Timing of meds & vitamins

[Patience_1]

Hello fellow sufferers. I have been very slow to fall in to the possible implication of info (gained on this forum, naturally!) that pred affects the impact of calcium and so should be taken separately.

I do take my calcium (with Vit D) separately, but I'm now wondering about the timing of taking Vitamin K2. I take this to help the calcium to distribute effectively, but have usually taken it at breakfast with my pred, together with magnesium and ginger supplements, so that all I have to remember later is the calcium itself. Should I group my Vit K2 together with the calcium? Do any of you have any knowledge about this? Any thoughts would be appreciated.

[DorsetLady PMRGCAuk volunteer]

Hi,

I take Vit C - have done for years long before steroids came along, always in morning. But once I started Pred I took it same time as VitD/Calcium i.e before lunch time ish!. In fact I still do take both at that time although off Pred.

Not sure that there is any need to take Vit K at different time than Pred, sure others more knowledgeable will advise idc.

I decided that it might be a good idea to let the Pred "do it's thing" without any possible interactions! But that's just me!

[Patience_1 in reply to DorsetLady]

Thanks DL. I think if the general view turns out to be to shift the VitK2, I'll probably end up isolating the pred as you have done and group all the others - I want the simplest life possible!

[DorsetLady PMRGCAuk volunteer in reply to Patience_1]

Yep - totally agree, and as you're taking one tablet at a different time, then adding another is no problem.

[jinasc in reply to DorsetLady]

Hi, you wrote

I decided that it might be a good idea to let the Pred "do it's thing" without any possible interactions! But that's just me!

Nope, I am another one, I reasoned that I would not add anything I did not actually need, until I ran into a problem, when I did run into problems, I checked everything I was given with Lola, who sadly has left her position to start a family and they would not contemplate part-time. However Lola's replacement is equally as friendly.

So I made a friend of my Pharmacists and twice she saved my when my GP prescribed something that was not compatible............not his fault, he is a GP and not a Pharmacist.

So two Vikings with the same................

[jinasc]

In the booklet 'Living with PMR & GCA' there are pages of Tips and Tricks.

This one I have taken the time to re-produce:

The Rule:

Early am: prednisolone (with food)

Mid-am 1st ppi (on an empty stomach before food)

Lunch time 1st Calichew (with food).

This rule was checked out by a Lead Pharmacist working in a large hospital and in charge

and a Microbiologist who posts on here as PMRpro.

Now I cannot re-produce word for word the 3 Golden rules or the rest of the five pages: but here is the 1st:

Pharmacists are trained for 6 years and then 1 year working under another Pharmacist, before they are let loose on the public. They no more about drugs than any other medic and that includes your GP. So you check every new drug you are prescribed or maybe buying OTC for for compatibility.

The booklet is worth purchasing.

[DorsetLady PMRGCAuk volunteer in reply to jinasc]

Very good advice! As you say Pharmacists are the experts, and have always found them to be very helpful

[Patience_1 in reply to jinasc]

Many thanks jinasc, that's good advice.

[Insight329]

Unfortunately, not all pharmacists are cut from the same cloth. After asking here about suggestions on taking my meds (thank you so much for your responses!), I followed the wonderful advice of checking with a pharmacist if I still had questions. I called one of the US's largest pharmacies (where I purchase all of my meds) and asked for an appointment to consult with a pharmacist. They called me back with a date/time. When I got there, the pharmacist acted like he knew nothing about the appointment but took it anyway. He printed out my med list, emptied my bag that held each bottle of the vitamins that I take, and said, "Now why are you here?" I told him I had recently started on quite a few new medicines and I needed help on when to take them, which I shouldn't take together, etc. He quickly looked them over and replied that he didn't see anything that would be problematic taking together. I replied, "I was told not to take my calcium with the Prednisone." He laughed and said "Where'd you hear that -- the Internet?" When I replied yes, he just rolled his eyes and said he didn't know of any reason they couldn't be taken together. I asked him about taking aspirin with Prednisone. His reply was 'no problem'. I mentioned the warning of possible stomach bleeds and his response was that I was more apt to have a stroke than a stomach bleed. I replied that that might be true for the masses, but that years ago I had to have multiple blood infusions followed by surgery due to an ulcer of the esophagus/stomach. His response was still no problem as low dose aspirin. I thanked him for his time and left.

[Patience_1 in reply to Insight329]

Oh dear, sounds like a really unhelpful experience! I suppose it's a case of try it and see - and then take your pick of whose advice to follow. It really is a minefield, isn't it - and all we are trying to do is self-help and optimise the effectiveness of what we do. I guess in the absence of definite info that it's helpful to take other meds together with pred, the safest course is to separate it off.

[PMRpro Ambassador in reply to Insight329]

Mind you - a company pharmacist and the guy in the pharmacy on the corner have different world views...

[Patience_1 in reply to PMRpro]

Of course this is the problem of seeking advice! Today I have taken my pred on its own (with food), and the rest at a different time (again with food). So far, I've lived to tell the tale!

[PMRpro Ambassador in reply to Patience_1]

You get the lot in a tub in hospital - and even when something is supposedly time-critical they rarely get it right...

[sondya in reply to Insight329]

Hope you've never gone back. As you say, some spin any yarn which could be dangerous!