Cutting coated Pred tablets.

[HalleysComet]

Is there any reason for saying you should not cut coated Pred tablets? My pill cutter will chop them in half. So there must be another reason for not doing so.

[jinasc]

As far as I am aware, the uncoated are faster release , the coated are slower to release and protect your stomach. So when a pharmacist says you should not cut any enteric coated - that is it.

[DorsetLady PMRGCAuk volunteer]

The coating is protecting your stomach, cut them and it negates that protection.

From Patient Information Leaflet (PIL) -

"How to take Prednisolone tablets

You will be supplied with a ‘Steroid Treatment Card’ which includes important details of your treatment. This card should be carried at all times.

Always take this medicine exactly as your doctor or pharmacist has told you, especially if you are elderly. Check with your doctor or pharmacist if you are not sure.

Swallow the tablets whole, with a little water. Do not chew or cut the tablets."

They come in 1mg, 2.5mg, 5mg (in UK) so you can mix and match almost any dose except for 1.5mg and 0.5mg - when you need to use uncoated ones to make dose required

See this from FAQs -,

healthunlocked.com/pmrgcauk...

[piglette]

The coating is for protection, cut it and your stomach is no longer protected. I am sure pill cutters will chop lots of things which should not be cut!!

[PMRpro Ambassador]

The whole point of the enteric coating is to protect your stomach from the irritant effect of pred - the whole tablets passes all the way through the stomach and is not broken down until it reaches the less acid environment of the lower gut which protects the stomach lining where it is very acid.

[Melti in reply to PMRpro]

Does this mean that if a coated tablet is cut, it just acts like an uncoated tablet?

I somehow imagined that some awesome potency would be released, making the cutting really dangerous......

[DorsetLady PMRGCAuk volunteer in reply to Melti]

Precisely to first comment…....hopefully not to second…😳. just more likely to upset stomach, but taking with a spoonful of thick yogurt will help.

[Viveka in reply to PMRpro]

If you take pred in the morning should the acid effect on the stomach be much less by night time? Or is it for the full day. Six months into pred I started with acid reflux symptoms in the morning after sleeping. This is a longstanding issue because of dodgy oesophogeal sphincter which gets disturbed by exercise but then usually settles again. But this time it is not settling. Wondering if swopping to coated would help?

[PMRpro Ambassador in reply to Viveka]

The coated sort might well help - they have been the solution for quite a few people on the forums over the years. Only available in the UK before everybody gets excited ...

[Viveka in reply to PMRpro]

Thank you! I will ask my GP...

[HalleysComet]

I take a Lanzoprasole tablet with each Pred dose. I always assumed that gave enough stomach protection whether the tablets were coated or plain, cut or uncut. I asked because I shall have to start cutting tablets when 0.5mg is needed to make up the dose. That may not be for some time, however.

[DorsetLady PMRGCAuk volunteer in reply to HalleysComet]

As I said in previous reply…mix & match..only find you’ll need uncoated ones is when you are on1.5mg and/or 0,5mg

[Rugger in reply to HalleysComet]

I use gastrocoated pred tablets and will only need to request some plain 1mg tablets to cut when I get to 1.5mg or 0.5mg doses. I'm currently on 2.5mg and all doses so far can be worked with 1, 2.5 or 5mg coated tablets, without cutting. Plain pred tablets are cheaper than coated, so it's a waste of money and the coating to cut them!

[Rugger in reply to HalleysComet]

The cost of 30 gastrocoated 1mg pred tablets is £7.43, but 28 plain 1mg tablets cost just 88p!

[DorsetLady PMRGCAuk volunteer in reply to Rugger]

Yet for 2.5mg - it’s GC -£1.33 and plain £3.91. ….Bonkers.

[AyJayBass]

According to the reference below, cost to the NHS of 2½mg enteric coated is LESS than the cost of 2½mg uncoated! Work that one out. When I asked for 2½mg tablets in order to be able to do ½mg tapers without cutting 5mg tablets, I was supplied with coated. I don't actually need coated as I take daily Omeprazole and always take Pred with breakfast anyway. So, when I get below 2½mg per day and want to start tapering in ¼mg increments I intend to cut to coated 2½mg tabs where that's useful. Cutting 1mg tabs into 4 is going to be fun!

I'm just reaching 5½mg at the moment, hoping for 5mg by Christmas and I intend to pause at that dose for an extra week or two rather than plunging into a new taper straight away, so 2½mg daily is well into the future. I am using DL's plan to reduce by ½mg every 5 weeks and this is serving me well.

bnf.nice.org.uk/medicinal-f...

[DorsetLady PMRGCAuk volunteer in reply to AyJayBass]

It does seem an anomaly that gastro 2.5mg are cheaper than plain tablets, but 1mg are more expensive.

Can only assume that 2.5mg gastro ones are more popular than plain, and visa versa with the 1mg size. Usually down to economies of scale.