Pred - mix on tablets?

[Hopingsail]

I'm just looking forward to starting next reduction which will be 5 > 4.5. Order placed at Pharmacy a week ago - some some tabs at 1mg and 2.5 mg. A friend has been to collect as I have the wretched Covid.

She has reported that they have given her 1mg in plain tabs (as usual) but 2.5 tabs are COATED. This has not been discussed with me. I recall from the Forum that thay have different release times - will this be problem? I normally take my pred at bedtime (10pm). Do the 2.5mg only come in coated?

(Other meds are simply missing!! Namely Fosinopril (for BP) and Adcal.)

[SheffieldJane]

I think my Entric coated 5 mg Pred tablets take 4-6 hours to enter my system and I take them at bedtime which seems to work. My next taper from 5 mgs, will be half a 1 mg uncoated tablet, as it must be to cut in half and as you know, we can’t get them coated anymore. I think I will take uncoated tablets first thing in the morning and the 2.5mg coated at bedtime and see how I go. This of course will blow my pharmacist’s mind, judging by my past experiences with her.

I assume the missing medication is an error?

If only they acknowledged how stressful messing with our meds is, ie as people with chronic conditions.

[piglette]

It seems there is a shortage of enteric coated 1mg. Not that long ago they did not exist at all!

[Bluey-1 in reply to piglette]

My pharmacy procured a box of them within a day of ordering.

[DorsetLady PMRGCAuk volunteer]

2.5mg come in coated (gastro resistant) and uncoated -so would guess either a manufacturing and/ or supplier issue or cost.

Ironically 2.5mg GR ones are cheaper than plain- most others sizes are other way round.

Yes, GR tablets go take longer to get into system -but as you take them at night it may not be much of a problem.

Never took tablets at night nor GR ones so don’t know but someone will.

You do need to chase up rest of script though….

PS -sorry about Covid.

[PMRpro Ambassador]

If you take them at bedtime anyway it probably won't matter. If it doesn't work - have you got plain 5mg tablets left? Get a pill cutter. If you take enteric coated pred at bedtime they will be in the system after about 4-5 hours, nicely in time for the morning dose of inflammation. The plain pred will get there quicker.

[Hopingsail in reply to PMRpro]

Thanks for that - I was just thinking that it might in fact just work nicely! As Sheffield Jane was commenting though, when your expected meds fail to turn up, or are not what you expect, panic mode sets in! I'm not immune to a bit of panic!

[PMRpro Ambassador in reply to Hopingsail]

My reaction tends to be "Oh sh^t" Mind you - it is a very rare problem here in dippy Italy - they do some things very very well!

[PMRnewbie2017]

Speak to the pharmacy!! Errors, shortages who knows. Only once fully appraised can you make some decisions. On a clinical matter, you're not going to reduce while you have Covid are you?

[Hopingsail in reply to PMRnewbie2017]

Thanks for the warning - but no such intention! I use Dorset Lady's Slow Taper but pause at particular stress or ache for as long as it takes- it seems to work well for me.

[Suet3942]

My 2.5 pred face always been coated and the 1mg unvisited. Never found a problem taking them together. I’m currently doing a slow taper to 3.5

[Cfmad298601]

I’ve been given the coated 2.5 too, I didn’t ask for them neither did the drs mention they had put them on the prescription. I’ve been cutting them as I’m starting to taper again, after having a nasty cold, but also assume as I’m exposing the inner they will act similar to the plain ones?

[PMRpro Ambassador in reply to Cfmad298601]

Yes - you lose the USP of the enteric coated version, it usually upsets the stomach less. But because the outer coating is broken, the pred inside is exposed to the gastric acid and absorbed in the stomach instead of passing though unchanged and then absorbed in the less acidic duodenum.