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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.
The only official branded version of levothyroxine is Eltroxin. 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
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.
The electronic Medicines Compendium (eMC)
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/
UK - Synthetic Levothyroxine (T4) Replacements
currently available with an NHS or private prescription are:
Teva (www.tevauk.com)
Teva UK Limited - Head Office
Ridings Point , Whistler Drive, Castleford WF10 5HX
Tel: +44 (0) 1977 628500
Information below taken from PIL dated August 2010
Marketing Authorisation Holder and Company Responsible for Manufacture:
Teva UK Limited, Eastbourne, BN22 9AGLevothyroxine 50mcg and 100 mcg tablets
Ingredients:
Levothyroxine Sodium
Lactose Monohydrate, Dextrin, Maize Starch, Magnesium StearateTeva 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.
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 tabletsClick here to:
Download the MHRA Press Release in PDF formatClick here to:
Download the MHRA Questions and Answers document about Teva 100mcg
Wockhardt (http://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 9UFLevothyroxine 25mcg tablets
Ingredients:
Levothyroxine Sodium
Lactose, Sucrose (fine powder), Maize Starch, Magnesium Stearate
Actavis (http://www.actavis.co.uk)
Information below taken from PIL dated August 2007
Marketing Authorisation Holder and Manufacturer:
Actavis, Barnstaple, EX32 8NSLevothyroxine 50mcg and 100mcg tablets
Ingredients:
Anhydrous Levothyroxine Sodium
Lactose, Magnesium Stearate, Maize Starch, Stearic Acid, Pregelatinised Maize Starch
*Eltroxin (http://www.goldshieldgroup.com)
12-16 Addiscombe Roa,d Croydon, Surrey CR0 0XT
Tel: 020-8649 8500
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 (http://www.goldshieldgroup.com)
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
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 the manufacturers 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'.
Almus (http://www.almus.co.uk)
Almus Medical Information Line
Telephone: 0800 917 7983
Email: medinfo@almus.co.ukAlmus 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/5mlPlease note that Almus is simply the name of the supplier of generic medications.
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.
CP Pharmaceuticals Ltd.
Information below taken from PIL dated March 2005
Marketing Authorisation Holder and Manufacturer:
CP Pharmaceuticals Ltd, Ash Road North, Wrexham LL13 9UF, UK.Levothyroxine 25mcg tablets
Ingredients:
Levothyroxine Sodium
Lactose, Sucrose (fine powder), Maize Starch, Magnesium Stearate.
Evotrox Oral Solution (Lactose Free)
Marketing Authorisation Holder and Manufacturer:
Kappin Ltd, Cunard Road, Park Royal, London NW10 6PN
Phone: 020 8961 851125 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
Glycerol, Citric Acid Monohydrate, Sodium Methyl Parahydroxybenzoate (E219), Purified Water
UK - Synthetic (T3) Replacements
Liothyronine / Triiodothyronine
currently available with an NHS or private prescription are:
Goldshield (http://www.goldshieldgroup.com)
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
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 prescribe the natural desiccated thyroid products.
However, if you're allergic to pork, a synthetic combination product may be worth investigating.(see below)
UK – Desiccated Thyroid
(also known as Natural Desiccated Thyroid or NDT)
There are no UK manufacturers of desiccated thyroid hormone replacement.
These 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
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.
Thyroid®
http://thyroid.erfa.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
NP Thyroid
http://www.AcellaPharma.com (website does not have any specificinformation about their products)
This is a generic (i.e. non-branded) desiccated thyroid product.
Active Ingredients:
38mcg levothyroxine (T4) and 9mcg liothyronine (T3) per one grain (6mg)
Other Ingredients:
Calcium Stearate, Dextrose Monohydrate, Maltodextrin, Mineral oil
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 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.
Non-UK Synthetic T4 + T3 combination
Thyrolar (Forest Pharmaceuticals)
http://www.thyrolar.com
Information below sourced from Patient Information Leaflet dated 04/2005
Active Ingredients:
Synthetic T3 plus Synthetic T4 in a ratio of 1:4 (i.e. one part T3 to four parts T4)
Other Ingredients:
Calcium Phosphate, Colloidal Silicon Dioxide, Corn Starch, Lactose, Magnesium Stearate.
Thyrolar tablets also contain various dyes used to signify dose strength.
* Non-UK Manufactured Prescription Thyoid Medications may be obtainable on prescription in the UK through the 'Named Patient Basis'.
Article last updated: 27/02/2012
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| Page last uploaded
Tuesday, April 24, 2012
Website by Anna Laurie © Content copyright Thyroid UK |
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Thyroid UK - Registered as a Company limited by guarantee in England & Wales No. 6254073. Registered office: 32 Darcy Road, St Osyth, Clacton on Sea, Essex, CO16 8QF Registered Charity Number: 1125270 |
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