Thyroid Cancer / Nodules & Hyperthyroidism Expert Forum
Generic or Synthroid?
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Questions in the Thyroid forum are answered by Mark Lupo, MD. Topics covered include Goiter, Graves Disease, Hyperthyroid, Parathyroid/Calcium Problems, Thyroid Cancer, Thyroid Nodules/Cysts, Thyroiditis, Thyroid & Pregnancy, Thyroid Stimulating Hormone (TSH), Thyroid Tests, and Thyroid Surgery.

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Generic or Synthroid?

Dear Dr. M.L--I have seen you advise patients to make sure the tablet they take is Synthroid and not a generic. Do you make this recommendation in all cases, or just for certain patients with specific thyroid conditions? I am currently taking levoxyl (Monarch-Jones) after a TT in July for nodules, and my TSH is between 1 and 2.0.  My doctor and surgeon both said there's not a proven advantage to Synthroid. Thank you in advance.
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Levoxyl is another brand -- there is no advantage to Synthroid.  Protecting the brand has advantages over generic regarding consistency of levels.

the generic is levothyroxine
8 Comments
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If you want to use a generic, you just need to make sure it's always made by the same manufacturer.  The "problem" with generics is that your pharmacy can change manufacturers without letting you know.
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Yes, my pharmacy has already done this once. I noticed right away, but there was nothing I could do. The original manufacturer was Sandoz, and they had to stop making the drug due to inconsistencies found by the FDA. The pharmacist assured me that the new generic was identical. Should I have switched to Synthroid?
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Thank you doctor! The names are mighty confusing.
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158939_tn?1274918797
For what it's worth I've been on Synthroid for about 3 years.  One month a few years ago my pharmacy gave me the generic.  Since I didn't want to hassle with paying full price and fighting with the insurance company I just took it.  I could tell the difference within just a few days.  My doctor now has a standing order for name-brand only for my thyroid replacement.  

My sisters have the same problem with generic thyroid replacement.  Perhaps we are just more sensitive to it than most but I can tell the difference (for me taking the generic felt like going completely off Synthroid for RAI treatment).
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Avatar_f_tn
The most attractive advantage to generic is cost savings.  The generics perform as well as brand name.  

The real issue whether using a brand name or generic is if you change manufacturers you must get lab's done at 6 weeks to confirm levels.  Once you are on a particular brand (manufacturer)and have stable labs there should be no issue.

Pharmacies should well understand the importance to not switch a thyroid replacement user to a different brand or manufacturer whether it be Sythroid or a certain brand of generic such as Unithroid, Levoxyl.  The real responsibility falls on the patient to be aware when they pick up their prescription and check it at the counter before paying.  If you are forced to mail order your meds your out of luck.  I personally would never order my thyroid replacement through a mail order program.

To avoid any mix up's I always insist on prescriptions for 100 tablets which I request the pharmacy give me in the original unopened bottle.  It costs me $4.50 more ($38.00 for 100qty) vs. paying the $10 co pay for monthly prescription refills.  I then also have the actual expiration date.   Synthroid on the other hand would cost around $55.00 for a bottle of 100 and $60 in co pay.
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158939_tn?1274918797
I wish that my endo (or someone) would have told me about getting name brand once I've been established on it.  

Being brand new to thyroid replacements, I had no idea.  About five months after my thyroid surgery (cancer) my pharmacy (Walgreen's) just decided - out of the blue - to give me generic one month.  I didn't know better - it's never been a problem with antibiotics or anything else.  It affected me right away.  I finally ended up calling my doctor and he figure out what had happened right away.  He called the pharmacy who said it was my insurance wanting them to put me on a generic.  The doctor left a standing order for only name brand on my thyroid replacement no matter what the insurance company said.

Similar thing happened to my sister around the same time - different pharmacy (local store in her county) and different insurance but she got a generic handed to her and had similar problems.

It would be nice if thyroid problems came with an instruction manual.

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Avatar_n_tn
i have taken both and can tell a difference when taking levothroxine (levothyroxine).  After going throught this a couple of times, my doctor suggested only taking syntroid.  The phamacist insists there is no difference.  He may think that but there is definetely a difference in the way i feel taking it.
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