Steroids and Medications

[Linny3]

Hi All

I have been reading 'Coping with Prednisone' by Eugenia Zukerman and there was interesting info about steroids and medications.

"Some meds can bind steroid doses in your intestines so that the steroids are not well absorbed. For example, antacids such as Tums can decrease steroid availability, probably by physical absorption (binding) of the steroid to the antacid. Thus antacid doses should be taken separately from the steroid doses.. Oral contraceptive may increase steroid effect. Review all supplements and medication with dr." Seems to be a good idea to go over all meds to see how they mix with whatever else you are taking.

It is a very informative book, I would recommend it to all on prednisone, for any reason not just pmr.

[Hidden]

Hi Linny

You’ll find many threads on this forum particularly on Calcium & taking it later in the day, away from your Pred.

If you are taking many Meds try to keep to the same Pharmacy & have a chat with the Pharmacist to Review all your Meds especially if you have something new added!

Taking our Meds correctly is actually more important that just taking them!

Best Wishes

Mrs N

[ClarkB in reply to Hidden]

I have just taken my calcium alongside my prednisone and blood pressure tablets. Didn’t realise that calcium needed to be taken at a different time. I have to take it twice a day. I do take Lansoprazole earlier-still not sure about that one. I must admit I miss some of the threads, and so was unaware of it. One thing I’ve wondered about with dosage is if one’s weight plays a part? I am 7stone 11. Wonder if it makes a difference if people are heavier.

[Hidden in reply to ClarkB]

Hi Clark

Yes Calicuum can affect the absorption of the Pred so l always take mine in the afternoon & early evening.

I think it was DL who said Pred for Breakfast, Calcium for Lunch & Dinner or it might have been PMRPro?

I’ve often wondered about the Pred/Weight relationship, l know in Children that Pred is given according to child’s weight (1mg per Kilo of Body Weight) l know this because one of my sons was asthmatic & had severe food allergies, he actually still does & is 35years old!

PMRPro will know more about this aspect.

Just remember Pred in the morning, Calcium at Lunch & Dinner.

Mrs N x

[PMRpro Ambassador in reply to Hidden]

In an Italian study some years ago they established that 75% of patients with PMR would respond well to 12.5mg within a month. The small dainty ladies responded faster than larger heavier gentlemen. Obviously most doctors haven't read it when they insist that after 2 days you should be "cured" - only if the dose is high enough, otherwise it will take longer.

So size matters - but less than you would think. They used to work out dose on the basis of skin area which doesn't vary that much. For GCA they say x mg/kg body weight up to a limit - i.e. very large people don't get more than a medium sized person (sorry, can't remember the exact figures).

[ClarkB in reply to Hidden]

Thankyou for that! Will remember now!

As for weight/dosage, it’s probably better for me, in that it may be more effective since I seemed to be put on a fast track reduction initially. (Still can’t think in kilos, more like bushels and pecks, and feet and inches!)

[Mike1964 in reply to ClarkB]

Lol, I must try that. I weigh 6 bushels and 4 pecks sure sounds kinder than the sad truth in Kilos. And as we all know, self deception is everything!

[ClarkB in reply to Mike1964]

I actually move about on the scales to make them go up and me seem heavier!

[Mike1964 in reply to ClarkB]

Ouch, that wasn't nice ClarkB, I think nothing less than you taking 2 bushes and 1 peck from me should result in you being removed from this forum! "I'm quite happy to post it!"

[ClarkB in reply to Mike1964]

😳 🍕🍔🍰🍧🍟 should do the trick!

[gtate1914]

I just ordered it on eBay! Thanks for suggestion.

[SheffieldJane]

Thanks for posting!

[FRnina]

does anybody know HOW MUCH calcium inhibits prednisone uptake? In the leaflet instructions I have for prednisone there's no mention of taking/not taking calcium at the same time. Also, if breakfast (when I take my prednisone: at present 7mg) includes calcium (goat milk, almond milk but only a little) would that have an effect on the pred uptake?

[PMRpro Ambassador in reply to FRnina]

Dietary calcium is not thought to have any real effect although I'm not sure about the calcium in almond milk as that is effectively just a solution of a calcium supplement.

It doesn't really make much difference for us with supplements either since we titrate the dose of pred and all that is likely to happen is you might need a bit higher dose.

[FRnina in reply to PMRpro]

Thanks so much for that bit of reassurance PMRpro.

[HeronNS]

I don't know why we aren't all told to avoid taking calcium at the same time as pred given that nearly all of us are advised to take calcium when we start pred to avoid bone thinning. The bone thinning effect is worst at the beginning of pred use, so I was quite ticked when it was three months, the three months I was between 15 and 10 mg, before I discovered this important little fact. I double checked the info sheet which came with my first prescription and it says nothing about calcium.

[piglette in reply to HeronNS]

The fact I should not take pred and calcium together was actually typed on my box of pred from the pharmacist.

[HeronNS in reply to piglette]

My only message was to take with food!

[Joaclp]

I liked this book, Linny, when i read it years ago. Still look at it from time to time. Think she is especially good on mood changes.