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Re: Armour thyroid problesm

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i use alot of armour their web site says temp delay. lets hope they are correct

in the mean time westhroid has a similar product google them for there info and

conversion .. i guess the dessicated thyroid is made by one manufacturer which

supplies armour and has had some production changes so who knows the final

outcome ..

Armour thyroid problesm

I'm pretty vanilla in my thyroid hormone replacement in that I mostly just

follow tsh and give levothyroxine generic. But I do have a patient on Armour

thyroid along with her levothyroxine who has done well with it.

Now she has notified me there is a problem with Armour thyroid and it will no

longer be sold, and she's worried about her clinical issues.

I'm wondering if anyone on the list knows the low-down on Armour. And, if it is

not going to be available, do you have suggestion about dose transition back to

levothyroxine dosing alone?

Thanks

Tim

Malia, MD

(phone / fax)

www.MaliaFamilyMedicine.com

www.SkinSenseLaser.com

Malia Family Medicine & Skin Sense Laser

6720 Pittsford-Palmyra Rd.

Perinton Square Mall

Fairport, NY 14450

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my understanding is that there is a nationwide shortage.  I recently had a local compounding pharmacy make some desiccated thyroid for someone.  There is also something called Thyrolar which is a synthetic T3/T4 combination agent.  You can relatively easily switch between desiccated and regular T4 (i think is 30 mg of desiccated = 50 mcg of T4).  Patients may complain of being a little sluggish without the T3 burst

 

i use alot of armour their web site says temp delay. lets hope they are correct in the mean time westhroid has a similar product google them for there info and conversion .. i guess the dessicated thyroid is made by one manufacturer which supplies armour and has had some production changes so who knows the final outcome ..

Armour thyroid problesmI'm pretty vanilla in my thyroid hormone replacement in that I mostly just follow tsh and give levothyroxine generic. But I do have a patient on Armour thyroid along with her levothyroxine who has done well with it.

Now she has notified me there is a problem with Armour thyroid and it will no longer be sold, and she's worried about her clinical issues. I'm wondering if anyone on the list knows the low-down on Armour. And, if it is not going to be available, do you have suggestion about dose transition back to levothyroxine dosing alone?

Thanks Tim Malia, MD (phone / fax) www.MaliaFamilyMedicine.com www.SkinSenseLaser.com

Malia Family Medicine & Skin Sense Laser 6720 Pittsford-Palmyra Rd. Perinton Square Mall Fairport, NY 14450 -- Confidentiality Notice -- This email message, including all the attachments, is for the sole use of the intended recipient(s) and contains confidential information. Unauthorized use or disclosure is prohibited. If you are not the intended recipient, you may not use, disclose, copy or disseminate this information. If you are not the intended recipient, please contact the sender immediately by reply email and destroy all copies of the original message, including attachments.

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I ran into this about 4 weeks ago.Locally, the pharmacist says the brand name armour is out but the generic is availableyou could try asking for that?Also there's an approximate conversion formula, ask the pharmacist, they will give it to you.LynnTo: From: gthomson@...Date: Thu, 3 Sep 2009 08:24:16 -0400Subject: Re: Armour thyroid problesm

i use alot of armour their web site says temp delay. lets hope they are correct in the mean time westhroid has a similar product google them for there info and conversion .. i guess the dessicated thyroid is made by one manufacturer which supplies armour and has had some production changes so who knows the final outcome ..

Armour thyroid problesm

I'm pretty vanilla in my thyroid hormone replacement in that I mostly just follow tsh and give levothyroxine generic. But I do have a patient on Armour thyroid along with her levothyroxine who has done well with it.

Now she has notified me there is a problem with Armour thyroid and it will no longer be sold, and she's worried about her clinical issues.

I'm wondering if anyone on the list knows the low-down on Armour. And, if it is not going to be available, do you have suggestion about dose transition back to levothyroxine dosing alone?

Thanks

Tim

Malia, MD

(phone / fax)

www.MaliaFamilyMedicine.com

www.SkinSenseLaser.com

Malia Family Medicine & Skin Sense Laser

6720 Pittsford-Palmyra Rd.

Perinton Square Mall

Fairport, NY 14450

-- Confidentiality Notice --

This email message, including all the attachments, is for the sole use of the intended recipient(s) and contains confidential information. Unauthorized use or disclosure is prohibited. If you are not the intended recipient, you may not use, disclose, copy or disseminate this information. If you are not the intended recipient, please contact the sender immediately by reply email and destroy all copies of the original message, including attachments.

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Here's a company that is supplying natural Thyroid hormone

http://www.nature-throid.com/

 

I'm pretty vanilla in my thyroid hormone replacement in that I mostly just follow tsh and give levothyroxine generic. But I do have a patient on Armour thyroid along with her levothyroxine who has done well with it.

Now she has notified me there is a problem with Armour thyroid and it will no longer be sold, and she's worried about her clinical issues.I'm wondering if anyone on the list knows the low-down on Armour. And, if it is not going to be available, do you have suggestion about dose transition back to levothyroxine dosing alone?

ThanksTim Malia, MD (phone / fax)www.MaliaFamilyMedicine.comwww.SkinSenseLaser.com

Malia Family Medicine & Skin Sense Laser6720 Pittsford-Palmyra Rd.Perinton Square MallFairport, NY 14450-- Confidentiality Notice --This email message, including all the attachments, is for the sole use of the intended recipient(s) and contains confidential information. Unauthorized use or disclosure is prohibited. If you are not the intended recipient, you may not use, disclose, copy or disseminate this information. If you are not the intended recipient, please contact the sender immediately by reply email and destroy all copies of the original message, including attachments.

-- M.D.www.elainemd.comOffice: Go in the directions of your dreams and live the life you've imagined.This email transmission may contain protected and privileged, highly confidential medical, Personal and Health Information (PHI) and/or legal information. The information is intended only for the use of the individual or entity named above.

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From a patient on Armour who works for drugstore.com :

Armour recently reformulated using a cellulose base. The new base (cellulose)

and new equipment to produce it, caused problems with absorbtion and many

complaints along with a challenge from the FDA because this was a " new "

medicine. Not sure if Armour is trying to go back to old formula or not.

Nature-throid is similar but there is a nationwide shortage as well.

What you can do is go to your compounding pharmacy for a T4/T3 combination. 4:1

ratio. Armour has some T1 and T2 so it will not be identical.

Also can use time release compounded T3 along with levothyroxine.

I have worked extensively for the past year in bio-identical hormone

preparation. Problems I see with compunding are usually quality issues: unless

there are strict quality control and testing the compounded formula can be way

off. Tested what was supposed to be 25 mcg T3 and only had 7.5 mcg actual.

Compounding specialty pharmacy in Bellevue corrected this for me and I trust

their formulas. ITC in Denver is also good and will ship to patients.

If anyone wants more info just email me.

Freida Eng,

Seattle

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This site says...

 

http://www.ashp.org/Import/PRACTICEANDPOLICY/PracticeResourceCenters/DrugShortages/GettingStarted/CurrentShortages/Bulletin.aspx?id=459

 

Thyroid Tablets

31 August 2009

Products Affected - Description

Products in Short SupplyThyroid (desiccated) 120 mg tablets, 1000s (NDC 00904-0762-80), Major - discontinuedThyroid (desiccated) 30 mg tablets, 100s (NDC 00904-7865-60), Major

Thyroid (desiccated) 30 mg tablets, 1000s (NDC 00904-7865-80), MajorThyroid (desiccated) 60 mg tablets, 100s (NDC 00904-0761-60), MajorThyroid (desiccated) 60 mg tablets, 1000s (NDC 00904-0761-80), Major

Thyroid (desiccated) 120 mg tablets, 100s (NDC 00904-0762-60), MajorThyroid (desiccated) 180 mg tablets, 100s (NDC 00904-0763-60), MajorArmour Thyroid 15 mg tablets, 100s (NDC 00456-0457-01), Forest

Armour Thyroid 30 mg tablets, 100s (NDC 00456-0458-63), ForestArmour Thyroid 30 mg tablets, unit dose, 100s (NDC 00456-0458-01), ForestArmour Thyroid 30 mg tablets, 1000s (NDC 00456-0458-00), ForestArmour Thyroid 60 mg tablets, 100s (NDC 00456-0459-63), Forest

Armour Thyroid 60 mg tablets, unit dose, 100s (NDC 00456-0459-01), ForestArmour Thyroid 60 mg tablets, 1000s (NDC 00456-0459-00), ForestArmour Thyroid 90 mg tablets, 100s (NDC 00456-0460-01), Forest

Armour Thyroid 120 mg tablets, 100s (NDC 00456-0461-63), ForestArmour Thyroid 120 mg tablets, unit dose,100s (NDC 00456-0461-01), ForestArmour Thyroid 120 mg tablets, 1000s (NDC 00456-0461-00), ForestArmour Thyroid 180 mg tablets, 100s, 00456-0462-01, Forest

Armour Thyroid 180 mg tablets, 1000s, 00456-0462-02, Forest

Nature-Throid NT-1/4 16.25 mg (1/4 grain) tablets, 100s (NDC 64727-3298-01), RLCNature-Throid NT-1/2 32.4 mg (1/2 grain) tablets, 100s (NDC 64727-3299-01), RLCNature-Throid NT-1 64.8 mg (1 grain) tablets, 100s (NDC 64727-3300-01), RLC

Nature-Throid NT-2 129.6 mg (2 grain) tablets, 100s (NDC 64727-3308-01), RLCNature-Throid NT-3 194.4 mg (3 grain) tablets, 100s, 64727-3312-01, RLC

Westhroid 32.5 mg (1/2 grain) tablets, 100s (NDC 64727-7070-01), RLCWesthroid 32.5 mg (1/2 grain) tablets, 1000s (NDC 64727-7070-02), RLCWesthroid 65 mg (1 grain) tablets, 100s (NDC 64727-7073-01), RLC

Westhroid 65 mg (1 grain) tablets, 1000s (NDC 64727-7073-02), RLCWesthroid 130 mg (2 grain) tablets, 100s (NDC 64727-7080-01), RLCWesthroid 130 mg (2 grain) tablets, 1000s (NDC 64727-7080-02), RLC

Discontinued ProductsThyroid (desiccated) capsules (Bio-Tech Pharm) - discontinuedThyroid (desiccated) tablets (Qualitest) - discontinuedThyroid (desiccated) tablets (Time-Cap) - discontinued

Reason for the Shortage

Several thyroid (desiccated) products have been discontinued. The manufacturers would not provide a reason for the discontinuations; however these products are not FDA-approved. Forest states that the shortage of Armour Thyroid is due to a shortage of raw material. Major and RLC will not provide a reason for the shortage.

Estimated Resupply Dates

Thyroid (desiccated) products are not FDA-approved and therefore cannot be AB-rated. Major has all presentations on back order and the company cannot estimate a release date. Forest has available Armour Thyroid 240 mg tablets in 100s (NDC 00456-0463-01) and 300 mg tablets in 100s (NDC 00456-0464-01). All other presentations are on back order and the company cannot estimate a release date. RLC has all presentations of Nature-Throid on back order and the company estimates a release date of early-December, 2009.  RLC also has all presentations of Westhroid on back order and the company estimates a release date of early-December, 2009.

Related Shortages

Liothyronine Tablets— Resolved

Liotrix Tablets

Updated

August 31, 2009; July 31, 2009; July 6, 2009; June 9, 2009; May 26, 2009; April 24, 2009; March 23, 2009; March 11, 2009; February 26, 2009; February 5, 2009; January 16, 2009; December 18, 2008; November 25, 2008; November 4, 2008; October 2, 2008; August 21, 2008, University of Utah, Drug Information Service. Copyright 2009, Drug Information Service, University of Utah, Salt Lake City, UT

Locke, MD

 

From a patient on Armour who works for drugstore.com :Armour recently reformulated using a cellulose base. The new base (cellulose) and new equipment to produce it, caused problems with absorbtion and many complaints along with a challenge from the FDA because this was a " new " medicine. Not sure if Armour is trying to go back to old formula or not.

Nature-throid is similar but there is a nationwide shortage as well.What you can do is go to your compounding pharmacy for a T4/T3 combination. 4:1 ratio. Armour has some T1 and T2 so it will not be identical.

Also can use time release compounded T3 along with levothyroxine. I have worked extensively for the past year in bio-identical hormone preparation. Problems I see with compunding are usually quality issues: unless there are strict quality control and testing the compounded formula can be way off. Tested what was supposed to be 25 mcg T3 and only had 7.5 mcg actual.

Compounding specialty pharmacy in Bellevue corrected this for me and I trust their formulas. ITC in Denver is also good and will ship to patients.If anyone wants more info just email me.Freida Eng,

Seattle

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