Question regarding use of gelatin capsules for pr... - PMRGCAuk

PMRGCAuk

21,317 members40,425 posts

Question regarding use of gelatin capsules for prednisone

GratefulBailey profile image
18 Replies

Further to my post this morning, I am requesting some information regarding using gelatin capsules for my prednisone...I take my prednisone after breakfast (8 a.m. ..I also take pantoprazole 1/2 hour before breakfast, and for the past week, 1 at bedtime.) If I begin using these capsules, will that cause a delay in the absorption of the drug and possibly cause a flare? Or will it take a few days to adjust to this new drug protocol?

I'm Desperate Bailey today!

Written by
GratefulBailey profile image
GratefulBailey
To view profiles and participate in discussions please or .
Read more about...
18 Replies
miss-philosopher profile image
miss-philosopher

I have been putting my pred in gel capsules for the last 4 yrs after advice from this site. I couldnt do without. I think it absorbes about 2 hours later than usual, other than that that no problems.

GratefulBailey profile image
GratefulBailey in reply tomiss-philosopher

Did you notice any increase in symptoms when you first started using them?

miss-philosopher profile image
miss-philosopher in reply toGratefulBailey

No, but I later felt that I maybee needed a bit more pred as it was absorbed lover in the gut, and I maybe absorbed a little less. (Just guessing ) but I had no choice, Pred In the capsules I`m fine, - without it ruins my stomace.

GratefulBailey profile image
GratefulBailey in reply tomiss-philosopher

Thank you for your response...hoping I can have as much success as you! (or at least some!)

SheffieldJane profile image
SheffieldJane

My move to gastric resistant Pred has been all positive. I now take my dose at bedtime. The tablets seem to take around 6 hours to take effect. When I did the transition, I took the dose, morning as usual then my first dose on that night. Prior to this I had been getting gastric disturbance, pain and oesophageal spasms. I have had no problems since.

GratefulBailey profile image
GratefulBailey in reply toSheffieldJane

I had read some of your posts last summer and fall regarding your stomach discomfort and could so often identify with your symptoms. I am happy to hear that the gastric resistant pred is working for you. Thanks for sharing this ...gives me some hope that the capsules will do the same for me!

PMRpro profile image
PMRproAmbassador

It will cause a dealy in absorbing the pred, that is the idea of using them so that the capsule passes through the stomach and that reduces the gastric problems. But the delay is only about 4 or 5 hours - they break down as soon as they reach the less acid regions of the lower GI tract.It MAY also result in a lower peak level of pred in the blood but it is usually present in the blood for longer - some people find they get a better result because the effect lasts longer and takes them until the next daily dose is due. Others find that initially the peak level being lower means the inflammation isn't dealt with quite as efficiently. Plain white pred is absorbed in the stomach and effective within 2 hours maximum, Acid-resistant forms take a lot longer and so the symptoms will last that much longer too.

Both aspects can be improved by taking the acid-resistant version (whether as e/c coated pred in the UK or ordinary pred in capsules) before bed. That means the pred is present in the body early in the morning so the inflammation is dealt with immediately. If you take it in the morning, after the release of the inflammatory substances at 4-4.30am, it will take longer for the pred to reach the bloodstream and take effect and that may feel like the pred isn't working as well.

GratefulBailey profile image
GratefulBailey in reply toPMRpro

In desperation, I emptied a Vitamin K capsule and put in my prednisone for this morning's dose. I took the tablets about an hour later than I usually do (7 a.m. vs 8 a.m.) and so far, so good. No stomach pain, still dealing with nausea, but I can control this with Ginger Gravol. "Regular" capsules arriving today via Amazon. Now that I have now reached low dose prednisone (3 mg), I am hoping I won't be bothered with the delayed absorption.Now my next question - do I still take pantoprozole daily? I realize I have to slowly taper it when I do come off this medication, but can I safely do this perhaps in a couple of weeks when - hopefully - my stomach issues are controlled by taking the prednisone in capsules? I had thought of replacing the pantoprazole with Pepcid one dose a week to begin with as a way of reducing... when I can.

PMRpro profile image
PMRproAmbassador in reply toGratefulBailey

Seems like a plan - but be careful reducing the pantoprazole. You could use more Pepcid and have Gaviscon handy? Do you have Gaviscon?

GratefulBailey profile image
GratefulBailey in reply toPMRpro

Yes, Gaviscon is in my “arsenal” - as well as Milk of Magnesia. Gaviscon is my first “go to”. Still doing well...Thank you so so much for your advice - the difference just today is unbelievable.

alvertta profile image
alvertta in reply toGratefulBailey

You can cut the pantaloc in half. I have done that.

tangocharlie profile image
tangocharlie in reply toPMRpro

Can I check I have understood this correctly, do you mean there is a 5 hour delay on top of the usual time it takes for e/c Pred to work? Due to allergies to the tablets, I take either e/c tablets with the colouring washed off (shocking how much needless red dye comes out) or ordinary Pred in a gel capsule, or to be totally on the safe side, enteric in a gel capsule. I take them in the morning about 9am if I'm up that early. I don't think they fully kick in until late afternoon though which is a bit useless but I tried taking them before I went to bed and it seemed to affect my sleep so went back to mornings. I can't seem to sleep no matter when I take them, maybe because I'm still on 17.5 but I remember years ago I had problems sleeping even on when I was on 5. I didn't have any problems sleeping when I was on the depo medrone injections, or the weight gain, or the moon face. *sigh*

PMRpro profile image
PMRproAmbassador in reply totangocharlie

Don't think so. The 5 hours is the transit time through the stomach plus the time it takes for the outer coating to break down. If you put e/c pred into a gel capsule it will depend on where it breaks down and how quickly. to release the e/c tablet to the digestive process.

tangocharlie profile image
tangocharlie in reply toPMRpro

Thanks. I noticed the other day I put the enteric caps in some water in a mug to start the process of washing the coating off the outside, forgot about them and left them a few hours and noticed they had dissolved, which surprised me as I thought it would take strong acidic digestive juices to do that, not just tap water! Do you know where they are dissolved in the body, is it the stomach or beyond that in the guts somewhere? Sorry about my total ignorance when it cmes to biology. The water in the mug had turned bright red too, I was surprised what a bit of coating could produce.

PMRpro profile image
PMRproAmbassador in reply totangocharlie

No - they are resistant to acid, that is the point, they survive gastric acid and dissolve in the more alkaline lower gut.

tangocharlie profile image
tangocharlie in reply toPMRpro

Ah, I see ..... thanks.

SheffieldJane profile image
SheffieldJane

Once I had weaned off Omeprazole ( it caused more issues than it helped) I would just take an over the counter indigestion remedy, as and when required. I didn’t need them very often.

GratefulBailey profile image
GratefulBailey

That sounds like a bit of Heaven to me...thank you!P.S.1:30 in the afternoon here in Canada and so far so good!!

Not what you're looking for?

You may also like...

Rate of Prednisone Decrease after Upping for a Flare

I’ve been on the increased (15mg) dose of prednisone for ten days now and even though gluteal/thigh...
Donna5658 profile image

What happens if Prednisone isn't taken for PMR?

I'm at what seems like a familiar dilemma for Autoimmune conditions: Diagnostic overlap, and...
kp60 profile image

Is it ok to use metronidazole cream for rosacea when on prednisone?

My GP has just diagnosed my very red cheeks as rosacea and has prescribed metronidazole topical...
Mrs-CJ profile image

Timing for Prednisone

I have been taking my Prednisone in the morning and would like to switch to bedtime if it won’t...

Advice regarding use of herbal licorice to help with taper

I recently had a consult with a Naturopath for general well-being health recommendations. I also...

Moderation team

SophieMB profile image
SophieMBPartner

Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.

Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.