Thought you might like to read my Rheumys comments in letter to GP about enteric coated Prednisolone.

[HappyDiamonds]

First of all thank you to everyone who responded to me when I was having a problem reducing my Pred. Im pleased to say that I was given an appointment with my Rheumy within a couple of days and she gave me the choice of reducing by 2.5mg every 2 weeks as I requested or adding in Methotrexate. I chose to go with the slower reduction and its working so very much better. As you all knew it would!

To be able to reduce by 2.5mg my GP prescribed enteric coated 2.5mg tablets as I only had 5mg oral dispersible tablets. I was really surprised that the Rheumy didn't agree with enteric coated tablets being used and she gave me a prescription for ordinary 2.5s.

This is what she wrote to my GP " I have given her a prescription today for Prednisolone 2.5mg as I understand she has some enteric coated 2.5mg tablets at home. However the absorption of these is variable and therefore we prefer to avoid enteric coated preparations. I would be grateful therefore if you could change this for her on her regular prescription"

[SnazzyD]

I agree with her it could be variable if my experience is anything to go by. I found that a meal affected the absorption such that my symptoms started to return quickly in my first three weeks of GCA. Luckily I put two and two together and made sure I took it two hours away from food. After that it was fine.

[HappyDiamonds in reply to SnazzyD]

That is very interesting. So very much to learn and without the lovely people on this forum I don't think I would be coping anywhere near as well as I am. Always been very healthy and this has all come as a bit of a shock to me tbh.

[SnazzyD in reply to HappyDiamonds]

Oh yes, there are plenty of us who were (thought we were) hail and hearty only to be broadsided by PMR or GCA. I likened my experience to having a car crash, one day I was trotting along aged 54 being all things to everyone and then next day life was unrecognisable and has remained so. Not all misery I hasten to add. Acceptance is key; trying to fight and claw oneself back to the past doesn’t help, but seems like the obvious thing to do in the face of an uncertain future. Trying to get one’s head round all the ins and outs is distressing when tanked up on Pred, trying to advocate for oneself without seeming like a madwoman.

[Hidden in reply to SnazzyD]

That's useful to know. I thought we had to take our Pred directly after B/fast, which I've been doing for almost a year now. How long after food is recommended Snazzy ?

Anne

[PMRpro Ambassador in reply to Hidden]

If you are taking PLAIN pred then it is best to take it with food. If, on the other hand, you are taking enteric coated pred, it is not important that ie is taken with food and you can take it at a time that works better for you, before or after food.

[SnazzyD in reply to Hidden]

Plain Pred is ok with food. As for the coated, there wasn’t a recommended optimal time. My two hours away from food with coated was trial and error.

[PMRpro Ambassador]

It is claimed yes - however, I believe the study was done in patients with gastrointestinal autoimmune disorders. Dodgy guts anyway ...

It really doesn't matter - the dose is being titrated to find YOUR personal best dose and, as Snazzy says, all that happens it it takes longer if you take it at the same time as food. Perfectly logical if you listened to your pharmacy lectures!! And something that applies for many other drugs if she did but know.

You can't take plain pred can you? Or am I mixing you up with someone else?

[HappyDiamonds in reply to PMRpro]

Thank you for replying. I have difficulty swallowing but I am managing the one plain tablet in greek yoghurt. Might be more difficult for me when I have to start introducing 1mg tablets as well. Dropping by just 2.5mg each fortnight has made such a difference to me its worth the effort as I wasn't coping well with a 10mg drop which was then reduced to a 5mg drop. Hospital wasn't too happy to reduce it again but I pointed out to them that it only extended my taper by a few weeks.

[PMRpro Ambassador in reply to HappyDiamonds]

If only they could stop panicking about a few mg of pred and accept what works for this patient!