Prednisolone - Repeat Prescription or Acute?

[Nuff1]

OH's pred has been removed from online repeat prescription; phoned surgery and it's been changed to "Acute" i.e. a single prescription each time.

Reliable info from elswhere is that this has been done because reviews were being skipped. Dont' know whether thiis is local surgery, Wales HS or general UK NHS.

Possibly relevant

cks.nice.org.uk/giant-cell-...

" A suggested schedule is to:

Continue high-dose prednisolone 40–60 mg daily until symptoms have resolved and erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) level has returned to normal (usually 4 weeks), then

Reduce the dose by 10 mg every 2 weeks until the person is taking 20 mg daily, then

Reduce the dose by 2.5 mg every 2–4 weeks until the person is taking 10 mg daily, then

Reduce the dose by 1 mg every 1–2 months, provided there is no relapse.

One week after any change in dose, review the person to exclude any relapse of symptoms (it may be possible to do this by telephone)."

[jinasc]

"Specialists may consider the use of steroid-sparing treatments such as disease-modifying anti-rheumatic drugs for people who experience frequent relapses [Dasgupta et al, 2010a], although there is a lack of good-quality evidence to support their use."

Read it and when I came to this bit.............thought finally it is on paper.

[DorsetLady PMRGCAuk volunteer]

In that case, make a monthly appointment with GP! I’m sure after a few months, GP may well decide it’s not necessary and revert to a ‘repeat” prescription.

Early days I saw the GP monthly anyway to discuss taper, but as I got lower and changed surgeries where GP let me do my own thing, we had an agreement that Pred would be on repeat, unless or until I rang and told him of my new dose. He would then change prescription accordingly.

But I do live in England and it was a few years ago - so policies may be different!

[PMRpro Ambassador]

Very helpful ...

My cousin used to have to get her thyroid medication every 4 weeks - and they refused to give extra even when she knew in advance she was going on holiday. She wasn't ever going to be able to stop it. Jobsworths who haven't had to live with it if you ask me ...

[YuliK in reply to PMRpro]

My grand daughter, who unfortunately 😢has diabetes 1, has to request a repeat prescription...ridiculous, like it's going to disappear over night. Lives in North London

[PMRpro Ambassador in reply to YuliK]

That REALLY is ridiculous - and costing the NHS quite a lot as each month they are having to pay the pharmacy the dispensing fee. Which is the same for 1 months worth or 6 months worth of the same thing/dose.

[piglette]

Had reviews been skipped? I have never discovered what I should do for the review, I used to make an appoiment, I now just phone up. My brother says he never bothers. I did read that they were intending making Gapapentin a non repeat medicine. I don’t know if they have. My pred is still repeat I hope!

[Hidden]

I was reviewed during an appt last month and there is a big capital lettered "authorised" on the computer now. A few years ago they made tramadol and zopiclone a different category and i had to see a dr for prescription. That lasted 2 months. Then they made it that, unlike my other meds, the dr physically had to sign them out but i didnt have to see dr. Then other meds were emailed as white copies. But Green signed copy of prescription collected by hand by chemists for tram and zop. About a month ago the pharmacist said they had all been transferred to white copies. The dr did talk about rationalisation of my meds. I said if theres any you can take off that i dont need to have a good quality of life, help yourself...

[Soraya_PMR]

I have to request each month separately, which I do very carefully noting all the doses of pills and amount needed.

They rang me once to ask me why I was requesting it early: because you take such a long time sorting it out!

They rang me to ask me to clearly specify the current dose, which I do, but they send whatever they feel like, such as when I asked for 5.5 x30 days, I got 14mg daily. Hey ho into the cupboard for my secret squirrel store.

One time they totally messed it up, not giving me sufficient 1mgs to take required dose. Receptionist told me I MUST take what was prescribed (a much higher dose). I told her she could tell my consultant why I was taking more than I needed.....she sorted it!

The review date for my HRT is November 2017 😮 so glad they’re keeping a close eye on things! Surely the computer must flag this stuff up? Or what’s the point?

[Mrsd12f]

Hi , Nuff 1. My other meds (HCQ and calcium) are on repeat prescription, but I have to put in a separate prescription for the Pred., every time.

On the order form from my GP practice, there's a box asking for the reason you're requesting Pred. I used to have to do this, every month, but now they usually give me enough for a couple of months - presumably, they've realised I'm not selling it behind the bike shed!

I also have a review, every few months, as I'm under the rheumatology department at the hospital and the consultant communicates with the practice.

I notice you mention Wales: I'm in Wales, but not sure whether this is NHS Wales policy or just what happens in my neck of the woods.

[Nuff1]

I'd left a phone request for GP - she explained that someone had had 3x required strength (not sure where) and she'd explained to OH!!

However on repeatt online there's a message box and she said to add requirements in there - no need for him to go to have GP appointment.

Fingers crossed.

[SuziCutie]

I live in Wales and can’t have pred on repeat prescription. But I can request 2 months supply with out problem, thankfully .

[Nuff1 in reply to SuziCutie]

Odd isn't it? OH has had his pred on repeat prescription since diagnosis last June (N.Wales)

[Carrollee]

Hi Nuff. I request my pred on line whenever I want, 1mgs and 5mgs. I have never been questioned and never had my prescription reviewed in 4 years. I do see a rheumatologist every 6 months and have ultrasounds and a letter is sent to my GP. So maybe that is seen as a review. I find it quite distressing that others have such a hard time acquiring their medication. All the best to you and hubby cc 🤗