I've been taking 5mg and 2.5mg gastro-resistant prednisolone tablets because the ordinary ones give me heartburn. As part of stepping down, I've been prescribed 1mg tablets.
I've checked on the eMC ddatabase and find that 1mg gr prednisolone is manufactured by a UK firm, Alliance Pharmaceuticals, under the trade name Deltacortril.
However, after taking the script to 2 different pharmacies ( Boots and Lloyds) both have told me they can't issue it as their suppliers don't supply it.
Has anyone else been able to get hold of it? Or found a way round a similar problem?
Thanks
The prescribing information I found first only lists Deltacortril as in 5mg and 2.5mg tablets and the leaflet was revised in July 2016.
This, about the 1mg tablet
medicines.org.uk/emc/medici...
is from August.
Certainly when I was on it it only came in the 5 and 2.5mg doses and we were told by the company that it was not cost-effective to produce it in a 1mg version (they would cost the same as 5mg). I wouldn't be surprised if the chemists may not be aware of its existence - but I am SO pleased you have posted about this! We in the PMRGCA community have complained about this for years!!!!
That Boots claims they can't supply it doesn't surprise me - but I bet if you pointed out that Alliance is part of their group they might possibly be more helpful! Other patients on the forums have been told by Boots they can't have Drug x because their supplies can only be obtained from Alliance Healthcare and they don't stock it. Also doubtful.
Other than Boots/Lloyds, do you have an independent chemist anywhere? They usually have total freedom to obtain supplies.
And on the PMR/GCA forum I suggest this way of reducing - whatever size tablets you are forced to use. You don't have to take the same dose every day and by alternating 2 doses 2.5mg different you have a difference of not much above 1mg/day. Spread the mix over more days and the dose reduction becomes less obvious to the body. Using this approach
healthunlocked.com/pmrgcauk...
you only have 1 day of the new lower dose at a time and then go back to the old dose to recover for a few days, how many is up to you. I find I feel "different" for the first 3 or 4 times but then my body stops protesting and settles down again. You can slow it down as much as you like.
That's a really helpful reply, PMRpro.
The pharmacists at both took the scripts and said that the information on their ordering screen was ambiguous. Each held onto the script for a couple of days and then rang to say that they had spoken to the suppliers. Neither were able to offer more information than , "The suppliers just say that they can't supply it".
I will try the local independent. Failing that, I may not need the 1mgs after all, thanks to your tapering regime.
Thank you once again x
Do tell me what happens. The lack of an enteric coated version was a pain (literally!). However, a lot of people manage the 1mg tablet when they can't manage a higher dose - and normal practice is to give a PPI to "protect the stomach". You know, add yet another drug to the mix - but don't get me started on that!
It is possible that they don't have stocks - but it does seem strange that the company that makes the stuff can't supply it to the distributor!
We should send Paul off in his "contact the suppliers" suit!
So true!
I have been refused entaric coated prednisolone tablets because of the cost doctor said it no longer existed chemist said they are lying
A few years ago they decided that there was no evidence that enteric coated was any better than plain pred and in some illnesses it is actually less good (gut ones, interferes with the absorption which is lower down the gut than the stomach. It was also considerably more expensive - they claimed 17x, not sure I believe them but no doubt they used the retail not the negotiated price. So enteric coated was to be stopped and a PPI given together with the plain white variety. If people couldn't cope with the plain white then enteric coated was to be approved. Apart from the fact that introduces another layer of tablets (poorer compliance) and side effects they didn't actually understand the arithmetic. Nor the pharmaceutical manufacturers - who immediately increased the price of plain white pred considerably!
The arithmetic (figures supplied by a pharmacist 2 years ago):
30 tabs 5mg enteric coated cost £1.86 plus a single dispensing fee which is IRO £1 (it can be more) Total £2.86
30 tabs 5mg plain white cost £1.31
30 tabs PPI (omeprazole) cost £1.86
plus TWO dispensing fees IRO £2 Total £5+
Your average 7 year old would manage to see that plain white now cost heading for double the enteric coated. No savings!
The GPs had agreed to it - but within weeks patients were appearing with stomach problems - despite (and in some cases because of) the omeprazole. Many said they regretted having agreed now they realised what problems their long term pred patients were having.
And of course - one of the side effects of omeprazole is to reduce the absorption of calcium - leading to osteoporosis when used long term (which it isn't meant to be).
fascinating! thanks.
Thanks for that info I am going to make an appointment with my gp next week to discuss everything I am on omeprazole have been for years and I have osteoporosis and the diarrhoea and stomach problems drive me mad .
You might find using ranitidine/Zantac instead relieves the diarrhoea at least - does the same thing by a different mechanism so different side effects. PPIs are slightly more effective (in the sledgehammer way) but don't work at all for about a third of patients. Zantac plus lots of yoghurt would be as good! And lots of us have managed fine with just yoghurt...
Thanks for your advice I will look into that x
Is there a better drug than omeprazole one that doesnt reduce the absorption of calcium Jan 22
Probably not one that allows complete absorption of calcium as it requires some acid to be present. Ranitidine/Zantac is felt to pose fewer risks and has different side effects.
Lots of us have never used either - yoghurt worked well for many of us. Or we have cast iron stomachs!
Wow thanks for all the information and a great reply ! Very informative 😀