Wondering the difference in times of absorbtion for coated v uncoated prednisolone? I have both and was wondering if I took say the uncoated two hours after the coated ones would that be like the same?
Now that I have asked is taking something later the same as taking it earlier I better stay quiet now lest someone sends the lads to take me away!
Uncoated pred is absorbed almost immediately from the stomach so reaches its peak in the blood in about 1 to 2 hours, it rises quickly (like a cliff) and then falls off more slowly taking a few hours to halve in the blood. Coated pred resists the effect of the stomach acid so it passes through and only breaks down in the alkaline environment lower down the gut. Then it is absorbed more slowly. So there is an approximately 3-4 hour delay (depends how much food is in the stomach) before it starts to rise and it rises more slowly to its peak, which may be as long as 5-7 hours after taking the pred and which is usually lower than the peak achieved with plain pred. Then it falls off in a similar way to the plain pred.
It won't be the same but one way of taking it might be taking the coated immediately before bed so it is at a peak in the early morning and then take the plain pred later in the morning or even the day. You can experiment a bit and find out what works best for you.
But even easier would be to ask the GP for 1mg enteric coated pred - it does exist:
medicines.org.uk/emc/produc...
but is relatively new (2016) and even pharmacists aren't aware of it.
Thank you PMRpro, you are so helpful in everything, a wealth of information. I will see can I source the coated 1s.
I take a mixture of both. I have found I can take the coated ones mid evening to stop the pains I used to get in the early hours. I have not been able to get the coated 1Mg for some reason even when I pointed it out to the GP, they have to be specially ordered I think. As I need to cut the occasional 1mg the coated ones wouldn't work.
I find that if I take the uncoated too close to bed time I get some acid reflux hence I take them mid evening with yoghurt or kefir.
Hope this helps.
Yes, thank you so much Scats. Currently I intend next to try a drop from 15mg to 13.5 made up of two coated 5s , one coated 2.5 and an uncoated 1.
If you have 5, 2.5 and 1mg coated pred you never need to cut until you get to 1.5mg!!!
Yes but I'm trying to take as few uncoated as possible, especially as I take them in the evening. At least that's my way of thinking.
I said coated - NO uncoated!!
They won't let me have the coated 1mg too expensive!
cheaper than managing gastric problems... But I know what you mean!!
I haven't needed gastric treatment so far, so perhaps my warped logic works. Said with fingers tightly crossed!
I’ve tried both coated and uncoated but haven’t really noticed any difference. I’m on 2.5 at the moment which is coated, having just reduced from 3 uncoated. By the way the coated isn’t hugely more expensive. It’s a relatively inexpensive drug. Strangely, I don’t get pain in the morning at all but will have a bit of stiffness in the evening although I take my pred at 7.30am. I do wonder whether I actually still have PMR. My recent ESR was within normal limits and CRP just slightly high. Here’s hoping.
Thats interesting. I used to be woken each morning at about 3am with leg pains and decided to try taking the pred before bed so that the coated should be active in time to help with this. This worked for me and was fine at the time. As I reduced I needed to use my uncoated 1mg and I didn't want too much of this as the last thing in my stomach before bed. More than my head could cope with to remember two different times!
I hope you're right and your PMR is in remission
The ESR and CRP SHOULD be in normal limits - if they aren't it is a sign the pred isn't enough to keep the inflammation under control.
Thanks PMRpro My CRP was 5.8 and ESR 13. I thought that CRP could be raised for non PMR reasons such as arthritis or an infection? isn’t 5.8 just above normal ? It was originally 79 before going on Pred.
What does your lab quote for the normal range? That is what matters - in some labs it would be under 1, in others under 10 (or a different figure, they vary). CRP can be raised for other reasons, chest infections for example, but ESR can be raised by a hold range of things.
ESR range is less than 20 and CRP is less than 5. The rheumatologist I went to see (Rod Hughes) said not to pay too much attention to the blood tests as how you feel is what matters.
I’ve had coated because I couldn’t get on with uncoated. What I did find was that a full stomach adversely affected the absorption so made sure I had it two hours before a meal to give it a head start.
Last paragraph! My smile for the day. Thank you. 😀😀
Found it, thank you Harbel. Joyce
mixing coated and uncoated pred
cutting Uncoated 1 mg 
Is there any difference between uncoated and coated prednisolone?
2.5mg enteric coated or 2mg + cutting a half of uncoated? 
Cutting Gastro coated Pred. 
