Shortage of 1mg enteric coated Prednisolone?

[podo]

I've had a suspicion for some time that 1mg tablets of enteric coated prenisolone were about to become unavailable. My supplies come from Alliance and for at least the past year all boxes have had the same end date of November 2020 suggesting that a large batch was produced at some time. My pharmacist seems to be having problems getting them at the moment. Does anyone else have this problem? Are there alternative manufacturers? This is avery important consideration for anyone tapering at low doses and doubly so for those who have had medication-caused gastric ulcers.

[SnazzyD]

I’ve had trouble as long ago as 2 years, they do seem do have fits and starts and mine have always come from Alliance. My pharmacy said they don’t come from anyone else in the UK.

[SheffieldJane]

I noticed the same use by date on my latest supply. I haven’t been told that there is a problem looming but that’s not unusual.

[Rose54]

Hi

I have no problems here, got 12 Packs of ones before Bank Holiday from Co-Pharma expires 07/2024

[PMRpro Ambassador in reply to Rose54]

Enteric coated?

[Rose54 in reply to PMRpro]

No sorry nor enteric ones

Not with it this week spent Monday night in A and E after having Palpations all day.

Hopefully due to very low Potassium levels and nothing else

[PMRpro Ambassador in reply to Rose54]

Did they work out why the potassium was low?

[Rose54 in reply to PMRpro]

Indapamide tablets so have had to stop taking them

Last year after HA I was dangerously low and 10 years ago after Gall Bladder Surgery .

At least the taste of the Potassium tablet drink has improved .

[PMRpro Ambassador in reply to Rose54]

Hadn't they been checking electrolytes? With you being on pred, thiazides can lead to potassium depletion. It is one of the interactions they warn about.

[Rose54 in reply to PMRpro]

Last time I had blood test was February which was my Yearly review

How often should I asked for them to be checked ?

My Potassium level was 2.9 on Monday, ECG and Tropine levels all ok .

Thanks for info

[PMRpro Ambassador in reply to Rose54]

Once that is sorted and they have changed your medication - to a potassium-sparing diuretic or other BP meds - it should be OK. But the number of doctors who use thiazide diuretics for patients on pred is worrying. Every couple of months for electrolytes would be OK probably - as long as they see the potassium is stable. If it falls, then they need to do it more often.

[Rose54 in reply to PMRpro]

Thank you

At least my PMR is behaving

So something is going right

[Ansteynomad]

Mine's not enteric coated, but I've not had a problem getting it. It's badged as Wockhardt.

[Jan_Noack]

What does Rayos cost, if you pay privately. I have finally found a website , supposedly in Canada that has Rayos. it says 2mg delayed release is $260 for 100 tablets? canprescserv.com/low-cost/r... I have never ordered from here before so I do not know if genuine or not.

They state they get it from a UK pharmacy so there must be product available..or they maybe have no stock themselves,and just expect the UK pharamxy to have it in stock.

They are also selling prednsione .no name brand for an almost $90? It is listed under Rayos, but it does say plain prednsione, and I do not think no name Rayos or Lodatra is available as yet. I can get plain old prednisone for about $5.60 to $10 AUD which is about equal to CAD...so I'm a tad suspicious of the site

[PMRpro Ambassador in reply to Jan_Noack]

Rayos/Lodotra are NOT enteric coated - the coating delays the release of the core plain pred by about 4 hours but it is no different from the plain tablets otherwise and is intended to be released in the stomach. Crack the coating and a red tablet of prednisone appears.

It is also prednisone - and the enteric coated/gastro resistant pred available in the UK only is prednisolone.

The cost of a month's supply of Rayos/Lodotra depends on the dose you need. 30 tablets of whatever dose, 1, 2 or 5mg, costs the same, about £25 in the UK. So if you need 4 tablets to make up your dose (13mg as 2x5, 1x2 and 1x1 for example) that is £100, 3 tablets as in 9mg, cost £75.

[Highlandtiger]

Mine (1mg enteric coated - Alliance) have all had the same expiry date (November 2020) since I started getting them in 2018! I have the same fear as you that they may become unavailable soon. I'm about to request a new prescription so will let you know how I get on. I don't think any other manufacturers produce them in the UK.

[PMRpro Ambassador]

1mg enteric coated pred has been discontinued - you will see the notice at the top of this data sheet:

medicines.org.uk/emc/produc...

It has only been available since August 2016 and was tried to see if it was worth it. Since most doctors and many pharmacists are totally unaware it exists, they don't prescribe it until someone who knows about it demands it. So the demand has been small - not least because 1mg is relatively very expensive compared to 2.5mg - and it simply won't have been financially viable. It costs the same to make any dose - the cost is in the process, not the active substance.

[Highlandtiger in reply to PMRpro]

Oh dear. That's disappointing but not unexpected then.

[podo in reply to PMRpro]

At the moment I'm on 3mg so hopefully will get down to 2.5mg before my 1mgs run out. Assuming the 2.5 mg will continue to be available.

[MrsNails]

We’ve had this issue before & it maybe worth asking at Independent Pharmacy’s and/or even The Big Boys - l’d just phone & ask to speak to the Pharmacist, save your legs.

[piglette]

I got some yesterday, still Nov 2020. Looks like they did one big batch, possibly as a trial.

[Roy46]

I've confirmed with Alliance that the manufacture of 1mg coated pills has been discontinued, hence the end November use by date on all pills. At 7mg (5+2x1) I've enough coated pills to last me throughout most of November. Then what? Do I move up to 7.5 (5+2.5) but that's defeatist. Or do I take the coated 5mg plus 2x1 non coated and lansoprazole? I'll probably go for the latter, unfortunately.

Any chance that PMR/GCA could make representations to Alliance?

[piglette in reply to Roy46]

I thought that might be the case. I would just take 5mg plus 2x1mg you will have problems if you used 2.5mg where would you got from there when you wanted to reduce? 5mg?!!

[Roy46 in reply to piglette]

Agree. Over the past 6 years I once reached 6mg for a short spell. I suspect my aim for Zero will be in vain. At 74 I have to be realistic.

[piglette in reply to Roy46]

One day I am sure you will make it. My sister's godmother had it for eight years and it went into remission when she was in her 70s, she is now in her 90s.

[Constance13 in reply to piglette]

"went into remission" - what wonderful words!😂 I've had it for 8 1/2 years - in pain every day - no sign of remission.😏