Generic Prednisolone

[PMRandRA]

In the year that I have been on Pred, I have been coming off it the Doctors way and started yo yoing, then I started the slow method from this site, and had successfully reached 13mg a day and feeling goodish. My next prescription heralded a different generic manufacturer and came in a gaudy pink box. After a week taking the new tabs, I was feeling pain again and I believe that the new pills were not working. Amazingly, both the Rheumy nurse and the Pharmacist agreed that this can happen. So back to 15mg a day and a re start!

Has anyone else experienced this kind of generic incorrectness? I wish NHS would stick to 1 kind instead of going for the cheap an nasty makes.

[kingharold11]

I totally agree they keep altering my blood pressure medication to a different generic sort. I have been on the same one for years with no problems but now I feel like throwing the lot in the bin and requesting the previous sort

[PMRpro Ambassador]

When I was in the UK I was on enteric coated pred, red 5mg, brown 2.5mg. They came in a small box, in blister packs, and I had no bother at all. When I moved to Italy part-time I continued to stock up on a few months pred each time I was home and all was well until one day I was handed two tubs, one of a couple of hundred 5mg, and a similar number of 2.5mg tablets. I still had a month or so of the old stock so I was here when I took the new ones. I was on a multiple of 5mg at the time and within days I was flaring. I tried taking the same dose of 2.5mg tablets and was fine - but of course they weren't going to last long. I rang the pharmacy from here - no, no-one else had complained and they'd never heard of such a thing.

I had to switch to Medrol, methyl prednisolone, which is all you can get here. It is supposed to more effective but it didn't work well for me and slowly I was increasing the dose and still feeling worse. Eventually I was up to 20mg and unless I took them at night had no daytime relief before mid afternoon. I had horrendous Cushingoid side effects (lovely dark beard included).

I was switched to the only form of prednisone you can get here - Lodotra, taken at night to avoid morning stiffness. I went straight from 20mg that didn't do a lot to 15mg - with the typical pred miracle - and have reduced steadily since to below 5mg. It is still under patent (a delayed release coating) so there are no generic versions. I'm guaranteed the same stuff every time. At the price I'd hope so.

My point is that not only are different generics a problem, so are different forms of steroid. If you are someone who doesn't respond well to one you may need a much higher dose of pred - and we know who gets most scared about that!

Doctors I have told about this looked surprised. I wasn't in the least surprised to find such differences. I'm not even sure some of the tablets are real - there is so much counterfeit stuff floating around and the NHS rule of taking the cheapest supplier puts it at risk of ending up with duff stuff. It might be worth making a note of the versions you are fine with - and shopping around.

[PMRandRA in reply to PMRpro]

I knew I wasn't barmy! despite those looks from Doc, Rheumy and Pharmacist! Pharmacist sorted it out, now trying to get back to so called normal. Thank you, times a zillion!

[linda49]

I haven't experienced any problems with different generic steroids, but certainly have with generic blood pressure medication. I regularly take Candesartan which, for me, has always been white uncoated pills. Then I collected my repeat prescription which contained pink uncoated pills. Didn't seem to make any difference to the control of my blood pressure but I did develop a nasty skin rash with sores on my lower arms. I didn't connect the two events at the time and my next repeat prescriptions returned to white pills for several months. When the pink pills appeared once more, so did the sores on my arms! Discussed it with pharmacist who said that pharmaceutical companies are allowed to add colourants to generic preparations and some people are sensitive to them. He has now put a marker on my records to ensure I only get the white one prescribed.

[HeronNS]

This week our public network (CBC) is airing an expose of supplements. Apparently MANY of the supplements do not contain what they claim to. I know this is not nearly as critical as prescription medications, but you'd think if they claim that something has a certain amount of Vitamin C, or protein, or omega3 they could actually manage to make sure that nutrient is in the product. Now I look at the products I'm relying on to help rebuild my bones and my blood and wonder.... We do not have public pharmacare here (Canada) yet, but many health plans do cover drugs and unless you get your doctor to say otherwise you will be given the generic if one is available. This has proven a fairly serious issue for my husband who needs something specific for glaucoma.