Need help with pharmacology, please.

[Insight329]

Can someone help me figure out when I should be taking these meds during the day, i.e., breakfast, lunch, dinner? I'm afraid I may be mixing meds that should't be taken together. I'm taking Prednisone, Amlodipine Besylate (blood pressure), Lisinopriil (blood pressure) , Simvastatin (chlorestorol -sp?), fish oil. Low dose aspirin, Vitamin K2, Calcium, Vitamin D3, CuraMed (curcumin). I'm taking my Prednisone and blood presure meds with breakfast and that's working well. I take the Simvastatin at bedtime. Otherwise, I'm clueless on the best times to take the suppliments. Also, has anyone used the product Bone-Up? (Can i ask about a product here?). Thanks for your assistance!

[DorsetLady PMRGCAuk volunteer]

Hi,

I took any vitamins (except for VitD/Calcium which I took lunchtime and before evening meal) same time as Pred & BP tablets with breakfast for 4 plus years no problem. But if you're not sure check with pharmacist.

Can't help with Bone-Up, sorry.

[Insight329 in reply to DorsetLady]

Thank you so much! Pharmacy said I'd need to make an appt with pharmacist and I thought I would check here first as the amount of knowledge you, PMRPro , and others is simply amazing. Thank you so much for taking time to help all of us on our paths through this.

[Celtic PMRGCAuk volunteer]

Hello Insight, the only thing that stands out as needing changing in the timing of your pill-taking, is the calcium supplement. This should be taken a few hours apart from the Prednisone as calcium can reduce the effect of the steroid. As you are taking the Pred with breakfast, then taking the calcium supplement at lunchtime and with evening meal is generally recommended.

[GOOD_GRIEF in reply to Celtic]

Celtic:

Thanks so much for this. I'm on split dose Pred and have been taking the calcium with moring and late night doses for months. No one ever mentioned it would interfere with the steriods. That actually explains a lot, including maybe why I have struggled so much trying to reduce Pred by even .5 mg/day.

[Celtic PMRGCAuk volunteer in reply to GOOD_GRIEF]

Do let us know, if you feel any improvement, Insight - I do hope you will.

[HeronNS in reply to GOOD_GRIEF]

Not only does calcium interfere with prednisone but prednisone interferes with calcium. They are definitely incompatible. But do double check with pharmacist if you are still concerned about other interactions. However there are some good drug interaction checkers on the internet.

[barbthy in reply to HeronNS]

Thanks, I too will change the way I take my calcium

[Insight329 in reply to GOOD_GRIEF]

No one told me that, either, Good_Grief. So important to know, isn't it?

[Baileyw06 in reply to Insight329]

I also didn't know that calcium interfered with prednisone.I am going to change the way I Take it😊

[HeronNS in reply to Insight329]

I didn't know for the first three months I was on pred (my highest dose time of course) until it was mentioned on one of the forums. Changed my habits too! Why it isn't said out loud to us as the prescription is handed over, I don't know. nearly all of us are told to take calcium when we are put on pred. I suppose it's somewhere in the fine print of the document you get with the first prescription.

[Insight329 in reply to Celtic]

Wonderful! As I feared there are some that shouldn't be taken together. Thank you so very much for helping me with this!.

[England05 in reply to Celtic]

I didn't know that about calcium. Thanks

[Sorop in reply to Celtic]

Thank you all for that piece of advice I have been taking calcium and vitamin D at breakfast the same time as my Pred and will now take lunch time and evening meal.

[GOOD_GRIEF]

Will do.

[Hidden]

my pharmacist always my.first port of call. more knowledgeable than a lot of GPS. I have literally watch them ignore drug interaction warnings on computer when they request drugs and they don't even tell you. I try to do my due diligence by reading leaflets in box and all manufacturers sites. I keep one leaflet from eAch drug and change if new version printed...and best of all do what you have done. ask here.

I don't know how long you have been on Amlodipine and if it agrees with you. I was just terrible on it. fatigue and general unwellness and this was long before PMR. After a month I went to Dr and they took me straight off it. I understand it is not tolerated by some people and drs aware of this. If you are fine with it. great!! As others have said pred and calcium support separated and statins night time (some statins can cause muscle probs but other brand can be done.. .been through two.)

As someone said elsewhere on this group ...these are arsenals of drugs many of us take. I am currently down to 17 which like you I have to separate across the day. I rattle and I am sure you do. best wishes

[Insight329 in reply to Hidden]

Started the Amloipine 3 months ago -- just before diagnosed with GCA. It's hard for me to know what's causing what as I started so many drugs all about the same time. Was rx'd fosamax, too, but after reading about the side effects, I'm stopping it. I'll take my chances with being vgilant in taking Vit D3, K2, calcium, and walking. Will have discussion with rheumy next week, but I don't have osteoporosis and those side effects worry me.

[Hidden in reply to Insight329]

I took alendronic acid which no believe is same as fosomax and had excruciating hip and thigh pain. only took it 5 times in 12 months to keep checking. refused to take and ask for bone scan. does your general feeling of fatigue and ...basically I thought I was crashing out with Amlodipine. perhaps discuss with gp then see what they ssay

[Insight329 in reply to Hidden]

I hit submit before I could thank you for responding, the sound advice, and the heads-up! So comforting to know so msny willing to hekp and share their experiences!

[Hidden in reply to Insight329]

yes. it helps you list potential questions for Dr. it also helps when others are struggling with similar issues ....especially the ones that make you feel bonkers! I had a feeling spiders were crawling up and down back but know others have similar. all bonkers together!!

[Hidden in reply to Insight329]

I have just learned to edit using that little box next to like. I often need editing.

[PMRpro Ambassador]

Yup - with that much you need to discuss it with an expert!

[hiandri]

Hi Insight,

I noticed you are taking low dose aspirin which no one has commented on. I have also taken low dose aspirin for many years prior to getting PMR as I believe firmly in the potential benefits of doing so. However, I did read that you should not take aspirin if you are on Pred. so I stopped doing so. If you are taking the aspirin for the same reason I was, you should mention my comment to your doctor or perhaps do some research on this site and Dr Google!

[Insight329 in reply to hiandri]

Thank you, hiandri! My rheumy who is treating for me for the GCA told me to start taking it after I was diagnosed. I'll research and then discuss with him. I may have to refer to a pharmacist on this, also. Thanks so much!

[Hidden in reply to hiandri]

I was put on low dose aspirin in 2001 when diagnosed with diabetes as part of the protocol they used as preventative measure. Also had to take ppi to protect stomach. Told a month or so ago that aspirin no longer on protocol because latest evidence is it has no benefits in terms of preventing associated cardiovascular issues. In similar vein I was put on statins at same time. Latest research is that no benefit for women who have no existing cardio issues and of little benefit if probs exist already. Has preventative benefit for men however especially if already had cardio event. Can't remember reference at moment. Havent decided whether I will stop that yet.

[Insight329 in reply to Hidden]

Gesh, another thing to add to my list to discuss. This forum is so valuable in sharing information! Thank you so much!

[Hidden in reply to Insight329]

Yes. for past few years when I get fed up of pill popping I go in and say I want to come off something. Up to now was told needed it all. In past 6 weeks dropped aspirin and lanzoprasole and may drop pravastatin. I do miss my aspirin in terms of thinking at least I might prevent stroke but if no tangible benefit I can't see point. That said it will undoubtedly come back in fashion. The nature of science is it changes and certain ideas become popular if pharma gets behind it. No such thing as unbiased research I am afraid.

[hiandri in reply to Hidden]

Hi Poopadoop,

Have a read of Ian Wishart's book, 'Show me the money, honey!, bit of an eye opener, especially in regards to statins - I no longer take them! John

[Hidden in reply to hiandri]

Thanks. it'll probably tip me over!

[PMRpro Ambassador in reply to Hidden]

The real line in GCA at least is that the combination of aspirin, even low dose, and pred is associated with more risks than benefits.

[Insight329 in reply to PMRpro]

Gesh! Thank you, PMRPro! I have to say, at this point, my confidence in my Rx is low.