What can I take when Prednisolone is out of stock at the chemist?

[SlowboatToTheIslands]

Prednisolone is out of stock all over Greece. I'm on 5mg daily but as soon as I stop the pain comes back so I'm a bit desperate. Does anyone know what I can take as an alternative short term until I can get it again? Thanks!

[PMRpro Ambassador]

There is no alternative except other corticosteroids: methyl prednisolone, prednisone or hydrocortisone (it is much weaker and must be dosed 2 or 3 times daily).

But if you have been on pred for long, it is extremely dangerous to just stop corticosteroids suddenly - you MUST get medical advice to avoid the risk of adrenal problems necause of the lack of steroid.

[SlowboatToTheIslands in reply to PMRpro]

Thank you! I know I mustn't stop suddenly so I'm in a bit of a panic as I only have 10 days' worth of pills left! Couldn't have happened at a trickier time of year! I've sent an email to my rheumatologist but who knows if he's even turning on the computer between Christmas and the New Year...

[PMRpro Ambassador in reply to SlowboatToTheIslands]

There must be an emergency service - even if it means the equivalent of A&E. And the hospital pharmacy may have supplies of the other options.

[MrsNails]

Has the pharmacy not offered any suggestions? Could it not be supplied through a hospital pharmacy? It’s not a drug you can simply stop as it can cause serious issues. Good Luck

MrsN

bnf.nice.org.uk/treatment-s...

I’ve found this from the BNF - hopefully you can open it - if not l’ll copy & paste it for you but have screen-snapped the equivalent doses for information.

You need to discuss with your Specialist and/or GP as they must have a plan in place regarding this situation…..

Chart

[PMRpro Ambassador in reply to MrsNails]

BNF is not available outside the UK - there might be a payment system for organisations, not sure. Not for us mere mortals though.

[MrsNails in reply to PMRpro]

I thought that maybe the case - l can copy the article for SlowboatToTheIslands if she would like to read it……

[SlowboatToTheIslands in reply to MrsNails]

Thank you! I have made a note of all these now. The rhematologist has responded that I should take 4mg of Medrol (instead of 5mg pred). That's a brand name for Methylprednisolone here, so it is on the list... fingers crossed!

[PMRpro Ambassador in reply to SlowboatToTheIslands]

Good - that was what I mean. It should work fine - it does for most people. I had adverse effects with it that I don't have with prednisone or prednisolone and it also needed more for me for some reason.

[MrsNails in reply to SlowboatToTheIslands]

I’m pleased you’ve got your alternative - try & collect it in a day or two so your ahead of the game. Pleased we were able to help.

MrsN

[Nextoneplease]

Hi there 😊

I can’t add to what the others have said but just wanted to say I hope you get this sorted out soon! I’ve been in a similar situation with other essential meds and I know how anxiety-inducing it is 😖

Good luck xx

[HeronNS]

Looking on line it seems hydrocortisone is administered in emergency situations, so provided you are advised regarding correct dosage and timing it should work for you as a stop gap until pred available.

[SheffieldJane]

Have you tried to get your prescription filled on line at all? There seem to be many U.K. options. You have 10 days to try on-line pharmacies. How nerve wracking and peculiar.

[PMRpro Ambassador in reply to SheffieldJane]

Delivery becomes a problem though - especially at this time of year.

[Liby57]

Do you have your steroid card, perhaps you could go to A&E. you shouldn’t just stop taking Pred.

[PMRpro Ambassador in reply to Liby57]

The poster is in Greece!!!!

[SlowboatToTheIslands in reply to Liby57]

Thanks. I don't think the national health service here in Greece will respond in the same way as the NHS would in the UK although I suppose I could give it a go!

[PMRpro Ambassador in reply to SlowboatToTheIslands]

They'd have to cough up with something if you were heading for an adrenal crisis!!!!

[piglette]

Presumably it is a major problem in that case all over the country and someone must be doing something about it. Doctors must be aware if this is happening. Have you tried other pharmacies to ensure that it really is the case of no steroids in Greece? Lucky you have ten days supply.

[cranberryt]

You can also lower your dose a bit to stretch it out more even if it means you have some pain. Also ask about alternative dose amounts… ie. maybe they are out of coated but not uncoated or out of 1mg tablets but not 5mg.

[PMRpro Ambassador in reply to cranberryt]

Coated/enteric coated pred is only available in the UK.

[SlowboatToTheIslands]

I did think of stretching it out a bit, but I think I'm about as low as I can go on 5 mg. Good suggestion, though...

[Hosers2]

Last January, I had to get off of Prednisone quickly, because it was causing eye problems (Macular Degeneration). At the time, I was down to 7mg Prednisone and doing fine, I gradually switched to Hydroxychloroquine, Folic Acid, and Zinc. Every 5-6 days, I reduced the daily Pred by 1mg, while taking HCL twice daily (200mg x 2). My Rheumatologist also had me start taking 10mg of Methotrexate once a week.

A little over a month and a half, I was completely off of Pred, and feeling about the same as when I had PMR under control. So. . .generally, that method has worked for me. I still get the morning aches, so I try to take the new meds at 2:00am and 2:00pm daily.

It has now been almost a year, and I don’t have the slightest clue when I will ever get off of HCL. Methotrexate has been reduced to 5mg (once a week).

Hope that helps. There is an alternative to Prednisone. At least, there has been for me.

[Nextoneplease in reply to Hosers2]

Hi Hosers2I have macular degeneration but no one has linked it to pred - is it a general thing? (I did have it before PMR/GCA but don’t want it to get even worse!)

[HeronNS in reply to Nextoneplease]

I'm finding this puzzling too, but there are different kinds of macular degeneration. I think for at least one kind prednisone is helpful.

[Nextoneplease in reply to HeronNS]

Do you know which kind, Heron?

[HeronNS in reply to Nextoneplease]

I have problems researching because my computer is awaiting the arrival of a part from China and I am struggling with a little old tablet I usually just have for travelling. I'll see if I can find the article again.

[HeronNS in reply to Nextoneplease]

I think this was the article I saw before, and because inflammation is implicated, corticosteroids help with that aspect. But I did not read the entire article and possibly the timing of treatment in relation to the development of Age Related Macular Degeneration is relevant. I usually don't understand these articles and rely on the introduction and the conclusion

ncbi.nlm.nih.gov/pmc/articl...

[Nextoneplease in reply to HeronNS]

Thank you Heron 😊

I’ll maybe read this again tomorrow- bit late here, and as you say, this is quite complex! x

[artfingers]

I wonder, in a pinch, if a vet who also has prednisone might be a source? I know my dog took prednisone but I haven't researched how it compares to human prednisone. Just a thought.

[HeronNS in reply to artfingers]

Here (Canada) I've noted pets get prednisolone whereas we humans get prednisone. I think the pets have the better deal!