26953

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Evotrox Oral Solution (Lactose Free)

NB.
As of September 2012, Kappin Ltd confirmed that all strengths of Evotrox Oral solution have been completely withdrawn from the market.

The information below is for reference only as it refers to products previously , but no longer manufactered by Kappin Ltd.

Marketing Authorisation Holder and Manufacturer:
Kappin Ltd, Cunard Road, Park Royal, London NW10 6PN
Phone: 020 8961 8511

25 micrograms/5ml Oral solution, 50 micrograms/5ml Oral solution 100mcg/5ml Oral Solution

Ingredients:

Each 5ml contains either 25mcg or 50mcg or 100mcg Levothyroxine Sodium
Other Ingredients:
Glycerol, Citric Acid Monohydrate, Sodium Methyl Parahydroxybenzoate (E219), Purified Water

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UK - Synthetic (T3) Liothyronine / Triiodothyronine Replacements

UK - Synthetic (T3) Replacements
Liothyronine / Triiodothyronine
currently available with an NHS or private prescription are:

 

Goldshield / Mercury Pharma - Liothyronine Sodium BP 20micrograms Tablets

(The Marketing Authorisation Holder of this liothyronine product changed their name from Goldshield to Mercury Pharma in early 2012)

No. 1 Croydon, 12 - 16 Addiscombe Road, Croydon, Surrey, CR0 0XT, UK
Telephone: +44 (0)208 588 9100
Fax: +44 (0)208 686 0807
www.mercurypharma.com
Medical Information Direct Line: 08700 70 30 33
Medical Information e-mail: medicalinformation@mercurypharma.com
Customer Care direct line: +44 (0)208 588 9273

N.B. These are the only synthetic T3 tablets manufactured in the UK

Information below taken from PIL dated November 2006

Marketing Authorisation Holder:
Goldshield Pharmaceuticals. NLA Tower, Croydon, CR0 0XT, UK.
Manufacturer:
Custom Pharmaceuticals Ltd, Conway Street, Hove East Sussex, BN3 3LW.

Liothyronine Sodium 20micrograms Tablets
Ingredients:
Liothyronine Sodium
Lactose, Maize Starch, Powdered Acacia, Sodium Chloride, Magnesium Stearate, Industrial Methylated Spirit, Purified Water

 

UK - Synthetic T4 + T3 Combination Replacements

UK - Synthetic T4 + T3 Combination Replacements

There are no UK versions of this thyroid hormone replacement, and they are not prescribed on the NHS. It may be possible to obtain US or European combination products through a private doctor, although they tend to prefer to prescribe the desiccated thyroid products.

However, if you're allergic to pork, a synthetic combination product may be worth investigating.

 

UK - Desiccated Thyroid (aka NDT)

UK – Desiccated Thyroid
(also known as Natural Desiccated Thyroid or NDT)

There are no UK manufacturers of desiccated thyroid hormone replacement.
Non-UK manufactured desiccated thyroid products (see table below) can however be imported from outside the UK through specific medicines importers, through what is called 'Named Patient Basis'.

Desiccated Thyroid hormone replacements can be obtained with an NHS prescription and by private prescription. However, prescribing is at the discretion of the individual doctor, as these medications are unlicensed in the UK. It is also becoming increasingly common for NHS prescribers to refuse on grounds of cost.

For more information on Named Patient Basis click here

 

Special Order Levothyroxines Obtainable in the UK

European Lactose Free Levothyroxine tablets - Aliud Pharma

Product Name
L-Thyroxin 50mcg (other strengths may be available, ask your pharmacist)

Ingredients (Translated from German PIL)
levothyroxine sodium, microcrystaline cellulose, magnesium stearate (vegetable origin), colloidal silicon dioxide, pre-gelatinised starch (from maize), talcum

License Holder
ALIUD ® PHARMA GmbH, Gottlieb-Daimler-Str. 19, D – 89150, Laichingen

www.aliud.de

Email: info@aliud.de
Telephone: 0 73 33/96 51-0

Notes
Obtainable by pharmacists holding an account with IDIS.
PIL inside the box will be in German

European Lactose Free Levothyroxine tablets - Henning

Product Name
L-Thyroxin 25μg, 50μg, 75μg, 100μg, 125μg, 150μg Tablets

MA Licence Holder
Sanofi-Aventis GmbH, Leonard-Bernstein-Strasse 10, 1220 Vienna Austria
Telephone 01483 505515/2
Website www.sanofi-aventis.de

Ingredients:
Levothyroxin sodium
(Other ingredients not known but definitely lactose free)

Notes
This product is produced by the German branch but the UK company is very helpful.

Compounded Levothyroxine - Martindales

Martindale Compounded Levothyroxine - 25mc, /50mcg, 100mcg

www.martindalepharma.co.uk

Telephone: 0800 137 627
order@martindalepharma.co.uk

Product: Levothyroxine sodium plus one filler  (e.g. calcium carbonate/calcium phosphate) – filler should be discussed with your doctor.

Notes: Doctor must write on the prescription the strength, the quantity and which filler.  Pharmacist must hold an account with Martindale.

 

Non-UK Manufactured
Prescription Thyroid Medications

* Non-UK Manufactured Prescription Thyroid Medications might be obtainable on prescription in the UK through the 'Named Patient Basis'.

* Non-UK - Desiccated Thyroid (aka NDT)

Non-UK - Desiccated Thyroid
(also known as Natural Desiccated Thyroid or NDT)

Note that the following products are all porcine products manufactured using Thyroid USP which is derived from pigs.

 

Naturethroid™ and Westhroid™
http://www.nature-throid.com/
http://wes-throid.com/

Manufactured by RLC Labs in the US http://rlclabs.com/

Information below sourced from Patient Information Leaflet Rev021111/01

Active Ingredients:
38mcg levothyroxine (T4) and 9mcg liothyronine (T3) per one grain (65mg)
Other Ingredients:
Colloidal Silicon Dioxide, Dicalcium Phosphate, Lactose Monohydrate (Present in traceable amount as part of Thyroid USP [diluent]), Magnesium Stearate, Microcrystalline Cellulose, Croscarmellose Sodium, Stearic Acid, Opadry II 85F19316 Clear.

 

NP Thyroid
http://www.npthyroid.com

This is a relative newcomer to the desiccated thyroid products available from the USA.

Active Ingredients:
38mcg levothyroxine (T4) and 9mcg liothyronine (T3) per one grain (60mg)
Other Ingredients:
Calcium Stearate, Dextrose Monohydrate, Maltodextrin, Mineral oil

Prescribing information leaflet (downloadable PDF) here:
www.npthyroid.com/ACE%2015666%20PI.pdf

Thyroid® (Erfa)
http://thyroid.eci2012.net/

Manufactured by Erfa in Europe and distributed across Canada

Active Ingredients:
35mcg levothyroxine (T4) and 8mcg liothyronine (T3) per one grain (60mg)
Other Ingredients:
Cornstarch, Magnesium Stearate, Sugar, Talc

 

Armour® Thyroid
http://www.armourthyroid.com/

Manufactured by Forest Pharmaceuticals in the US http://www.forestpharm.com/

Information below sourced from Patient Information Leaflet dated January 2010

Active Ingredients:
38mcg levothyroxine (T4) and 9mcg liothyronine (T3) per one grain (60mg)
Other Ingredients:
Calcium Stearate, Dextrose, Microcrystalline Cellulose, Sodium Starch Glycolate, Opadry white.

 

* Non-UK - Synthetic (T3) Liothyronine / Triiodothyronine

Non-UK Liothyroine / Triiodothyronine (T3)

Cytomel (King Pharmaceuticals which is now part of Pfizer)
http://www.pfizer.com/products/rx/rx_product_cytomel.jsp

A synthetic T3 which is available from America.
It comes in 5mcg, 25mcg and 50mcg tablets.

The 5mcg tablets are especially helpful for those needing small doses of T3, rather than having to split the 20mcg tablets which are the only size of UK manufactured T3.

Inactive ingredients consist of:
calcium sulfate, gelatin, starch, stearic acid, sucrose and talc.

Paddock (Paddock Laboratories Inc)
http://www.paddocklabs.com

A synthetic T3 which is available from America.
It comes in 5mcg, 25mcg and 50mcg tablets.

The 5mcg tablets are especially helpful for those needing small doses of T3, rather than having to split the 20mcg tablets which are the only size of UK manufactured T3.

Inactive ingredients consist of:
calcium sulfate, microcrystalline cellulose, hypromellose, talc, colloidal silicon dioxide.

 

Generic versus Branded Levothyroxine

Medicines have both a trade or brand name, and a generic name. There can be several trade/brand names for a single medicine if several different companies supply it. For example, the generic name for synthetic T4 medicine is levothyroxine, but it can come with various different trade/brand names on the packaging e.g. Actavis, Teva, Eltroxin etc.

When you are officially diagnosed as hypothyroid by the NHS, you are prescribed levothyroxine. In the UK, hypothyroidism is one of a small number of medical conditions that currently entitles you to receive your medication completely free of charge. (You need to have applied for a Medical Exemption Certificate). In order to keep the cost of supplying this medication to the absolute minimum, it is usual for the prescribing doctor to simply write 'levothyroxine', with the relevant dosage, on the prescription. No 'brand' name will be specified.

This means that your pharmacy must give you the specified quantity and dosage of levothyroxine pills, as written on the prescription, but the pills can come from any manufacturer. So it is entirely possible that the packets of levothyroxine pills that you receive from your pharmacist can have a different name on the box each time your prescription is fulfilled.

The theory of generic medicine prescribing, is that whilst levothyroxine pills are made by a number of different manufacturers at various factories, the end products are all the same. So a 50 mcg pill from one manufacturer will do the same job as a 50 mcg pill from any of the other manufacturers.

However, thyroid patients often find that there is a very distinct difference between the various 'generics'. Everyone is different, and what suits one patient does not necessarily suit another. Also, swapping between the various brands on a regular basis makes some patients very unwell.

There is one official branded version of levothyroxine, which is Eltroxin (manufactured by Mercury Pharma). It is possible for your GP to write this brand name on your prescription, which will ensure that you are only supplied with the Eltroxin branded product. However, not all patients find that Eltroxin suits them.

If you have found that you feel better on tablets with a name other than Eltroxin on the box, you can ask your pharmacist to make sure that you are given levothyroxine from that supplier every time. Most pharmacies will try their best to do this for you if asked, but if necessary, shop around at different pharmacies until you find one that will accomodate your requirements.

NHS information about branded and generic medications can be found here:
http://www.nhs.uk/chq/pages/1003.aspx

 

Where to report medication side effects:

Yellow Card

http://yellowcard.mhra.gov.uk/

The Yellow Card Scheme is vital in helping the Medicines and Healthcare products Regulatory Agency (MHRA) to monitor the safety of the medicines and vaccines that are on the market.

 

Where to find information online about medications:

The electronic Medicines Compendium (eMC)

http://emc.medicines.org.uk/

The eMC provides electronic Summaries of Product Characteristics (SPCs) and Patient Information Leaflets (PILs).

It provides information on thousands of licensed medicines available in the UK.

The eMC is continuously updated with new and revised SPC and PIL information which, after approval by the licensing authorities, is submitted directly by pharmaceutical companies.

British National Formulary (BNF) http://bnf.org/
The BNF provides UK healthcare professionals with authoritative and practical information on the selection and clinical use of medicines in a clear, concise and accessible manner.
Registration (free) is required.

Medicines and Healthcare products Regulatory Agency (MHRA)
http://www.mhra.gov.uk/Patientsandpublic/

 

Information last updated: 23/02/2013