The Generics are Coming, The Generics are Coming!!!

First, if you are on Synthroid or Levoxyl, and you get a generic, you may find that you absorb or process it somewhat differently. If you are stabilized on a brand name levothyroxine, but want to try a lower-cost generic, or don't have a choice and must switch to a generic at the direction of your insurance or HMO, be sure to discuss it with your doctor. If you do switch, monitor your symptoms carefully (Note: the "Hypothyroidism Symptoms Checklist in my book Living Well With Hypothyroidism is a good way to monitor symptom changes and severity.) Plan to have your thyroid levels rechecked about six weeks after the switch, to ensure that you are not having fluctuations in key thyroid blood levels.

Second, the key challenge with generics, and a valid complaint by doctors, is that when you have a prescription for generic levothyroxine, every time you get a refill, you may get a levothyroxine made by a different company. This means that every time you get a refill, you may have a product that has slightly different potency, which could have an impact on your TSH levels. This is particularly a concern for thyroid cancer survivors, who require careful dosing in order to suppress TSH as a way to prevent cancer recurrence. One way to minimize this fluctuation is to get a supply that will last for some time. Consider getting your doctor to write you a prescription for a six-month supply, for example. But when you get this prescription filled, make sure you get a fresh batch, one that will not expire unti long after you will have used up the six-months' worth of drugs.

Third, if you and your doctor determine that you should not try a generic, or if you have tried a generic and determined that you prefer a brand name, be sure to have your physician write your prescription along with the special designation "DAW" or "dispense as written" along with "no generic substitution." This way you have a better chance of having your insurance company or HMO fill the brand name prescription as written, without attempting to substitute the lower-cost generic.