Are there any alternatives to Prednisolone?

[BP135]

Good morning all

I am just wondering if anyone knows of any alternatives to pred I can discuss with my GP? I've never liked them as I struggle to sleep when taking them during a chest infection. However, my mental health has suffered (like most peoples) during the pandemic and I'm finding my negative feeling are really intensified whilst on pred.

I've booked a call with the GP for my day off and I'm trying to book counselling for as soon as possible but I really do think the pred makes me worse.

Thanks in advance for any suggestions! xx

[twinkly29]

Not really for an acute need. If you're needing pred often then they need to ensure that your preventer meds for your asthma are optimised to try to reduce the flares. And making sure vit D levels are good as low vit D levels can make people more susceptible to infections (or the body less prepared to fight them or something...!)

But for acute issues, it's usually a case of managing with side effects as say 5 days of that is generally better than acute severe asthma issues. What do they normally give you, pred-wise?

[BP135 in reply to twinkly29]

Thanks for your reply twinkly29.I recently discovered that I have low antibody levels to Haemaphillius Influenzae which has caused years of infections and now the beginnings of bronchiectasis. I had an adult Hib jab 4 weeks ago and have a blood test booked in 2 weeks time to see if it has managed to raise my levels. If not, I can have a second hib jab and re-test again. If that still doesn't help I may have prophylactic antibiotics.

I've had my inhalers changed a couple of times in recent years and have had montelukast added. I'm under a respiratory consultant at my local hospital.

I have a tapered does starting on 8 tablets a day..I think they are 5mg each. I also take doxycyline for 2 weeks.

That's interesting about vit D. I will check that. I had a blood test last week for b12 levels, I'm not sure what else they checked so will ask the Gp about that too. xx

[twinkly29 in reply to BP135]

Ah sounds like they are doing all the right things for the infections - hopefully the HiB jab will have done its stuff and prophylactic antibiotics usually do help to prevent infections.

I may not have got the correct reasoning with the vit D but I know that one of the symptoms of low levels can be repeated infections. Not meaning the cause of yours as that sounds separate but more that good levels might just help in some positive way!

Hopefully once the infection side of things is in hand, you'll have fewer infections and so not need the pred so much.

I know some people find they struggle with the 40mg a day pred but can tolerate 30mg....but it may be with your other issues the doctors would want you to have the higher dose (although of course they're not the ones dealing with the side effects!)

[Poobah in reply to BP135]

This is an interesting read relating to Haemaphillius Influenzae and asthma and novel treatment with long term Azithromycin, atsjournals.org/doi/full/10...

Azithromycin is only available via your consultant and I suspect they've already tested your sputum to inform re your lung microbial community and so would know if Azithromycin would be a suitable treatment. I have to use it instead of Prednisolone because of my type of asthma. However, it may be that you have eosinophilic asthma so Prednisolone would be more advantageous.

I don't tolerate Prednisolone and the maximum I can take is 25mg a day, the side effects are more tolerable.

If you are going to consider VitD3 as a supplement then there is a very well informed Facebook group "Vitamin D & Co-factors. UK". Their files have all the information that you need to get started, including good products.

[BP135 in reply to Poobah]

Thanks Poobah, that's really helpful. I will take a look. I'm making notes to discuss all these suggestions with the GP tomorrow. xx

[Dogruff]

Hi, I don’t sleep either with pred and it makes me a little too happy. I take promethazine to help me sleep on it and in my days off I take a dose during the day. Keeps me from needing anything hardcore. The bonus with it is that it is also an antihistamine so if there is also an allergy at play it will give a little help to that. Oh.... and it helps with sickness if pred makes you sick too. Worth asking your GP for it when you need to take pred.

I’m on my 4th week of pred now and if it wasn’t for the promethazine there is no way I would be able to function. I missed 3 nights of it and I became increasingly more insomniac despite being exhausted.

[BP135 in reply to Dogruff]

Hi Dogruff. I haven't heard of that one, I will ask the GP about it, thank you for the information. No problems with sickness luckily, but insomnia and mood swings are proving more difficult each time, especially with a full time job and 2 little ones to look after. I don't want to be grumpy, over emotional mum! I know what you mean about being unable to function! I Hope you can catch up on the sleep you missed x

[Hidden]

A steroid inhaler taken every day like fostair..x

[BP135 in reply to Hidden]

Thanks airbags. I was on fostair for a year and then got my inhalers changed again because it didn't seem to be helping unfortunately. x

[Pugdog]

Hi, I take Dexamethasone instead of pred. Much better for me and less side effects. Worth discussing with GP.

[BP135 in reply to Pugdog]

I was wondering if this was an alternative, I'd never heard of it pre-covid but you hear it all the time now. Thank you x

[Pugdog]

Yes my GP not sure why not prescribed more often. Maybe it’s more expensive? Have used ever since diagnosed as like you first couple of courses with pred were horrible with terrible insomnia.