Pred and Lactose Intolerance?

[KerryIreland]

Hi all, I’m back on Pred as my “putting up with PMR” didn’t last long! I’m finding this forum very helpful. I started 15mg pred in March last year and it took until October to realise that the stomach problems were not side effects but due to lactose-intolerance. When I changed to lactose-free food it made a huge difference. As I finished the course the PMR came back so after about 5 weeks I phoned the Dr. and went back to 5mg.....now tapering very slowly and wondering whether pred caused the intolerance and if so is there a lactose-free version??

[DorsetLady PMRGCAuk volunteer]

This is from one patient information, but most are similar - check yours -right at the end.

6 Contents of the pack and other

information

What Prednisolone Tablets contain

• The active substance (the ingredient that

makes the tablets work) is prednisolone. Each

tablet contains 1mg of the active ingredient.

• The tablet also contains lactose monohydrate,

maize starch, povidone, purified talc, colloidal

anhydrous silica, magnesium stearate.

What Prednisolone Tablets look like and

the contents of the pack

Prednisolone are white, circular, flat bevelled

edge tablets.

Pack sizes are 28.

Marketing Authorisation Holder and

Manufacturer

Accord, Barnstaple, EX32 8NS, UK

you would need to research other makes to see if there is a lactose free version.

[PMRpro Ambassador]

I might be wrong but I think the only lactose-free versions of corticosteroids are either injections with Depotmedrone or liquid pred which is very expensive so the NHS is a bit reticent about it being used.

However - usually once you cut the amount of lactose in your diet, the small amount in tablets is tolerated unless it is a really severe intolerance but people usually notice that very much earlier. Most adults are not particularly tolerant of lactose and it is possible that the autoimmune part of PMR has led to the problem worsening - it almost certainly made me intolerant of wheat starch.

[S4ndy]

I have developed lactose intolerance although looking back to my childhood I think I may always have had it to a degree. I can have small amounts of lactose but try to use lactose free milk. It's very noticeable if I have too much lactose. My tummy bloats up, I have pain and my digestive system plays up. I don't think the small amount in my medications make much difference though.

[Gaycreasey]

I have been lactose intolerant most of my adult life and cannot take any amount comfortably. I have used liquid prednisolone almost from the beginning (5 years) although the GP is not happy because of the cost. He did try to make me take some dissolvable tablets but they did nothing to help the pmr pain. I am down to 5mgs and have been yo-going for about two years. I got down to 3 mgs at one point but was soon back up to 5mgs. I think that is my limit at the moment and will stay on that for the time being. COVID is enough to deal with!!

[KerryIreland in reply to Gaycreasey]

Thanks for sharing that...we’ll see what my doctor says...