empty capsule cases

[lennysmummy]

Hi, I’m prone to gastric problems and just had a stomach ulcer heal but now I’m on Prednisolone I’m finding they are irritating my stomach to how it was before. I take them with food. I am getting no joy asking for the coated ones do was wondering whether to just buy empty capsule cases and put them in those. Also because they are mainly 5mg and 2.5mg what size capsule would you recommend? 🙏

[SnazzyD]

Have you given up on the Omeprazole now?

[lennysmummy in reply to SnazzyD]

No but for some reason although they have always helped, they seem to be doing absolutely nothing. I’ve never been able to take aspirin or any tablets classed as … minds gone blank again, eg diclofenic, naproxen. Just think the gelatin capsules might be kinder on the stomach.

[lennysmummy in reply to lennysmummy]

nsaids. That’s the word. 🙈

[PMRpro Ambassador]

You need gastric resistant ones really - not just simple gelatine. It's an online search ... There are a couple of people who do it;

[LIVEORDIEHEREIAM in reply to PMRpro]

PMRPro, were you referring to gastric resistant empty capsules? That could a game-changer!🤞

[PMRpro Ambassador in reply to LIVEORDIEHEREIAM]

PMRCanada uses them I think

[PMRCanada in reply to PMRpro]

Yes, I use enteric coated empty capsules, size “0”. I purchase them online from a company called Capsuline (1000 at a time). I split my dose and was tired of getting up at 2am each evening that’s why I started using them for my evening dose (my morning dose is uncoated pred tablets with food). My evening dose using the capsules is taken around 11pm to be onboard by around 2-3am. Works a charm!

[PMRpro Ambassador in reply to LIVEORDIEHEREIAM]

Have you seen PMRCanada's reply?

[lennysmummy in reply to PMRpro]

yes just seen it. Thank you.

[LIVEORDIEHEREIAM in reply to PMRpro]

Yes. Thank for pointing that out, PMRPro!

[PMRpro Ambassador in reply to LIVEORDIEHEREIAM]

HU is a bit useless about notifications for these conversations within a thread! I always check.

[Bluey-1]

Really push for enteric coated ones. I was prescribed gastric resistant ones by my rheumi at diagnosis and had to press hard to the prescribing nurse for these to continue via my GP. My GP was ok prescribing them. They’ve helped me. At least gastric problems are a side effect I’ve avoided.

[lennysmummy in reply to Bluey-1]

Yes I will push for them. Thank you. 🙏

[Blossom20]

Yes, your gp should prescribe them. I take them. At first my gp said they don't make any difference, and they don't make them in the potency i needed...but then he agreed!

[lennysmummy in reply to Blossom20]

yes I will probably have a battle! 😏

[PMRpro Ambassador in reply to Blossom20]

What dose don't they make?

[Blossom20 in reply to Blossom20]

It wasn't true. He was just trying to put me off. He then looked it up and found they did make them...

[Yellow-dog]

I also find the usual steroid tablets give me stomach problems. I have asked for the gastric coated ones and my doctor said it made no difference, obviously it does or why would they make them.

I have managed to get my prescription changed for the 5mg tablets but cannot seem to get the 1 mg ones. Does anyone know why doctors are so reluctant to prescribe them? Are they more expensive?

[DorsetLady PMRGCAuk volunteer in reply to Yellow-dog]

Some are more expensive if you look at the cost per packet -but not all -seems to vary according dosage (so presumably amount manufactured).

But if you factor in aPPI plus a plain Pred it’s as expensive or more than a GR one!

[PMRpro Ambassador in reply to Yellow-dog]

There was a study comparing them against plain pred and there wasn't a real difference, although possibly they didn't work as well for the purpose. HOWEVER- it was a particular purpose in patients with a lower GI disorder where someone thought the fact the enteric coated don't release until lower down the gut might improve the effect. OTOH - they appeared not to consider the fact that GI disorders MIGHT impair the absorption. DOH ... They DO make a difference for patients with gastric problems.

[AshPen9 in reply to Yellow-dog]

Yes, Yellowdog, the 1mg tablets are much more expensive than the 5mg and 2.5mg ones. They're around £30 for 100. My GP says they're blacklisted due to that, but she has prescribed them for me. She's the only one though, no-one else at the practice will let me have them. Good luck!

[DorsetLady PMRGCAuk volunteer in reply to AshPen9]

2.5mg/5mg are about £5 for same amount…so you can understand why they are reluctant to prescribe.

As I said earlier, not so many 1mgs GR manufactured

[AshPen9 in reply to DorsetLady]

It's never straightforward geeting hold of them DL. I ended up speaking to Phoenix in Ireland just before Christmas (I think it was you who gave me their contact details some time ago?). I managed to get a prescription. I thought that was the difficult part over with, but then every chemist I tried said that they couldn't obtain them. Phoenix said that they were definitely supplying them to the wholesalers. Eventually Boots said that there was a note on their system saying that they would be available in a couple of days, and they got them for me. It must have been some sort of distribution hiccup.

[DorsetLady PMRGCAuk volunteer in reply to AshPen9]

Yes I think it was me .. and disruption maybe that why the price has shot up. this subject comes up quite often, so I have checked prices from time to time, over the years, and they never used to be this high...😲

[AshPen9 in reply to DorsetLady]

Yes, I have only been having the 1mg tablets for a year or so, and they were definitely quite a bit cheaper the first time I looked for the price. On occasion rather than use four of them I have had a 2.5mg and a 1mg and have then popped half an uncoated 1mg into an empty capsule! That way I don't have to ask the GP quite so often.

[DorsetLady PMRGCAuk volunteer in reply to AshPen9]

Think lot's do that anyway...and 1/2 a 1mg tab is probably not causing much issue ...but it would be better to have the correct meds.

[Groovykindoflove1992]

I was on Lansoprozole, and when I was given an NSAID whilst still on pred, (one called Celebrex), I was told to double the dose to protect my stomach.

[Zappata]

I was allergic to some pred brands so maybe ask the doctor or pharmacist if you could try another brand. They do not all contain the same ingredients and when I was first prescribed it I had 3 months of pain and diarrhea (extreme pain and going to loo 15 times a day) thought I would die until my daughter suggested asking the chemist for a different brand. Can't remember now what the ingredient was but within a week of switching I was fine

[lennysmummy in reply to Zappata]

Thank you. I didn’t know that. 😩