Gastro resistant pred

[Gaz227]

I was told today by my pharmacist that 1mg gastro resistant prednisolone is now discontinued . I contacted my GP , he said I will just have to use the standard tablets , anyone else had this issue , I’m in the uk . I had stomach issues with the standard ones dreading going back on them , I’m taking methotrexate also , already had nausea issues , so they will put the cat amongst the pigeons .

[SheffieldJane]

I am changing to uncoated - back to taking them with organic, thick Greek Yoghurt with a dash of Manuka honey. Gaviscon is pretty effective and a careful diet. One good thing for me is the ability to cut them in half with a pill cutter. I want my tapers to be very gentle and tiny. I have had about 3 years of coated and now have lower abdominal pain, I suspect that they dissolve low down and have caused inflammation, over time. I think others have queried this shortage in more depth and maybe have more success in challenging this issue. It is pure ignorance about the way long term users should be tapering. I hope this get solved. It just adds to the misery for so many.So far my GP’s have only prescribed Lansoprazole which made me feel as if I’d been punched in the gut. Others are luckier.

[Gaz227 in reply to SheffieldJane]

Yes, totally agree about cutting tabs , none gastro resistant are good for that . I have 2.5mg and 1mg gastro resistant , so the only issue with cutting is below 2.5 Mg unless I try quarter cuts which quite difficult . They offered me liquid pred which I have never used so can’t comment on that , I can imagine measuring it precisely might be difficult .

[PMRpro Ambassador in reply to Gaz227]

Measuring liquid pred is easy enough - the pharmacist should provide a syringe and they are easy to obtain for dosing children's liquid meds. Accuracy isn't crucial - just needs to be less than the previous dose.

They are funny though - claim e/c pred is too expensive when it isn't much more than plain pred now but offer liquid pred which costs about 30x as much ...

[SheffieldJane in reply to Gaz227]

I wonder how liquid Pred would be mixed with something viscous, or jelly-like?

This is daft, we ought to report a genuine medical requirement for 1 mg coated Pred to the supplier. The liquid will be allowed for those who cannot swallow medication.

[Hidden in reply to SheffieldJane]

Currently I'm taking 7.5mg One 5mg is not coated but the 2.5mg is. I've had no issues at all. Rarely take the Omeprazole either. When I needed to cut a white one in half I too have a pill cutter.

[SheffieldJane in reply to Hidden]

I wonder if you’ve hit on the ideal split dose for your current requirements?Is Omeprazole effective as and when required? I didn’t think it was. That would suit me much better. What is a “white one”? Uncoated? I haven’t had 2.5 mgs for years. It seemed too hard to explain the intricacies of tapering to the pharmacist.

[Hidden in reply to SheffieldJane]

No Jane, my 2.5mg is a little brown one coated, the 5mg is white uncoated...I'm fine with both. Yes, dreading dropping to 7mg and even worse 6.5mg where I managed to get to a couple of months ago then blinking GCA again. I thought GCA disappeared after 2 yrs. If I feel a little discomfort in my chest (indigestion) I just take one and all good. Heard they're not good to take permanently, they have their own issues, like most wretched drugs.

[Sho-Sho]

I am surprised, I only yesterday collected my gastro- resistant 1mg pred from our GP’s pharmacy. It is ordered through Alliance Healthcare.

[Gaz227 in reply to Sho-Sho]

I was told a few chemist might still have some stock but once that’s gone it will dry up , I live in the midlands so maybe that’s just the companies that supply the NHS in that region , who knows , thanks for the reply .

[JanetRosslyn]

There were a few weeks when I couldn't get them, but Phoenix Labs, Suite 12, Bunkilla Plaza, Bracetown Business Park, Clonee , County Meath, Ireland have now released a batch with an expiry date of October 2023 and my pharmacy got them for me a week ago. I'm in Hertfordshire.

[SheffieldJane in reply to JanetRosslyn]

The Boots concession in my local Waitrose just say they can’t get them and don’t know if they ever will be able to. Mind you, the sales assistant seemed particularly disengaged with her job. Perhaps I should try the Pharmacist next time.

[Ronzy in reply to SheffieldJane]

I’ve just had a load prescription 5mg don’t seam to be reacting. Is it me 🤷🏽‍♂️

[PMRpro Ambassador in reply to Ronzy]

I had a dodgy batch of e/c pred years ago - the 2.5mg batch dispensed the same day were fine, the 5mg lot I flared with. I was switched to Medrol as I was here in Italy and they rarely use prednisolone and never the e/c coated.

Take them back to the pharmacy you got them from and tell them what has happened.

[SheffieldJane in reply to SheffieldJane]

I agree. Take them back. I think this happened to me years ago when I was less experienced. X

[DorsetLady PMRGCAuk volunteer]

There seems to be a reoccurring issue with 1mg GR tablets, if you look at related posts, it has come up many times- going back at least 3 years, but then it resolves.

As you can still get your others, not sure it’s going to be a great problem using 1mg/0.5mg plain tablet especially if you take them with a good thick yogurt…

There is no reason why you cannot take a mixture of GR and uncoated tablets….if that is what your GP is implying.

[SheffieldJane in reply to DorsetLady]

You will need to take into account that coated tablets can take 4 hours plus to get into your system and uncoated about 2 is it? My coated ones seem to take 6 hours to work, maybe that’s why I have lower abdominal pain.

[Floridafan]

This has been discussed recently, it also happened 18 months ago. The coated 1mg tablets should now be available from your pharmacy. They are no longer in boxes but a bottle of 100 tablets. The new expiry date is October 2023, as mentioned in the post above. I have just sent in my prescription so interested to see what my pharmacy has to say!

Here’s the link: healthunlocked.com/pmrgcauk...

[piglette in reply to Floridafan]

I get mine in foil still 30 to a pack.

[Coffeebeans in reply to Floridafan]

Yep agree. I just got my 1mg coated loose in a bottle.

[PMRpro Ambassador]

No it isn't, it is being made by a different manufacturer and a new batch was issued just recently. There are a few posts about it in the last few months.

I'd lay odds they haven't tried to get it.

[Gaz227 in reply to PMRpro]

Thanks that’s interesting . My pharmacy said they had tried and it wasn’t available

[PMRpro Ambassador in reply to Gaz227]

They rang once and that supplier didn't have it in. There were still gaps in supply quite recently - there are links and relevant addresses further up the thread.

[Gaz227 in reply to PMRpro]

I will ask a few questions when I go in for my prescription 👍

[Dobermanlover]

I had a delivery of 1mg GR Pred tablets on Friday and they were obviously dispensed from a larger bottle as were not in the usual foil strips. I was previously told that 1mg GR tablets were unavailable but my stomach was getting more and more sore taking the un-coated ones and made a bit of a fuss about them not being available. Perhaps if enough of us make a fuss they will listen!Yes you do need them when reducing by half mg at a time. The trouble comes when you are coming down from 10 mg and you need to come down in smaller increments, sometimes having to take 2 x 1 mg to make up the quantity.

[Rostom]

I asked for enteric coated prednisolone from my GP but was not prescribed it.

In fact (and quite unusually as they are normally very efficient - perhaps Covid-related staffing issues?) I struggled to be prescribed at all and very nearly ran out, despite giving a week's notice (dispensed scripts are usually ready at my chemist the following day).

I have a repeat prescription for prednisolone for an asthma 'rescue pack' and can only think that the doctor just didn't read my submission requesting both 5 and 2.5mg for PMR and just authorised a repeat 'rescue' pack.

Without being too pushy, how insistent can I be to try to 'encourage' my GP to change to enteric coated tablets? I will use what has been just prescribed first.

I would very much like to try these early morning.

I have no idea if I have any 'rights' and feel a bit guilty even asking as I am very grateful to our NHS for the many drugs it supplies.

[PMRpro Ambassador in reply to Rostom]

If you want to try early morning - what sort of time? Quite a few use enteric coated to take before bed as they take 4 or 5 hours to get into the system - from about 2am on you might as well use plain pred as you need it in the system by about 4-4.30am for best morning relief of symptoms.

[Rostom in reply to PMRpro]

Sorry, I have not replied to your response. I am a night bird, and ideally would love to take my pred around 1,00 - 1.30 am. which seems my natural bed time.

As you suggest that from around 2.00 am, I may as well use uncoated pred, I will have to begin enjoying yogurt (a big dislike at the moment!) and give that a try.

As I understand the 'best' timing of pred is important, at the moment I rise early morning to take a Lanzoprazole, wait half an hour, eat food (just an egg or cheese), take my prednisolone, then go back to bed for an hour or two, all of which is making me tired - and grumpy - or so I am told!

[PMRpro Ambassador in reply to Rostom]

Sounds like a plan - and worth a try at least.

[DorsetLady PMRGCAuk volunteer in reply to Rostom]

Don’t feel guilty about asking for the tablets that best suit you -no doubt you spent 40years or more paying into the system -and probably still are!! ..and Pred are a lot cheaper than a good number of drugs.

[Rostom in reply to DorsetLady]

Apologies, I missed your reply. Yes, I have contributed to NHS coffers quite solidly but have also drawn on them a fair bit too! Just my natural guilt feelings coming to the fore I suppose....

I had also assumed that Prednisolone was far more expensive than it seems to be. I guess we are fortunate that there is not a struggle to obtain the main drug that we need.

[DorsetLady PMRGCAuk volunteer in reply to Rostom]

No probs….. as we are always saying Pred is very cheap compared to other drugs…which is why no pharmaceutical company is really interested in looking for an alternative…

Yes most of us have had a fair amount back, I have over last few years, but a heck of a lot of years when I didn’t…

[PMRpro Ambassador in reply to DorsetLady]

I feel almost guilty here - entitled to full cover in this system without having contributed much to it. Was counting up what they spend on me - quite impressive!

[DorsetLady PMRGCAuk volunteer in reply to PMRpro]

No need to feel guilty -sure during all those years pre Brexit the UK (where you contributed for quite a while ) put some of your pennies into the coffers!

[PMRpro Ambassador in reply to DorsetLady]

More the fact I get treatments here I couldn't/wouldn't be offered in the UK. Like 3 weeks residential rehab which is on the horizon at present. And TCZ for PMR

[DorsetLady PMRGCAuk volunteer in reply to PMRpro]

Still no need to feel guilty….😊

[PMRpro Ambassador in reply to DorsetLady]

I told daughter No2 all the things I have access to here and she admitted there wasn't much incentive to return to the UK!

[Rostom in reply to PMRpro]

Three weeks residential rehab?! Shades of the UK in the 1950/60's.

My quite elderly neighbour (mid eighties) had a hip replacement last month. I battled to obtain some aftercare for her - in vain. Because she had funds she had to buy in the services of day and night nurses for a fortnight. I had assumed that a week or two of convalescence in a home where she would receive nursing care, food and physiotherapy. would be on offer but it was not. Think we should all move to Italy!

[PMRpro Ambassador in reply to Rostom]

Don't know if Italy is as sorted - I live in a German-speaking autonomous region. Lots of Italians queue up at the hospital for MOTs when they are here on holiday!

[piglette in reply to Rostom]

There is a fantastic place near me for rehab. What a pity they are not everywhere.

[Katkin1]

I haven't had any problem getting the 1mg or 5mg of coated Pred. However, I recently asked my doctor if I could have some 2.5mg coated Pred to help with tapering, and she said 'no, they are on the list'. I asked what this meant, and she said they were too expensive!

[DorsetLady PMRGCAuk volunteer in reply to Katkin1]

Actually looking at the drug prices, 2.5mg are about same price as 5mg, it’s the 1mg that are expensive-

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

[PMRpro Ambassador in reply to DorsetLady]

Out of interest, how much do 2.5mg plain cost?

[DorsetLady PMRGCAuk volunteer in reply to PMRpro]

Sorry just been talking to Caron -£3.91 for 28

[PMRpro Ambassador in reply to DorsetLady]

Which is how much compared to 5mg plain? Sorry - I can't access BNF or I would look myself.

[DorsetLady PMRGCAuk volunteer in reply to PMRpro]

5mg plain £0.98 and 1mg plain £0.79 -both 28 pack

No probs.

[PMRpro Ambassador in reply to DorsetLady]

Illustrates the point nicely though doesn't it? If you are on plain pred, it is crackers to ask for 2.5mg tablets - just cut the 5s

[PMRpro Ambassador in reply to Katkin1]

I wouldn't mind these claims - if they were true!! But 2.5 and 5mg e/c are used a lot so moderately priced.1mg isn't used a lot - not least because many doctors and pharmacists don't know they exist in the first place. Because they arent used a lot - they cost more for a run of tablets. The pred is the least of the price factor - it is the production which is the same whether it is 5mg or 1mg in them but they don't sell as many to cover that cost.