Thyroid Meds--Is there a debate about the generics?

Question

Sinthroid is given for thyroid problems like hypothyroidism but for years the word was that the (cheaper) generics didn't work exactly the same in the body. They were broken down slightly differently but in a way that could make a big difference to the user. My friend's doc insists on brand name Sinthroid only, not on using generics. Has this ever gotten settled? And if there is a difference, how can the FDA okay the substitution of the generic for sinthroid? Lots of people use the generics. What's the real scoop on this?

Answer 1

Certain thyroid meds are equivalent to others, but not all the generics are equivalent to all the brands, and all the brands aren't equivalent to each other. Thats what makes it so complex.

For example, you have two brands - Synthroid and Unithroid. They may be equivalent to each other, but the respective manufacturers never did any testing to prove it. So, now a generic company wants to make a generic version - they need a brand to compare to - so they pick one. Say they pick Synthroid. They do their studies, and get approval. Now, they are only equivalent to Synthroid. Its not that they aren't equivalent to Unithroid - we just don't know because no testing was ever done. Multiply that by 4 brands, and you can see the complexity.

Another issues is this - to be considered equivalent, the generic has to be within a certain percentage of the brand in terms of blood absorption. Any generic, when tested in the body, could either be exactly the same, above or below the brand. Lets say that generic A tests slightly below the brand, and generic B test slightly above the brand. Both A and B are equivalent to the brand, but would they be equivalent to each other? Maybe, maybe not.

Another thinng to consider is this - every batch of the brand is not the same as every other batch. There are allowed to be manufacturing variations. For example, a batch of Synthroid, 100 mcg, can contain anywhere from 95 - 105 mcg. What if the generic picked one of the lots that was on the low side to compare to, and what if they were slightly lower. They would still be equivalent to that batch, but are they equivalent overall?

These situations aren't unique to thyroid meds. What is unique is this - thyroid medications belong to a very small class of drugs which are known to have a narrow therapeutic range. A very small change in potency could make a large change in efficacy. For most drugs, minor differnces described in the previous paragraphs would have no effect, but for a thyroid med, there could be an effect.

Add this to the fact that you were presumably "titrated" to get your optimum dose. That is, the doctor made an educated guess on how much you needed based on a number of factors - blood test results being a key factor. Then, you went back and were tested, and maybe the dose was tweaked, and you repeated until all your blood levels were acceptable. If you switched toa different brand or generic, you would need ot get tested again, because of the minor differences noted above.

The actual drug works exactly the same, and is absorbed exactly the same. But, there are a lot of other variables to take into consideration. The bottom line is, is the savings worth the hassle of getting retitrated, and then having to make sure you get the same generic each time. But, if you make the decision, rest assured that once you get titrated on the specific generic, you will be getting the proper amount of drug each time.

Answer 2

I know many people on Unithroid (considered a generic) that are doing well on it. Some do better on the thyroid brand name and others do better on the generic. Just whatever med you start on don't switch suddenly, as each med has to be adsjusted by blood work each time you make a change.

I'm on Armour thyroid, which is a brand name, however its a natural med containing T4 and T3 while Synthroid is only T4. I found it works better than T4 alone. I used to be on Levoxyl years ago, but it did nothing for my symptoms.

Answer 3

Salicylic acid is the generic name for aspirin. Many companies put their name on the bottle that sells salicylic acid. Is Bayer's salicylic acid ( 500 mg ) any different from Target's saliclyclic acid ( 500 mg )? All meds have a generic name. This is the name that a medication is at the time of its creation. When Bayer decided that it was going to sell salicylic acid they did not request that the formula be changed to enhance their name. The formula is the same which is why the name is the same. If you pick up a bottle of synthroid, look carefully and you should find the generic name for it as well.

Answer 4

Generics may be absorbed differently in the body and therefore require a different dose. 1 out of 3 of my endocrinologists were against using generic version. If you do use a generic make sure you use the same generic each month.

Here is what I found on American Thyroid Association website.

Synthroid®, Levoxyl®, Levothyroid®, and Unithroid® are the brand-name forms of thyroxine currently marketed in the U.S. In addition, there are several different generic versions of thyroxine on the U.S. market. The U.S. Food and Drug Administration (FDA) considers most of these preparations to be equivalent to each other. Therefore, in most cases your pharmacist is permitted to give you a generic thyroxine product instead of a brand-name product, unless your prescription specifies “no substitutions.”

Most endocrinologists believe that the FDA’s methods for testing the equivalence of thyroxine preparations are seriously flawed.

Thyroid disease often requires lifelong therapy and is best managed with consistent and precise treatment with the same brand of thyroid hormone. Your doctor may change your dose of thyroid hormone, but the brand of your thyroid hormone medication should be constant.

When you go to the pharmacy, do not change the brand of your thyroid medication without checking with your doctor. You should not change from one brand of thyroid medication to another, from your brand of thyroid medication to a generic product, or from one generic product to another without first checking with your doctor.

Answer 5

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Answer 6

the actual spelling is synthroid, i take synthroid. my endocrinologist will not let me take levothroxin. he says that the generic is unreliable. the difference in price to me would be $23.00 per 30 pills to buy generic. not sure if saving money if worth it....or doctors could be cahoots with the pharmaceutical companies!!!!

Answer 7

It doesn't matter what brand you take. What matters is that you get a brand and stick with the same brand. And that you get tested regularly and have your dosage adjusted according to the test.