FYI- 1mg gastro-resistant prednisolone unavailable.

[Kendrew]

Today I went down into my village to collect my prescription from that well-known high street chemist and was told gastro-resistant pred in 1mg tablets were now discontinued and would no longer be available... ever! I would either have to take ordinary pred 1mg with omeprazole or see GP for an alternative.

As you can imagine, I was somewhat perplexed by this news and quite frankly, didn't believe a word of it! So, I've just spent all afternoon 'investigating' this and here's what's really happening.

Phoenix Labs took over from Alliance Pharmaceuticals in 2020, (when many of you may remember we had a distribution problem then also) and they now manufacture these tablets.

I spoke to Ken Mcewan who is the Commercial Director of Phoenix Labs and he told me this:-

- the blister packs of gr pred-1mg are no longer being manufactured but some may still be circulating as their expiry date is April 2022. However, pots of 100 gr pred-1mg have now replaced them and all wholesalers were emailed at the end of Feb informing them of this change. They are available now and he gave me the PIP codes for pharmacies to order them should they not have them already.

He also said there are 3 main suppliers most chemists order from and here are their PIP codes:-

AAH - PRE1574M

ALLIANCE HEALTHCARE - 1252873

PHOENIX HEALTHCARE - 1252873

These may be helpful to give to your pharmacy should they have trouble ordering them for you.

Others may have further information to add but I didn't want anyone else to be told they're no longer available when quite clearly they are.

[Bcol]

Thanks for the info and a great bit of research. 🙂🙂

[Highlandtiger]

Well done! 👏🏼

I actually got mine in the new packaging without any difficulty about 3 weeks ago. I think it depends on whether the pharmacist can actually be bothered to try and find them or not. I know from my pharmacist that I’m the only person she orders the gastro resistant 1mgs in for and she gave me a few packets of the old ones (April 2022) to tide me over until the new ones came in. I’m on 4mg so I get through a packet a week. She’s told me in the past that she’s sometimes had to use different wholesalers but she’s always found them for me.

It seems extraordinary that some pharmacists are actually prepared to pass on such misinformation. Anyway well done and no doubt we'll be discussing this again in October 2023 when this lot expire! 🤦🏻‍♀️

[PMRpro Ambassador in reply to Highlandtiger]

One of the worst culprits is the Shoe substitute chemist - who as far as I know, are owned by the same group as Alliance

[Highlandtiger in reply to PMRpro]

I ditched them a couple of years ago when they just gave me plain 1mg ones without even asking me or indeed telling me that they’d done it. I only found out when I got home and opened the bag. Another big chain has served me well ever since. I suspect it’s down to the individual pharmacist rather than the particular chain to be honest.

[PMRpro Ambassador in reply to Highlandtiger]

I heard a pharmacist there "advising" a patient who had asked for advice on a suitable laxative that she didn't need a laxative, she needed more exercise and to drink more water. The lady did indeed need a laxative - she had a medical condition. The appalling female pharmacist was shouting - the whole fairly large shop could hear! Patient confidentiality ...

[Kendrew in reply to PMRpro]

That's so unprofessional, completely insensitive and wholly inappropriate behaviour.

[PMRpro Ambassador in reply to Kendrew]

Quite - I will not go there unless there is absolutely no other choice. AND they are rip-off merchants!

[Kendrew in reply to PMRpro]

My neighbour has myasthenia gravis and requires 1mg gr pred. His prescription is dispensed at another independent pharmacy about 4mls away, so I took my prescription there............ the tablets will be ready for me to collect tomorrow! Happy days!😀

[Kendrew in reply to PMRpro]

You're correct Pro!

[PMRpro Ambassador]

There have been a few posts about it recently but that adds some extra firm details about it. I hope everyone who has been fed the "get out" (synonym: I can't be bothered ...) takes note and provides the evidence!

[Rache]

Thank you for your thorough research. I had actually read on the forum that Phoenix Labs were doing them and was able to mention this to my pharmacist. They got me a bottle of 100 the next day! It’s a surprisingly small-looking container with 100 loose tablets inside. Easier to store than the long boxes.

[Highlandtiger in reply to Rache]

I prefer the boxes tbh but no doubt I’ll adapt! Just happy to get them at all!

[marigoldb]

Thank you for the information, and providing all the details. I too am on the G R 1mg daily.

[SheffieldJane]

You are a true detective! Thank you.

[Kendrew in reply to SheffieldJane]

🙂🙂🙂

[SheffieldJane in reply to Kendrew]

Went to Boots, I have my repeat prescriptions electronically delivered there, today armed with all your valuable research. Once I got past the sales assistant who was positively obstructive to the point of rudeness. I was informed by the pleasant pharmacist that these particular PIP codes were not used by Boots and they were unable to help. I would have to get another prescription from my doctor and take it to a private pharmacy who would be able to get them for me, using that information. It seems that Boots are a law unto themselves. So now I have to take up a doctor’s time in order to obtain a duplicate prescription. I can’t help wondering if the young pharmacist would have felt able to be more helpful if the the sales assistant hadn’t kept interrupting to say “ I told you we can’t get them”.

[PMRpro Ambassador in reply to SheffieldJane]

Not good enough. Complaint time. And probably time to tell the practice you don't want your scripts sent to Boots!!!

[SheffieldJane in reply to PMRpro]

Complain to whom though? The gorgon patrols that counter and it is by far the most convenient chemist for us. My husband is always popping in.

[PMRpro Ambassador in reply to SheffieldJane]

Boots - either the local manager or regional/head office. Shame that - personally I would walk double the distance to avoid them! Unless there was no choice at all.But I do appreciate the point! One of the things I like here - no big chains! You even struggle to find MaccyDs!

[Highlandtiger in reply to SheffieldJane]

Good grief! Do you have a Superdrug near you at all? They always manage to get mine.

[SheffieldJane in reply to Highlandtiger]

A car ride away. The hassle is the duplicate prescription and getting to a GP to get one. I like Superdrug.

[Highlandtiger in reply to SheffieldJane]

I changed from Boots to them when Boots just ignored my prescription and gave me plain ones without asking or even telling me they’d done it. I have two branches of Boots closer to home but I've stuck with Superdrug since then.

[Kendrew in reply to SheffieldJane]

I've just changed my dispensing pharmacy from my village one (Boo*s) to the independent one that's finally sourced my 1mg gr pred......it might be a short drive away and slightly less convenient but at least I don't have to endure unknowledgeable & incompetent staff....... and I receive all of my prescription!

[Kendrew in reply to SheffieldJane]

That's absolute rubbish...I know for a fact that Boots order from Alliance Healthcare (they are part of Boots!!) and Phoenix Healthcare. Of course they don't use those PIP codes!!..... they're new!!.... they won't have seen them before, but if they'd read their emails back in Feb, they'd have seen info from Ken Mcewan (Commercial Director for Phoenix Labs) informing them of this change! Take the photo of the meds that I've posted to prove it!

[PMRpro Ambassador in reply to Kendrew]

Or Boots is part of them - I meant to say that when I replied before. Think SJ's being taken for a ride ...

[Kendrew in reply to PMRpro]

Yes...sorry.....that's what I meant to say! Haha!... was getting too excited!!😂

[PMRpro Ambassador in reply to Kendrew]

Either way - please don't tell us you don't order from them!!!! I would be more impressed if he admitted they ONLY order from them ...

[SheffieldJane in reply to Kendrew]

I am beginning to think it’s me. I had an experience with a difficult sales assistant at the Pharmacy attached to my GP surgery. This woman made every month’s supply of my prescription items unnecessarily complicated. I felt as if it became deliberate. Her predecessor could not do enough for me - we do have quite complex requirements. Is this one of those jobs that attract obstructive people? Or am I particularly annoying? I moved my electronic prescription to Boots, all was smooth until the coated 1 mg tablets were hard to get and this grumpy woman, wanted me to just go away.

[Slowdown]

Good sleuthing ! Off to the pharmacy tomorrow armed with those codes. Let's hope it's the end of the annual panic - don't we have enough to deal with?!🙄 Thank you.

[123-go]

Now that's what I call perseverance! 👏👏👏

[Kendrew in reply to 123-go]

Haha!...... well you know what they say?....'The only way to failure is to not try"!

[bussell]

Thank you for your research and giving us all the ammunition we may need! Good work. Incidentally loose tablets in bottles is a lot more environmentally friendly than all those blister packs!

[PMRpro Ambassador in reply to bussell]

I have heard that some pharmacies in the UK now recycle blister packs

[Highlandtiger in reply to PMRpro]

Yes, mine does. There’s a big cardboard box you can put used blister packs in.

[bussell in reply to PMRpro]

Yes. You are right. I do collect them and then take a bagful to Superdrug (it has to be a branch with a dispensing pharmacy). I kind of wonder what happens then. Straight into the rubbish bin round the back? The staff were non committal.

[PMRpro Ambassador in reply to bussell]

terracycle.com/en-GB/brigad....

[Kendrew in reply to PMRpro]

Hmmm......not mine!☹️

[Rugger in reply to PMRpro]

Superdrug definitley - for Marie Curie cancer care.

[MrsNails in reply to Rugger]

Yes, we were in there yesterday…..

[Rugger in reply to MrsNails]

I should have said, as bussell says, it's only the Superdrug stores that have a pharmacy. My local one doesn't, but when I'm visiting a friend 10 miles away, I take mine to her Superdrug! "Recycler" is my middle name - all my rugs are made with waste fabric from a mill!

[Highlandtiger in reply to Rugger]

A guy I used to go out with a few years ago said I was "an avid recycler". I'm not sure it was meant as a compliment!

[DorsetLady PMRGCAuk volunteer in reply to Highlandtiger]

Well as you don’t go out with him any more, he may have a point🤣😂

[Kendrew in reply to DorsetLady]

😂😂 love that!

[Highlandtiger in reply to DorsetLady]

Very true! 😉

[SheffieldJane in reply to Rugger]

Talking about drugs Rugger. I asked my supplier Polar something, when I would run out of Tocilizumab because I would like to taper off it more gently - he almost said something and stopped himself. This made me wonder if there has been a change or extension for GCA patients. He had no reason to be evasive . He said that he will be talking to Sarah Mackie. Is something afoot? I hope so for your sake. I am taking it but not convinced.

[PMRpro Ambassador in reply to SheffieldJane]

There was talk of a review some time ago. It is usual, once they have been using something for a while, to assess whether they should change it.

[Rugger in reply to SheffieldJane]

My TCZ supplier is Lloyds Clinical Homecare, even though our prescriber is the same! The suppliers can only deliver if they have a prescription, so I assume he must be talking to her about that? I've heard nothing and am expecting to be started on Methotrexate in 3 weeks' time - unless something changes between now and then.....! Interesting.

[SheffieldJane in reply to Rugger]

He avoided telling me how many doses I had left. I imagined he was bursting with news and wasn’t allowed to tell.I have agreed with Sarah that I will finish the Toc course. The first jab after a 3 week gap provoked a violent sneezing fit. Let me know how you get on with Methotrexate. Wouldn’t it be great if it did the trick for you?

[Rugger in reply to SheffieldJane]

Another explanation could be that although it looks as if you might have some doses left, he's not allowed to dispense them after 31st March. Who knows? When I started on TCZ and was told it would be for one year, the Nurse explained that it was not 52 doses, but for a calendar year from Day 1. If I missed a dose due to an infection, I was told I couldn't 'bank' that dose and use it beyond the 52nd week.... Rules!!

Things have changed due to Covid, but the date of 31st March may just be set in stone?

[SheffieldJane in reply to Rugger]

Maybe he suspected that I was hoarding. What an utterly ridiculous situation! Penalised for infections provoked by the drug!

[Rugger in reply to SheffieldJane]

Wait and see!

[HeronNS in reply to Rugger]

Well done you!

[HeronNS in reply to bussell]

That is all I've ever had. Pharmacy always dispenses prescription into a small bottle (which means I don't know expiry date), and before pandemic allowed me to reuse. Must ask them if I can start reusing again. We do have plastics recycling, but that's up to us, not the pharmacy, and I don't know if everything we put into recycling bin actually gets recycled, doubt it actually.

[Hidden in reply to bussell]

This is why it’s being changed, plus it’s quicker on the packaging line, it’s happening in many medication formats within all sectors POM OTC and even SPECIALS (bespoke) meds. . I used to work at the Royal Pharmaceutical Society of GB selling drug companies advertising space in the weekly pharmacists magazine used to inform and influence pharmacists prescribing knowledge and habits. The main issue is that pharmacists are so overworked the drug companies find it hard to communicate changes to them and it’s often only when the patients point something out that they make the effort to find out. It’s no different from getting your local store to stock your favourite brand of bread for example, once they know they are usually happy to help, especially the independents.

[bussell in reply to Hidden]

Well, it's good to know that. I've got a bit of a bee in my bonnet about the millions of blister packs that must end up in landfill every year and big pharma seemingly totally unconcerned. Let's hope they soon go the same way as plastic straws, single use coffee cups. etc (blister packs, that is, not pharma companies!)

[Bcol in reply to bussell]

We recycle all ours, not in a Superdrug store but their pharmacy which is in Savers.

[SheffieldJane in reply to Hidden]

It’s a little more vital as there are often very sound reasons that you need a particular drug in a particular form and not obtaining this may have significant health implications. We are not just being a nuisance. Why are pharmacists over worked?

[Hidden in reply to SheffieldJane]

I didn’t infer any thing else. The analogy is to illustrate that pharmacies are businesses with targets and budgets like any retail outlet. Pharmacists are busier as more time is needed at the counter for advice due to restricted access to GPs and the move within surgeries to save money by prescribing changes.

Many smaller independents do not have tech investment so the move back to bottles which means manual onsite dispensing takes more time.

[SheffieldJane in reply to Hidden]

I didn’t mean to cause offence when I was venting about an obstructive sales assistant at my pharmacy. It seemed odd to be sent from Boots to a small private pharmacy so that they could go above and beyond to source coated Pred.

[Hidden in reply to SheffieldJane]

It’s so frustrating I know and I wish the GMC and RPSGB would collaborate on the prescribing front but I think that’s a pipe dream.

[Songbird69]

Thank you so much. To be forewarned is to be forearmed! I did notice that my current packs all expire at the end of February and knew something strange was going on.

[Floridafan in reply to Songbird69]

Are you sure they expire February, mine expire end of April 2022 and always have done for the last 18 months? 😀

[Songbird69 in reply to Floridafan]

Sorry! I meant April. What is wrong with me?!! Sorry for confusion …

[Floridafan in reply to Songbird69]

No need to apologise, I just thought you might have been going to throw them away when there was still time to use them 😀

[Ana-16]

Thank you for this. My chemist had problems finding the 1mg tablets then after a few days came along with the container as you have described. 100 x 1mg enteric coated tablets. Much to my relief

[MrsNails]

Well Done Kendrew - l will ask Fran_Benson to Pin this Post. Thanks MrsN

[Abcd123455]

Thanks for this, have a bit left still but have copied the ordering details in case I need them when next prescription is due.

[Hidden]

Excellent work!

[Pollyanna16]

Well done Kendrew, I am going to the pharmacy today armed with your info. They were looking into the shortage last week. This is an independent business who are normally very helpful, fingers crossed!

[Jackoh]

Well done Kendrew. Our NHS services and associated services are now becoming more DIY! Xx

[Floridafan]

Collected mine yesterday. As my prescription was for 120 tablets they had to open a second bottle to make up the difference. Strangely on Tuesday the chemist said there was no stock so I went to the other chemist up the road and they ordered them for me. They arrived the next day so I had to go to the original chemist to collect the doctors prescription to take to the second chemist but discovered it had already been made up. Both chemists had had a delivery that morning….ooops! So they are available folks!! 😀

[MrsNails in reply to Floridafan]

Maybe explain to the Surgery they are being issued in 100’s now so they can adjust your ‘script……

[Viv54]

Good for you, looks like the old saying { If its not on the shelf ] x🙄😜

[MrsNails]

Thanks again Kendrew - l have added this under Prednisolone in FAQ’s

[Kendrew in reply to MrsNails]

I hope it reassures anyone who was panicking at the prospect of not being able to acquire these gr tabs anymore. I'm very disappointed in my village pharmacy, particularly as the manager of the store categorically insisted that they were no longer available and wouldn't be in the future, and that there were no other suppliers.....as we now know, there are three suppliers in total!!Most important thing is that we now have some clarification on the matter.

[Singr]

Thank you for that. Are you in the UK? I asked my GP if I could have the gr ones and stop taking omeprasole. she told me they don’t exist. Wondering if I should approach my GP with this info.

[MrsNails in reply to Singr]

The majority of us are in the U.K. as is Kendrew so if you are too - you can show your GPMost GP’s prescribe prednisolone for short course eg Asthma so they simply use the plain ones as they are looking for a more immediate effect.

Regards

MrsN

[Kendrew in reply to Singr]

Yes, I'm in UK and your GP is definitely wrong. People have already been receiving the gr 1mg pred in the new format.

The Commercial Director of Phoenix Labs explained that when trying to order 1mg gr pred, (using the old PIP number) it shows up on the system as 'out of stock' ' no stock' or 'discontinued'.... because that version in the blister packs is now indeed all of those things. However, there is a new PIP number for ordering the new version that's replaced the blister packs (as seen in my original post) and all wholesalers were informed of this by email in February. Clearly some don't read all their emails!

[Singr in reply to Kendrew]

This makes me furious. I feel I’ve been unnecessarily forced to take omeprasole when I didn’t need to. I need to get armed with all the right information and write into GP because they are only taking emergency calls at the moment. Where can I get clued up and armed with the correct info?

[Kendrew in reply to Singr]

Well I could find no information online which is why I rang the supplier and spoke to their commercial director.See my original al post for more details.

[Highlandtiger in reply to Singr]

From memory I think you may live in Scotland although I could be wrong...? I get them in the Highlands so it's not as if it's an NHS Scotland issue.

[Singr in reply to Highlandtiger]

Good to hear that though. Why would they say to me they don’t exist in the UK?

[Highlandtiger in reply to Singr]

No idea. My pharmacist once told me that GPs "try and get away with only prescribing the plain ones if they can"...

[Kendrew in reply to Singr]

I think it's also to do with what the Commercial Director of Phoenix Labs explained to me...as far as the pharmacists are concerned, their system is telling them 'discontinued'. The old format of a blister pack IS discontinued, but not the actual gr tablets themselves......they are now very much available in a new format (bottles/pots of 100) but require a different PIP number to show up on the system for ordering!

[Highlandtiger in reply to Kendrew]

It just gives us all something new to stress about every 18 months or so…🤦🏻‍♀️

[Kendrew in reply to Highlandtiger]

And here they are...living proof!!

1mg gr pred

[Highlandtiger in reply to Kendrew]

Funnily enough I’d just taken a pic of mine to post too but you beat me to it! Great minds!

[Kendrew in reply to Highlandtiger]

😄😄😄

[PMRpro Ambassador in reply to Singr]

The gastro-resistant formulation ONLY exists in the UK, nowhere else. And all denominations are available now. 1mg gr has only been available since 2016 when they were trialed to see if it was worth their while. It obviously was since the company later sold the rights to Phoenix. They appear to make one large batch to last for about 18 months judging by the expiry date. It is setting a run up that costs in manufacturing and 1mg is used a lot less than 2.5 and 5mg so they aren't running them continuously. But they do seem to be being pretty good so far.

I do wish people wouldn't assert things don't exist when a simple google search would have found our information about it.

[Bobbury]

In response to all the comments regarding pharmacists and attitude and service. I use the pharmacist connect to the doctor's surgery. I have the same repeat prescription that I have had for the last ten years. I guarantee that every repeat prescription I collect is wrong! I have to check the contents before I leave and when (as always) the prescription is incorrect or just not included, I inform whoever it is at the counter that the prescription is incorrect, they look at me like iv'e got two heads. The response is " we'll have to make it up or can come back tomorrow or we've run out it will be in the next two days!!! Really how difficult can it be?

[MrsNails in reply to Bobbury]

Well that needs reporting the the Surgery Practice Manager as well as a Complaint to the Head of the Pharmacy - are they an independent? We’re all on the ball but not everyone is!….

[PMRpro Ambassador in reply to Bobbury]

I can accept the running out (sort of) - even happens at my pharmacy here but usually stuff will be in in the afternoon or next morning. But when people have to make a special journey to pick stuff up that they didn't get right it needs to be reported because SOMEONE isn't doing the job they are being paid for.

[Bobbury in reply to PMRpro]

I know you and Mrs Nails are absolutely correct. I need to be in the right frame of mind to deal with it!!!

[Telian in reply to Bobbury]

You could be describing the pharmacy next door to my GP surgery! I soon left them behind - it was no joke nearly everyone being served had a query of one sort or another and it was never their (pharmacy’s) fault. Then covid appeared and they ‘weren’t allowed’ to accept any more home delivery requests so I went elsewhere and it was the best move. Such a difference in service and always so courteous.

[Omanain]

Thank you very much for this. I will pass this information on to my doctor and local, well known, pharmacy.

[Kendrew in reply to Omanain]

Good luck 👍

[Omanain]

Sent a message to my doctor and spoke to our local Boots this morning. She was very pleased and using the codes you provided was able to order them. Thank you very much for doing this.

[Kendrew in reply to Omanain]

I'm so pleased that a successful outcome was reached...... one less thing for us all to worry about! 🙂