Coated and uncoated

[Lonsdalelass]

Hi, I know someone quite recently posted about having difficulty getting hold of 1mg gastro resistant pred, well today I too have hit a brick wall with this. The upshot is, I'm seeing my gp on Thursday to check I can take a mix of coated and uncoated. I'm sure I can, having read other posts here, but my question is, will I have to go back to taking lansoprazol once I'm back on the uncoated 1mg pills? I'm also on 5mg coated (taking 9mg altogether). I really want to avoid taking the lansoprazol if I can. I currently take my pred each morning with my breakfast, which is usually porridge or egg and wholemeal toast. Will I be OK just to carry on taking both kind of pred this way? Any advice before seeing gp would be appreciated.

[venezia1]

This is a but of a hobby horse of mine, so I apologise if you feel it is inappropriate in any way. Please don't just accept what your GP is saying, see your practice manager and argue the case - many of us can get enteric coated 1mg with no difficulty, so I feel you are being unfairly penalised if you are refused it.

[Lonsdalelass in reply to venezia1]

I think it's a problem with the suppliers. I've telephoned several pharmacies to see if they either have them in stock, or can order them in, but no luck. They all tell me the same thing.

[venezia1 in reply to Lonsdalelass]

Mine are through the Well pharmacy. If you like I could ask them who their suppliers are?

[Lonsdalelass in reply to venezia1]

May be worth a try, although I've tried the Well pharmacy here, and asked if it's Alliance who supplied my last lot. They confirmed it was.

[venezia1 in reply to Lonsdalelass]

Yes, mine are manufactured by Alliance. I'll ask at the pharmacy if they have any other supplier.

[Lonsdalelass in reply to venezia1]

Thanks venezia1, it would be good to know.

[venezia1 in reply to Lonsdalelass]

I went to collect my outstanding prescription of 1mg coated pred. Surprise, surprise - they have not arrived from Alliance, who do manufacture them. My Well pharmacy contacts them every day and feels certain they will have them by next month....!!!

[Lonsdalelass in reply to venezia1]

Yes, I'm not surprised by this. I've had to collect uncoated pred 1mg today. I'll ask again in two weeks to see if they can get any in. Good thing was that my gp said I should see how I get along before prescribing anything for the stomach as I'm currently not having problems. So we'll see. He's signed me off though for two weeks as I've been stressed and depressed, work related.

[SnazzyD]

I’ve got the same problem looming. The pharmacy can’t get 1mg coated for love or money from their suppliers. I’ll have a crack at non-coated but with a hearty breakfast.

[Rose54]

Hi

Thier are quite a few meds that are unavailable in the UK at present

I do wonder what the outcome will be as if you have a life threating condition and are unable to get those Meds what happens ?

[Suet3942 in reply to Rose54]

Very scary seeing as without pred it would be life threatening for us with no adrenaline. Been worrying me for months,

[Rose54 in reply to Suet3942]

Hi

I just spoke to my GP and she gave me loads of 5s and 1s just to be on the save side .

The same with Levothyroxine

[PMRpro Ambassador in reply to Suet3942]

Not half as much as the potential for me being without medical care of any sort!!!!!

[Telian in reply to PMRpro]

Dreadful thought but don’t think it will come to that - just watching the news - PM’s now owning up to possible B delay which might be granted!

[suzy1959]

I mix the 2 types- I am on 11mgs.- and I don't take Lanzoprazole anymore. I do take Ranitidine as and when needed which is less risky. Seems to work OK.

[Lonsdalelass in reply to suzy1959]

Thanks suzy, I hadn't heard of that one before. I know omaprozal is a bit kinder too. I'm hoping I won't be needing either.

[HeronNS in reply to Lonsdalelass]

Ranitidine isn't a PPI so it will not have the same side effects. If it works for you it is a safer medication .

[Lonsdalelass in reply to HeronNS]

Is that a OTC med, or do you need it on prescription?

[PMRpro Ambassador in reply to Lonsdalelass]

It's sold as Zantac but the chemist should have generic ranitidine too.

[YuliK in reply to PMRpro]

Common ranitidine side effects may include:

headache (may be severe);

drowsiness, dizziness;

sleep problems (insomnia);

decreased sex drive, impotence, or difficulty having an orgasm; or.

swollen or tender breasts (in men);

nausea, vomiting, stomach pain; or.

diarrhea, constipation.

Dec 9, 2018

I stopped taking because of the side effects.

Headaches and sleep problems.

[PMRpro Ambassador in reply to YuliK]

All medications have unwanted effects. The effects due to ranitidine and PPIs are different because they work in different ways. The main problem with PPIs is that they are not and never were intended to be used long term and continuously. Care is needed - but when you have been on them for a long time, getting off them is far harder than other options. Some people may need them, some people do not, and IMHO it is irresponsible to hand them out like sweeties "just in case".

[HeronNS in reply to Lonsdalelass]

It used to be prescription in Canada, but no more and drugstore brands readily available. Probably same in UK.

[polymy in reply to Lonsdalelass]

You can buy generic ranitidine in Tesco, Sainsbury, even Home Bargains under the galpharm label.

[Chrob in reply to polymy]

Thanks for this

[Telian in reply to suzy1959]

Does your GP prescribe Ranitidine Suzy?

[suzy1959 in reply to Telian]

yes!

[PMRpro Ambassador]

I could manage up to 4mg plain pred without any problem. And taking the uncoated in the middle of a meal is said to help a lot. The coated take at least 4-5 hours to get into the blood stream, the uncoated only an hour or so. You will have to try it to see if it works OK for you - if not you can split the time a bit to get a higher peak.

[Lonsdalelass in reply to PMRpro]

Thanks PMRpro, I suppose I have no choice but to take a mix, and fingers crossed I won't have any problems with my stomach. If I do I'll have to go back to the gp. He might just tell me I have to go back on the lansoprazol when I see him on Thursday. I hope not.

[PMRpro Ambassador in reply to Lonsdalelass]

I'd try gaviscon first

[Lonsdalelass in reply to PMRpro]

OK, I will. Would I take it before my pred, or only if I get problems?

[PMRpro Ambassador in reply to Lonsdalelass]

Don't know - does anyone else use gaviscon? I'd think only if you have problems

[EdithWales in reply to PMRpro]

Yes I love it. Had to come off the Lansoprazole and the others didn’t touch the sides. I find the liquid best and you can get sachets for travelling.

Like others have said there is a supply problem with the coated 1 MGM’s 🥂🥂

[Telian in reply to PMRpro]

I do

[Telian in reply to Lonsdalelass]

Usually if you get problems - my GP tells me.

[Lonsdalelass in reply to Telian]

Thanks Telian.

[HeronNS in reply to Lonsdalelass]

Is Lansoprazole one of those meds you have to taper because you can get rebound acid production? In that case one of the other kinds of meds like gaviscon or ranitidine would be strongly advised.

nhs.uk/medicines/ranitidine/

And in one of the links on that page:

Some antacids, such as Gaviscon, have an extra ingredient called alginic acid. They work by lining your stomach so that juices from it don't splash up into your foodpipe. They're especially good for relieving acid reflux.

[Lonsdalelass in reply to HeronNS]

Thank you HeronNS, that is a very helpful link and advice. Much appreciated.

[PMRpro Ambassador in reply to HeronNS]

Yes

[joyce69]

When I rang Alliance they were very clear - they have no supply issues. The next company in the chain to the pharmacies, I think Creopharma, couldn't see any stock on their system. They told me they weren't expecting any more stock until the beginning of March when orders from the next people down in the supply chain come in. I decided to wait until then before I pursued it any further as the problem appears to be with the various company's systems rather than manufacture, which was a relief! I'll ring the manufacturer today and ask the question.

[joyce69 in reply to joyce69]

Doh, rang!

[Rugger in reply to joyce69]

You can edit a typo by clicking on 'More' below your reply and choosing 'edit'.

[joyce69 in reply to Rugger]

Thanks Rugger, done.

[Suedeshayes]

Hi, I mix enteric and uncoated with no problems. 1 x 5mg coated and 2 x1mg uncoated. 7 altogether. Sue

[Lonsdalelass in reply to Suedeshayes]

Thanks Sue, and do you take lansoprazol too, or something similar?

[Suedeshayes in reply to Lonsdalelass]

Yes, I take omeprazole and as yet, have had no problems.

[Lonsdalelass in reply to Suedeshayes]

OK thanks. I am acquiring as much info as possible before seeing my gp on Thursday. Don't want a strong PPI if I can help it. So the omaprozal may be better then. Hoping he doesn't prescribe anything if I'm honest.

[maria40]

My pharmacist confirmed yesterday that there is a supply problem with 1mg enteric coated. They are keeping their order in every day and hope it will be resolved soon.

[Floridafan in reply to maria40]

Any updates yet re the 1mg coated tablets? My pharmacist still hasn’t been able to get any

[Lonsdalelass in reply to Floridafan]

No, I've had to take the uncoated ones as I couldn't get the coated, so at the moment I'm taking some coated (5mg) and 4 x 1mg uncoated to make up my 9mg dose. I'm hoping that I can get the coated 5mg ones in a week or so when my current ones run out. I think it may just be the 1mg coated ones that are difficult to get hold of.

[Floridafan in reply to Lonsdalelass]

Thanks for your reply. I too am on 9mg but take a 5mg and a 2 1/2mg (both coated) and a 1 uncoated then split another 1 to make up the other half. It’s a bit of a nuisance but I thought at least it cuts the amount of uncoated tablets down. Hope we can get the 1mg coated ones again soon

[Lonsdalelass in reply to Floridafan]

Thanks for your reply. Why didn't I think of that? I too could take the same dose as you as I have some of the coated 2.5 mgs as well, it's just the 1mgs I don't have. I don't have a pill cutter though, so don't know how easy it is to split one in half, but think I'll try. I'm going to blame this moment on the pred! Doh!

[Floridafan in reply to Lonsdalelass]

Lol, I bought a pill cutter from Boots. It’s not an exact half but certainly close enough considering the size of the pill. It would be virtually impossible to cut it in half using a knife!

[Floridafan in reply to Lonsdalelass]

Forgot to mention that I had a reply from another member who has managed to get the 1mg coated, see link below

healthunlocked.com/pmrgcauk...

[Lonsdalelass in reply to Floridafan]

That's good, there's hope for the rest of us then. Fingers crossed. X

[maria40 in reply to Floridafan]

No. I'm going into the pharmacy this morning to try again. I have phoned and was told they have been ordering but had no news so will press a little more.

[Lonsdalelass in reply to maria40]

I've tried again this morning to get the coated ones in all three strengths as my supplies are getting low in the 5 and 2.5mgs, so I will find out later in the week and let you know.

[Iloveholidays]

I take 2 x 5 mg uncoated and 2.5mg coated, I also take opmezrapole. Why are members not wanting to take the stomach protectors?? I learn something new everyday. Love this forum. Lifeline.

[suzy1959 in reply to Iloveholidays]

It is the PPI's that we are talking about. it is worth looking at the possible side-effects in the leaflet, but also, I read some study which suggests 40% of people using a PPI long term developed kidney problems. (I am happy to be corrected as I may remember it wrong!) After all, we must produce stomach acid for a reason, so stopping it must have an impact on our digestive system? I do know it was never meant to be used long term.

[PMRpro Ambassador in reply to Iloveholidays]

The PPIs, of which omeprazole is one, can cause osteoporosis on its own and is only meant to be used for a short time - so it is hardly advisable long term with pred if you think about it. The PPIs are also difficult to stop, you have to wean off to avoid rebound acid production and they are associated with various unpleasant side effects, a lot of people have bloating and diarrhoea.

[Lonsdalelass in reply to Iloveholidays]

Just more side effects!

[Iloveholidays]

Thank I’ll Look into it. I’ve been taking it for 3 months, initially when on high dose of ibuprofen before diagnosis and pred and have continued to take it, Gp has conintued to prescribe it!

[Koalajane]

I have been taking uncoated prednisolone for nearly 2 years without a PPI and have had no problems. I always make sure I take it halfway through eating my breakfast.

[Lonsdalelass in reply to Koalajane]

Thanks koalajane, that's reassuring, I do the same at the moment, so hopefully can just continue to do so without the need for anything else.

[maria40]

Just a thought, if you can get 2.5 enteric coated, you could cut the number of 1mg needed. If I have to go onto 1mg uncoated - my pharmacy still can't get enteric coated from Alliance - I will take Ranitidine rather than Lansoprazol or any of its relatives . I had a bad reaction to Omprezol.

[Lonsdalelass in reply to maria40]

Thank you for your reply, yes, like Floridafan, I'm going to take less of the 1mg uncoated by combining 5, 2.5 of the coated and then just 1and a half of the 1mg to make up my 9mg dose. Hopefully I'm not going to need anything for my stomach, like you say, they can upset some of us.

[Sunny465]

Slippery elm helps the medicine go down. It isn't a drug with side effects. It comes in a powder to be mixed with water. One tsp in a jar (with lid) adding water that makes a pourable consistancy, store in fridge.

[Hidden in reply to Sunny465]

There is a warning on various websites. I had wanted to try but found it hard to get into the rotation!:

Medications taken by mouth (Oral drugs)

Slippery elm contains a type of soft fiber called mucilage. Mucilage can decrease how much medicine the body absorbs. Taking slippery elm at the same time you take medications by mouth can decrease the effectiveness of your medication. To prevent this interaction, take slippery elm at least one hour after medications you take by mouth.

[Sunny465 in reply to Hidden]

Slippery elm contains musilage? I'll look it up. I took the pred at 2am because taking it at breakfast had no effect. Even 7 am was too late. Whole mornings wasted. The timing made a difference for me. I didn't start taking the slippery elm plus snack until i switched times to 2am. Not on prednisone at the moment. Thanks anyway i'll look into it for furure reference.