Just wanted to pass on some information to levoxyl users. I recently had my prescrip refilled and the tablets looked sort of different (my meds are .137 and a peanut shaped blue tablet.) They looked thicker and chalkier - the ones I used for years were a bit thinner and a harder tablet. Anyway I called the pharmacist and she informed me that they weren't bad but they are being manufactured by another company. The new ones seemed like they had gotten wet or something - gave me pause anyway. I was informed that they are just fine and exactly the same formula just in case anyone else has been wondering.
Levoxyl HAS changed. this is from the FAQ on their website:
Q. Is the new formulation of Levoxyl safe, because it feels, looks or tastes different?
A. Levoxyl (levothyroxine sodium tablets, USP) in the Accudose tablet is a new, advanced formulation of Levoxyl that has been manufactured according to the new stabilized formulation approved by the FDA. The new Levoxyl formulation is FDA approved as safe and effective. In addition, the new Levoxyl formulation is now proven to release at 100% of label claim. That means, for example, that when a patient is prescribed 100 micrograms of Levoxyl, the patient is actually taking a tablet formulated to deliver 100 micrograms.
This advanced formulation of Levoxyl is now lactose free. The lactose and pregelatinized starch have been removed and replaced with microcrystalline cellulose and croscarmellose, which causes the Accudose tablet to dissolve rapidly in the mouth. This rapid dispersion may make Levoxyl tablets easier for patients to swallow. In addition, the Accudose tablet is essentially tasteless, which may enhance its palatability to patients. As with many medications, it is recommended that the new Levoxyl formulation be taken with water.
The new, advanced Levoxyl formulation in the Accudose tablet also has some slight physical changes from the previous formulation. For example, a minor change in the tablet thickness may cause the appearance of the color to vary slightly from the colors in the previous Levoxyl formulation. However, the color and dosage combinations for all 12 dosages of the new Levoxyl formulation have not changed. The new Levoxyl formulation still comes in 12 color-coded dosage strengths for broad dosing flexibility, and it retains the unique thyroid gland-like shape, which helps patients quickly distinguish Levoxyl from their other medications.
Finally, it is important to note that all these physical changes do not affect the safety or efficacy of the new, advanced Levoxyl formulation in the Accudose tablet. In fact, it has been judged by the FDA to be safe and effective, and it is currently the number one prescribed FDA-approved brand of levothyroxine sodium.
Thank you Tree Frog and Lori. Thanks Meep for the very informative post. I'm just wondering if some of us might require a dosage adjustment since we may be absorbing the medication better. I know my body is ultra sensitive and I noticed changes when I switched to taking my Levoxyl on an empty stomach vs after breakfast. I felt a little on the hyper side for quite awhile by taking my medication on an empty stomach but that has ironed itself out now. What do you think; shouldn't we be very mindful of this new information? Might be worth watching the situation anyway. I feel sort of lost since my endo of 30 years just recently passed away. I have the task ahead of me of finding a new physician.
Also could you share the address of Levoxyl's website? I am not 100% sure that I got accurate information from my pharmacist because it doesn't sound like a new company - just a new formulation. I'd like to clear this up. Thanx<p>[This message has been edited by blondegal (edited 11-24-2001).]
I am leary of posting a link to a commercial website due to board rules, but if you add ".com" to the end of the name, you'll get there.
It may require a slight dosage adjustment for some and no change whatsoever for others. Just be aware that it is different and be prepared to adjust if necessary. A new set of labs 6-8 weeks into taking the new formula would be a wise investment.
The older version that you are used to is NOT the FDA approved version, the new one is, which is why they are changing it over.
I am sorry to hear about your Endo. Good luck finding a new doctor. I know that is a tough thing to do in some places.<p>[This message has been edited by Meep (edited 11-24-2001).]
Thanks Meep, I did indeed get there. The information is extremely useful to me as a Levoxyl user. I will get re-tested as the manufacturer recommends in about 6 to 8 weeks. There is definitely a shortage of specialists in my area. We have a total of about 5 or 6 glandular specialists here and they are loaded to the max with patients. I hope to find a good one and with this new development with my meds it will have to be sooner rather than later. (PS - ignorance is bliss. I thought my Levoxyl medication was FDA approved. A bit of a shock that it wasn't, I must say.) Best regards to everyone.
Look at the "Information Archive". I posted a list of questions to ask a potential doctor and the desired answers that most of us would liek to hear. It is a great tool to use to get on track and know what to expect (or what not to expect) from a new doctor. Here's the link: <A HREF="http://www.healthboards.com/ubb/Forum118/HTML/000005.html" TARGET=_blank>http://www.healthboards.com/ubb/Forum118/HTML/000005.html</A>
I repeat, this board has been so, so helpful to me. Today I got a list of 3 specialists in my area who might be able to take me as a new patient since my long time endo has passed away. I'm used to very good care so I'm going to be very selective. Thanks Meep for the pointing me to the list of issues to consider with a new physician. Also, I cannot believe my pharmacist is not giving accurate information on the changes in formulation with Levoxyl. I have been able to discern more on this board than from discussing my concerns with said pharmacist. I have only been on the new formulation of Levoxyl for a little over a week so it is too early to tell if I'll have to have a dosage adjustment but at least I know to look for that possibility and get it checked. So far, I can only say that I have been feeling slightly better. I've been a hypo patient long enough to know that it's much too early to tell what the big picture will ultimately be.
Thanks again, you all are worth a million dollars!!!
An update for anyone on Levoxyl. I've been on the new and improved, FDA approved Levoxyl for about 3 weeks now. At first, I felt like the new and improved ME with the typical kick I get on a new dosage (for about a week) and then started feeling "different." What that means is irritated, red, gritty eyes; hot puffy skin; feeling of fullness after meals, and restlessness at night. In addition I've lost about 6 pounds and don't want to be losing. My pulse is running about 72 and my hands are cool like they ALWAYS are. It seems like I might be getting better absorbtion from the new formula and now feel over Rx'd. Should I wait about six weeks before I'm re-tested, or is that not long enough? I'm still without an endo since mine has passed away so I feel a little lost. I think we only have 5 or 6 specialists in my area and not one of them is able to take me so far. I picked up my chart from my previous endo to take to a new one once I find one. My T3 runs about 34 or 35 as I observed from my lab reports and I've never taken anything but T4. Does that sound about right; does anyone know? On the board many hypo patients talk about taking T3 in addition to T4. Do they just have different requirements than I? I know I'm showing my ignorance here but I appreciate your help.<p>[This message has been edited by blondegal (edited 12-05-2001).]
Hi Blondegal. T4 naturally breaks down to T3 (and then to T2 and T1) as it's metabolised by the body. But some people don't convert their T4 to T3 very well, so they take a combination of the two as an extra boost.
The synthetic meds are only available as T4 (synthroid, levoxyl, unithroid, levothyroxine) or T3 (cytomel). "Natural" thyroid supplements (Armour) are derived from animals instead of in laboratories, so they are "total gland" supplements and include all components of thyroid hormone (T4, T3, T2, and T1).
There is not a lot of published knowledge about how the T2 and T1 work in our bodies, so doctors tend to focus on only T4 since, theoretically, it should break down to all the other components. But what occurs in the lab is often quite different than real life (as many hypo patients now on Armour can attest).
As far as your symptoms, well, many of us react to a new dose the way you've described (hyper at first, then a combination of symptoms, and then hypo). With me (on T4 - synthroid), it zigs and zags for about 6 weeks until my body finds a happy medium.
I'd advise keeping track of your symptoms (write the dates and the symptoms down), so that when you find a doctor you can present the changes to him/her.
I don't remember where you're located, but there may be some referrals to Endos in your area from the AACE.com board or you can ask your other doctors (OB/Gyn or Internist)...
Thanks ArtfulD, your post is very insightful and useful to me. I have decided to give it a full six weeks before I'm re-tested to give my body a chance to settle. It has been my experience that there is almost no such thing as immediate gratification when treating hypothyroidism. I like your idea of writing down my symptoms since I have a new doctor. I found a new doctor today who is not too busy to take me. I'm from New Mexico and I do know that he has been practicing for many, many years (at least 20.)
You know, one thing that I found very interesting from looking at my chart which I now have in my posssession, is that my doctor has almost solely gone by my symptoms and not my labs. In the thirty years I've been treated for hypothyroidism (after my initial diagnosis) there is not one time that my labs revealed anything out of the normal ranges and yet my doc has adjusted my dosage quite a few times because I reported to him I wasn't feeling well. So symptoms did weigh heavy in evaluating at least for my doctor.
I have been so pleased with Levoxyl so I hope I can stay on it. I have been relatively symptom-free in the 5 years I've been on it. Now with this new formula, the end result remains to be seen. Thanx for your help in the meantime.