Derbyshire Medicines Management and Clinical Policies
MHRA May 2021- Generic prescribing of levothyroxine remains appropriate for the majority of patients, and the licensing of these generic products is supported by bioequivalence testing.
If a patient reports symptoms after changing their levothyroxine product, consider testing thyroid function. If a patient is persistently symptomatic after switching levothyroxine products, whether they are biochemically euthyroid or have evidence of abnormal thyroid function, consider consistently prescribing a specific levothyroxine product known to be well tolerated by the patient.
If symptoms or poor control of thyroid function persist despite adhering to a specific product, consider prescribing levothyroxine in an oral solution formulation. Note levothyroxine oral solution is very expensive.
DNP: Intravenous/intramuscular formulation for myxoedema coma and hypothyroidism in patients where oral therapy is not feasible. Await clinician request. (Decision date - March 2023)
