Is NP Thyroid is generic of Armour Thyroid ?

[RxRetailRx]

I know they are not AB rated so far, but my rxm will switch one to another upon pt’s request...a floater just changed the armour to NP on a hard copy rx without notice MD, ....can we do that w/o prescriber approval ?

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[zelman]

I know they are not AB rated so far, but my rxm will switch one to another upon pt’s request...a floater just changed the armour to NP on a hard copy rx without notice MD, ....can we do that w/o prescriber approval ?

Varies by state.

 

[Sine Cura]

All dessicated thyroid products are unapproved drugs AFAIK (therapeutic equivalence ratings do not apply)

 

[HelpfulPharmer1]

All dessicated thyroid products are unapproved drugs AFAIK (therapeutic equivalence ratings do not apply)

Thank you very much for sharing that. I confirm this knowledge with screen image of Clinical Pharmacology as of 11-2017: I supply 2 images of Armour Thyroid and NP thyroid: They have no code to compare.
In the middle of image, you will see Orange Book TE code: NA which means:
"NA (Not Applicable) - Products that are not reviewed by the FDA such as those marketed before 1938, vitamins, and nutritional supplements."

For me at least, based on facts here, for Desiccated Thyroid, I will dispense any of these names:

• Armour Thyroid
• Bio-Throid
• Nature Thyroid
• Nature-Throid
• NP Thyroid
• Westhroid
• Westhroid-P
• WP Thyroid

 

[WVUPharm2007]

It cracks me up that people still prescribe this stuff. On one hand you have the people that swear that only brand Synthroid will work for them because of the narrow therapeutic index...then on the other hand you have people literally taking ground up and dried pig thyroid like its 1907 with dosage variability that nobody really knows from batch to batch.

 

[RxPreceptor]

But it's more "natural"...(><)

 

[RxRetailRx]

It cracks me up that people still prescribe this stuff. On one hand you have the people that swear that only brand Synthroid will work for them because of the narrow therapeutic index...then on the other hand you have people literally taking ground up and dried pig thyroid like its 1907 with dosage variability that nobody really knows from batch to batch.

Could not agree more!

 

[CinColo]

It cracks me up that people still prescribe this stuff. On one hand you have the people that swear that only brand Synthroid will work for them because of the narrow therapeutic index...then on the other hand you have people literally taking ground up and dried pig thyroid like its 1907 with dosage variability that nobody really knows from batch to batch.

As someone with autoimmune thyroid disease, "this stuff" is awesome, and the only medication that helps many feel normal or somewhat close to normal. It wouldn't have been around for over 100 years if it wasn't beneficial,and it wouldn't be used for over 100 years if the dosing was inconsistent. Ask the people that have been on it over 40 years (like my grandmother was). I've been on it for 5 now and have not had any problem with it, other than Armour changing the formula (which had been done in the past, and was also done by Synthroid at one time). That issue occurred with the greedy lab that changed the formula and increased the price for research. I switched to NatureThroid after Armour changed it. Are they seriously still teaching that lie that NDT is inconsistently dosed? The synthetic stuff works for some but for those that don't covert T4 to T3 sufficiently, the NDT drugs are a lifesafer and return many to a normal life. The scary drug that shouldn't be prescribed is levothyroxine. It's one of the worst thyroid drugs out there. It's inconsistent dosing puts many through hell, and many thyroid doctors will tell you they agree. What needs to be understood is what works well for some patients may not work well for others, and if one medication isn't working, try another. That's a basic understanding any good thyroid doctor knows.

 

[npage148]

Whatever one you pick and order will be the wrong one and the right one is on back order for 6 months or only available in 5000 count bottles. If you suggest a different one or using t-4 (like a modern clincian) you might as well have kicked their puppy. Don't question their naturopath!!

 

[Rouelle]

As someone with autoimmune thyroid disease, "this stuff" is awesome, and the only medication that helps many feel normal or somewhat close to normal. It wouldn't have been around for over 100 years if it wasn't beneficial,and it wouldn't be used for over 100 years if the dosing was inconsistent. Ask the people that have been on it over 40 years (like my grandmother was). I've been on it for 5 now and have not had any problem with it, other than Armour changing the formula (which had been done in the past, and was also done by Synthroid at one time). That issue occurred with the greedy lab that changed the formula and increased the price for research. I switched to NatureThroid after Armour changed it. Are they seriously still teaching that lie that NDT is inconsistently dosed? The synthetic stuff works for some but for those that don't covert T4 to T3 sufficiently, the NDT drugs are a lifesafer and return many to a normal life. The scary drug that shouldn't be prescribed is levothyroxine. It's one of the worst thyroid drugs out there. It's inconsistent dosing puts many through hell, and many thyroid doctors will tell you they agree. What needs to be understood is what works well for some patients may not work well for others, and if one medication isn't working, try another. That's a basic understanding any good thyroid doctor knows.

I see you just joined SDN today, welcome! Two questions just out of curiosity:

1. Are you a pharmacist (or other health care provider)?
2. Did you join today solely to champion dessicated thyroid / bash levothyroxine?

 

[RxPreceptor]

As someone with autoimmune thyroid disease, "this stuff" is awesome, and the only medication that helps many feel normal or somewhat close to normal. It wouldn't have been around for over 100 years if it wasn't beneficial,and it wouldn't be used for over 100 years if the dosing was inconsistent. Ask the people that have been on it over 40 years (like my grandmother was). I've been on it for 5 now and have not had any problem with it, other than Armour changing the formula (which had been done in the past, and was also done by Synthroid at one time). That issue occurred with the greedy lab that changed the formula and increased the price for research. I switched to NatureThroid after Armour changed it. Are they seriously still teaching that lie that NDT is inconsistently dosed? The synthetic stuff works for some but for those that don't covert T4 to T3 sufficiently, the NDT drugs are a lifesafer and return many to a normal life. The scary drug that shouldn't be prescribed is levothyroxine. It's one of the worst thyroid drugs out there. It's inconsistent dosing puts many through hell, and many thyroid doctors will tell you they agree. What needs to be understood is what works well for some patients may not work well for others, and if one medication isn't working, try another. That's a basic understanding any good thyroid doctor knows.

Yep, that's why there is also Liothyronine (T3) which can be used in addition to Levothyroxine (T4) both of which are synthetic & superior in terms of uniformity compared to dessicated thyroid. Saying Levothyroxine is is scary is just plain ignorance; keep in mind Armour thyroid is actually a higher risk medication due to the T3 component and cardiovascular stimulation. Here we go again with the "natural" argument with no defined standards or logic (>< snowflakes...)

 

[CinColo]

Yep, that's why there is also Liothyronine (T3) which can be used in addition to Levothyroxine (T4) both of which are synthetic & superior in terms of uniformity compared to dessicated thyroid. Saying Levothyroxine is is scary is just plain ignorance; keep in mind Armour thyroid is actually a higher risk medication due to the T3 component and cardiovascular stimulation. Here we go again with the "natural" argument with no defined standards or logic (>< snowflakes...)

No, again not superior for everyone. I had palpitations on both Cytomel and liothyronine, never on NDT. Ignorance is your not understanding what people who have the disease have to deal with and that a vast majority will tell you levothyroxine is crap medication. Join a Hashimoto's group, and you'll hear all about it.

 

[CinColo]

I see you just joined SDN today, welcome! Two questions just out of curiosity:

1. Are you a pharmacist (or other health care provider)?
2. Did you join today solely to champion dessicated thyroid / bash levothyroxine?

No, not a pharmacist. However, the fact pharmacists want to disregard actual users of the medication is concerning. No, I did not join to champion NDT. I actually like Synthroid also and consider it a superior T4 medication. It was like night and day going from levothyroxine to Synthroid. However, I and many other users of NDT, will tell you we obviously do better on NDT. There are others that do awesome on Synthroid or Levoxyl and even some that do fine on levothyroxine, but the overwhelming experience I've had with other Hashimoto's patients, is that levothyroxine sucks. Again, the thought you aren't actually considering what your patients go through and deal with on certain medications is what is concerning. A good medical provider is willing to educate themselves beyond what the textbooks teach them, and he/she knows the real value in learning from the patients. Tell me. How do you do on the various thyroid medications? I'm sure you know more than the people that actually use them.

 

[RxPreceptor]

No, again not superior for everyone. I had palpitations on both Cytomel and liothyronine, never on NDT. Ignorance is your not understanding what people who have the disease have to deal with and that a vast majority will tell you levothyroxine is crap medication. Join a Hashimoto's group, and you'll hear all about it.

Yep, that's why I said in "terms of uniformity" (english...)

Whatever you say Mr/Mrs. < 1%. In life, you can't let your emotions & subjective feelings get in the way of objective facts & data

Yes, apparently to be a good RPh I have to take every drug known to humankind & apply my subjective feelings as recommendations for the mass public rather than go by education & evidence based guidelines...(not responding to troll...troll-snowflake that is)

 

[owlegrad]

I like my statins to be in the form of OTC red yeast rice pills and I like my thyroid medications to be almost as unregulated, TYVM.

 

[CinColo]

Whatever you say Mr/Mrs. < 1%. In life, you can't let your emotions & subjective feelings get in the way of objective facts & data

Exactly. Check out how many get off of levothyroxine. However, you can't get a true number when there are so many that prescribe levothyroxine off the bat. There no subjective when your thyroid levels aren't optimal on certain medications. A good thyroid doctor also knows to treat patients based on how they feel, as you know, there are many other areas affected by thyroid disease, not just the thyroid, and as I stated earlier, some patients do better on one medication than another.

 

[CinColo]

I like my statins to be in the form of OTC red yeast rice pills and I like my thyroid medications to be almost as unregulated, TYVM.

Thank the FDA for that. Lol! It was grandfathered in. You still can't say that many don't do well on it. Or if you're just a student now with no real experience, perhaps you can.

 

[CinColo]

Yep, that's why I said in "terms of uniformity" (english...)

Whatever you say Mr/Mrs. < 1%. In life, you can't let your emotions & subjective feelings get in the way of objective facts & data

I've just got to say, thank God you guys aren't the ones prescribing.

 

[CinColo]

Whatever one you pick and order will be the wrong one and the right one is on back order for 6 months or only available in 5000 count bottles. If you suggest a different one or using t-4 (like a modern clincian) you might as well have kicked their puppy. Don't question their naturopath!!

Nope. I don't see a naturopath. I actually see an internal medicine doctor. I've never been out of any thyroid medication due to lack of supply (and I've had Hashimoto's for 20 years). However, the fact that happens is due to lab issues. I would love it if you all had a family member with thyroid disease. You would think differently.

 

[npage148]

I actually like Synthroid also and consider it a superior T4 medication. It was like night and day going from levothyroxine to Synthroid.

*paid for by AbbVie

 

[CinColo]

Yep, that's why I said in "terms of uniformity" (english...)

Whatever you say Mr/Mrs. < 1%. In life, you can't let your emotions & subjective feelings get in the way of objective facts & data

Yes, apparently to be a good RPh I have to take every drug known to humankind & apply my subjective feelings as recommendations for the mass public rather than go by education & evidence based guidelines...(not responding to troll...troll-snowflake that is)

No, but apparently your subjective feelings about a thyroid medication should be applied to the masses. It's your opinion, and not objective when you aren't the one using it. There is objective data to support its use. However, I can't post it.

 

[CinColo]

Yep, that's why there is also Liothyronine (T3) which can be used in addition to Levothyroxine (T4) both of which are synthetic & superior in terms of uniformity compared to dessicated thyroid. Saying Levothyroxine is is scary is just plain ignorance; keep in mind Armour thyroid is actually a higher risk medication due to the T3 component and cardiovascular stimulation. Here we go again with the "natural" argument with no defined standards or logic (>< snowflakes...)

Regarding the higher risk component. Of course. Those that convert T4 to T3 fine really aren't in need of NDT. I'm not saying NDT should be prescribed for everyone, just that it's a successful option for many. The T4/T3 amount in NDT is also standard and well documented (which is 38 mcg T4 and 9 mcg T3). They don't change the T4/T3 combination just for giggles.

 

[CinColo]

Yep, that's why there is also Liothyronine (T3) which can be used in addition to Levothyroxine (T4) both of which are synthetic & superior in terms of uniformity compared to dessicated thyroid. Saying Levothyroxine is is scary is just plain ignorance; keep in mind Armour thyroid is actually a higher risk medication due to the T3 component and cardiovascular stimulation. Here we go again with the "natural" argument with no defined standards or logic (>< snowflakes...)

Sorry. Last post. Since I can't post a link, I'll just post from one study:
SUMMARY OF THE STUDY
This was a study of 70 patients with hypothyroidism who were treated with either desiccated thyroid extract or levothyroxine for 12 weeks followed by a switch to orgthe other option for another 16 weeks. The participants were “blinded” during both phases – they did not know the type of pill they received. After each treatment period patients were weighed, had blood tests, underwent psychometric testing and were asked which therapy they preferred. The researchers report that 49% of the patients preferred desiccated thyroid extract, 19% preferred levothyroxine and 23% had no preference. Desiccated thyroid extract use was also associated with more weight loss. There was no difference in the psychometric testing or in any symptoms. Both types of thyroid hormone were able to normalize the abnormal thyroid blood tests.

WHAT ARE THE IMPLICATIONS OF THIS STUDY?
Although desiccated thyroid extract is not widely used, this study showed that many patients preferred this option as compared with levothyroxine. This result was observed despite there being no differences in thyroid function blood test and psychometric test results, although use of desiccated thyroid extract was associated with some weight loss. These results suggest that there may be a certain number of patients in who desiccated thyroid extract might be a reasonable treatment option. Further research is needed on this topic to confirm which patients this might benefit the most form desiccated thyroid extract therapy. — Angela M. Leung, MD, MSc Clinical Thyroidology for the Public, Vol 6 Issue 8, pg 3

 

[trailerpark]

This thread cracked me up.

 

[Sine Cura]

In reality I just leave it Armour Thyroid especially if it's a transfer and the insurance covers it (best option is to call or let your techs verify they want Armour Thyroid to begin with). Letting your pharmacy management system auto-sub it is asking for trouble as auto-sub should not even apply.

 

[WVUPharm2007]

Sad I had to work last night. Nothing like having some member of the general public stroll by and laymansplain things to me with their nocebo induced, n=1, subjective opinion that isn't based on actual data. Oh well.

 

[BidingMyTime]

Hey, since we are swapping anecdotes, let me say that I think generic levothyroxine rocks. I never wasted 1 extra penny on the brand Synthroid/Levoxyl, why would I when the generic completely cleared up all my hypothyroid symptoms? Plus, my lab levels shows it works, but it's the subjective symptoms that most of us are concerned about.

Cincokacola, I know you won't believe this, but look up what a "double-blind" trial is. You might be surprised to learn that double-blind trials have shown NO difference between AB rated forms of levothyroxine (ie, is doesn't matter if the levothyroxine comes from Abbie or from Mylan.)

But hey, no one denies the placebo effect is strong. If you are happy paying extra money for a placebo effect, so be it (I'm sure there are lots of worse things you can spend your money on.)

 

[lord999]

Hey, since we are swapping anecdotes, let me say that I think generic levothyroxine rocks. I never wasted 1 extra penny on the brand Synthroid/Levoxyl, why would I when the generic completely cleared up all my hypothyroid symptoms? Plus, my lab levels shows it works, but it's the subjective symptoms that most of us are concerned about.

Cincokacola, I know you won't believe this, but look up what a "double-blind" trial is. You might be surprised to learn that double-blind trials have shown NO difference between AB rated forms of levothyroxine (ie, is doesn't matter if the levothyroxine comes from Abbie or from Mylan.)

But hey, no one denies the placebo effect is strong. If you are happy paying extra money for a placebo effect, so be it (I'm sure there are lots of worse things you can spend your money on.)

The thyroids are like vancomycin. Prior to industrial analytical chemistry techniques that were automated in the 90s at the latest, batch testing and automated measurement was not done as thoroughly and there were variations in dosing (kind of like what you see right now with switching brand and biosimilars, the comparison analytic chemistry is not there yet). I won't accept a proposal for mass conversions of thyroid without appropriate testing followup, but it's doable where that wasn't the case 20 years ago. But it was believable in the 1990s to guarantee a dose adjustment when you switched synthetic T3s.

I think today there is still real controversy about the clinical effects of switching biologicals, but for standard SME's on your pharmacy shelf, it should be a fairly straightforward matter to switch with testing followup (and yes, this includes the all-time most sued over drug, warfarin, as "testing followup" means taking the PT/INR correctly for followup). You won't get wild swings unless you use those "natural" products like pig thyroid and racehorse piss (Premarin) which are variable by nature and are activity tested. There's more variation in activity for most drugs based on what you smoke, eat, and drink prior to taking the meds.

 

[CetiAlphaFive]

No, not a pharmacist. However, the fact pharmacists want to disregard actual users of the medication is concerning. No, I did not join to champion NDT. I actually like Synthroid also and consider it a superior T4 medication. It was like night and day going from levothyroxine to Synthroid. However, I and many other users of NDT, will tell you we obviously do better on NDT. There are others that do awesome on Synthroid or Levoxyl and even some that do fine on levothyroxine, but the overwhelming experience I've had with other Hashimoto's patients, is that levothyroxine sucks. Again, the thought you aren't actually considering what your patients go through and deal with on certain medications is what is concerning. A good medical provider is willing to educate themselves beyond what the textbooks teach them, and he/she knows the real value in learning from the patients. Tell me. How do you do on the various thyroid medications? I'm sure you know more than the people that actually use them.

"Learning from patients."

Patients without any professional knowledge are worthless as sources of information.
The ones that quote studies they can't analyze are the worst ones.

If you cannot calculate the NNT, power, or anything else from the study you posted, you shouldn't even have posted it.


People have always convinced themselves that untrue things are absolutely true.

Black cats.
Broken mirrors.
Synthroid.

 

[Rouelle]

I consume steak. That doesn’t mean that I am more knowledgeable about them than my butcher.

 

[CetiAlphaFive]

I consume steak. That doesn’t mean that I am more knowledgeable about them than my butcher.

I've also flown on many kinds of airplanes.

The fact that aerospace engineers and pilots won't accept my advice on aircraft design and flying is unacceptable!

 

[lord999]

"Learning from patients."

Patients without any professional knowledge are worthless as sources of information.
The ones that quote studies they can't analyze are the worst ones.

If you cannot calculate the NNT, power, or anything else from the study you posted, you shouldn't even have posted it.


People have always convinced themselves that untrue things are absolutely true.

Black cats.
Broken mirrors.
Synthroid.

Except I wish TX, AZ, and the DEA learned sooner from patients when it comes to addictive substances. At the start of my career and before, I remember filling #960 Carisoprodol q 2 weeks for patients on a routine basis. It took years for it to be scheduled despite the amount of evidence from the wholesalers that it was being sold at pretty outrageous quantities. Patient experience is definitely a good data point for feelgood stuff better than Wistars. If only BP meds were as pleasurable, a pity that there isn't a Viagra/lisinopril cross. I'd be willing to investigate a combo narcotic/BP combination for Appalachia to get people to take their lisinopril.

 

[genesis09]

People forget where the name Armour came from. The original manufacturer was Armour. Armour is a meat packing company. They wanted to sell everything they could from the livestock. They sold the pig thyroids to make Armour thyroid.

 

[owlegrad]

And a CE I took today reminded me that Armour Thyroid is on the Beers list and that we should be trying to switch elderly people to a levothyroxin product. Good luck with that folks.

 

[katpao2]

It cracks me up that people still prescribe this stuff. On one hand you have the people that swear that only brand Synthroid will work for them because of the narrow therapeutic index...then on the other hand you have people literally taking ground up and dried pig thyroid like its 1907 with dosage variability that nobody really knows from batch to batch.

Perhaps tell that to HRC, who takes Armour, or is she seeing a quack? What cracks me up is the fact that there are supposedly intelligent people in medical school who actually don't question when they are being told, that taking one out of five chemicals produced by a thyroid, will do an adequate job at replacing a thyroid.... like it's 1907. When I take synthroid, my hair comes out in clumps. When I take desiccated thyroid, it grows back. When I take synthroid, I am in a perpetual state of anger. When I take desiccated thyroid, I am not. When I take synthroid, my joints ache. When I take desiccated thyroid, my joints are perfect... with every single dose. Of course, you are likely siting the dosage variability from 1907 when they did actually grind it up, but this is 2018 and the there is no dosage variability from batch to batch. I am not the only thyroid patient who figured this out, and that's why they have to hire people to go online to the forums to debunk us. Oh wait, what's the problem with those little side effects? We have rogaine, prozac, and plenty of pain pills for those joints... right? I got your number. We'll see how long this post stays up...

 

[CetiAlphaFive]

Perhaps tell that to HRC, who takes Armour, or is she seeing a quack? What cracks me up is the fact that there are supposedly intelligent people in medical school who actually don't question when they are being told, that taking one out of five chemicals produced by a thyroid, will do an adequate job at replacing a thyroid.... like it's 1907. When I take synthroid, my hair comes out in clumps. When I take desiccated thyroid, it grows back. When I take synthroid, I am in a perpetual state of anger. When I take desiccated thyroid, I am not. When I take synthroid, my joints ache. When I take desiccated thyroid, my joints are perfect... with every single dose. Of course, you are likely siting the dosage variability from 1907 when they did actually grind it up, but this is 2018 and the there is no dosage variability from batch to batch. I am not the only thyroid patient who figured this out, and that's why they have to hire people to go online to the forums to debunk us. Oh wait, what's the problem with those little side effects? We have rogaine, prozac, and plenty of pain pills for those joints... right? I got your number. We'll see how long this post stays up...

Has your doctor ever prescribed cytomel?

Let me see if I understand your theory:

You think a drug company is paying agents to post online to defend generic levothyroxin AND synthroid, but another drug company that makes Armour is morally correct and OK.

What Abbvie evil and Allergan a moral champion?

I'm genuinely interested

 

[TMP-SMX]

Perhaps tell that to HRC, who takes Armour, or is she seeing a quack? What cracks me up is the fact that there are supposedly intelligent people in medical school who actually don't question when they are being told, that taking one out of five chemicals produced by a thyroid, will do an adequate job at replacing a thyroid.... like it's 1907. When I take synthroid, my hair comes out in clumps. When I take desiccated thyroid, it grows back. When I take synthroid, I am in a perpetual state of anger. When I take desiccated thyroid, I am not. When I take synthroid, my joints ache. When I take desiccated thyroid, my joints are perfect... with every single dose. Of course, you are likely siting the dosage variability from 1907 when they did actually grind it up, but this is 2018 and the there is no dosage variability from batch to batch. I am not the only thyroid patient who figured this out, and that's why they have to hire people to go online to the forums to debunk us. Oh wait, what's the problem with those little side effects? We have rogaine, prozac, and plenty of pain pills for those joints... right? I got your number. We'll see how long this post stays up...

One dose of differing thyroid hormone shouldn't cause clumps of your hair to fall out. Telogen effluvium takes 3 months to occur and shed. But as the others discussed we aren't discounting what you feel is real and perhaps there is something beyond the nocebo and placebo effect, but unless something is studied in a double blind randomized fashion it can't be proven beyond anecdotes. That's what separates professionals from facebook and chain emails of yesteryear.

 

[WVUPharm2007]

Perhaps tell that to HRC, who takes Armour, or is she seeing a quack? What cracks me up is the fact that there are supposedly intelligent people in medical school who actually don't question when they are being told, that taking one out of five chemicals produced by a thyroid, will do an adequate job at replacing a thyroid.... like it's 1907. When I take synthroid, my hair comes out in clumps. When I take desiccated thyroid, it grows back. When I take synthroid, I am in a perpetual state of anger. When I take desiccated thyroid, I am not. When I take synthroid, my joints ache. When I take desiccated thyroid, my joints are perfect... with every single dose. Of course, you are likely siting the dosage variability from 1907 when they did actually grind it up, but this is 2018 and the there is no dosage variability from batch to batch. I am not the only thyroid patient who figured this out, and that's why they have to hire people to go online to the forums to debunk us. Oh wait, what's the problem with those little side effects? We have rogaine, prozac, and plenty of pain pills for those joints... right? I got your number. We'll see how long this post stays up...

I really don't care which hormone replacement you take. They all work well enough and I get paid by the hour.