Coated or non coated Pred : Good morning, My new... - PMRGCAuk

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Coated or non coated Pred

Pangolin43 profile image
16 Replies

Good morning,

My new prescription for prednisone is not enteric coated (my previous one was). Does this matter and what is the difference? Is one more quickly absorbed into the system and does it have to be taken with food?

Apologies if these seem a silly or obvious questions. 🌞

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Pangolin43 profile image
Pangolin43
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16 Replies
Coffeebeans profile image
Coffeebeans

Hi Pangolin 43

Short answer, yes it matters. I had this issue of receiving whatever was on the shelf to start with and I'm sure it contributed to my struggle to taper.

The coated pred takes much longer to get into the system. The uncoated needs to be taken with some food.

Personally, I would ask for your prescription to annotate which you prefer to ensure you only get that from now on.

DorsetLady profile image
DorsetLadyPMRGCAuk volunteer

As advised, yes it matters, and check why it’s been altered. There obviously was a reason why you were prescribed enteric coated initially - it’s not normally first choice - do you have digestive tract issues? If so you may need a PPI - Omeprazole or similar.

MrsNails profile image
MrsNails

My Consultant gave me my 1st ‘Script & they were EC5mg but when l got my ‘script from GP he gave me plain & when l queried it, he bit my head off....

Nice Man! Down to cost in my case!

SheffieldJane profile image
SheffieldJane

This was probably a careless error on the part of the pharmacist that could have had unpleasant consequences for you. They need to be more careful. Personally I prefer Entric Coated . They take 4-7 hours to get into your system, you can take them at bedtime and feel good in the morning. You don’t need to take stomach protecting drugs that can have side effects and you don’t need to take them with food. You cannot cut them for 0.5 tapers though, as you can with non coated tablets. I used to get oesophageal spasms (scary) with the uncoated tablets. Some people think the coated ones are less effective. It is down to personal preference . They are definitely not interchangeable month by month. I would be annoyed.

PMRpro profile image
PMRproAmbassador

There are a lot of doctors who believe the assessment made several years ago that EC is not required as it doesn't stop the development of gastric ulcer - maybe no, but a lot of people find plain pred very uncomfortable to take LONG before any possible development of ulcers. Some doctors still think there is a massive difference in price - no there isn't by the time you add in the PPI and its cost as an add-on never mind the added adverse effects that including another drug can engender.

If the doctor didn't write EC your pharmacy probably won't give you them - they are handy enough at substituting when it suits them though! Plain pred is absorbed in about an hour after taking them, EC can take anything from 4 to 7 hours or more because they have to pass through the stomach to lower down the gut before the coating dissolves where it is less acid. I assume this is why they think the absorption is unreliable - doesn't matter as we are titrating the dose anyway.

Pangolin43 profile image
Pangolin43

Thank you to all who replied. I have now renewed my prescription and after listening to the advice on this forum I made a request for some 1mg EC tablets to support tapering. The doctor tried to give me non coated but I persisted. As some of you have already mentioned he said it is down to price. 100 non coated £9. 100 EC £72. (His words). However I persisted and got 100 EC tablets. I feel better taking the EC Pred as I don’t want to take yet another tablet if I don’t need to.

Thanks again everyone.

PMRpro profile image
PMRproAmbassador in reply to Pangolin43

Did he check that price in the current BNF? Because unless things have changed recently that seems high. That is the price of the Lodotra I get here in Italy - and EC pred is nothing like as expensive.

Can someone in the UK have a look at BNF - I can't, not available outside the UK.

Bcol profile image
Bcol in reply to PMRpro

EC 1 Mg £7.00/30, EC 5mg £4.00/30. Prices vary from different companies.

PMRpro profile image
PMRproAmbassador in reply to Bcol

Sounds more like it.

Thanks Bcol! Do GPs think we are totally gullible and stupid?

Is Lodotra listed in BNF? It is available in the UK on private prescription so it may well be.

Bcol profile image
Bcol in reply to PMRpro

Don't know I'll have a look

Bcol profile image
Bcol in reply to PMRpro

No, not listed.

piglette profile image
piglette in reply to Pangolin43

Prednisolone 1 mg30 tablet (POM) £7.43 from A A H Pharmaceuticals

I think your doctor must have looked up the wrong product.

PMRpro profile image
PMRproAmbassador in reply to piglette

One is left to wonder WHAT product! And if that is typical of their research powers, it is rather concerning ...

piglette profile image
piglette in reply to PMRpro

Well you know they can’t write so perhaps they can’t read either!

PMRpro profile image
PMRproAmbassador in reply to piglette

This is very true ...

Pangolin43 profile image
Pangolin43

Good to know 😀

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