predisolone

[Bedwell]

what is the difference between coated and incubated predisoline? How can I tell what I’ve got?!?!

[Bedwell]

uncoated!

[DorsetLady PMRGCAuk volunteer]

Uncoated are usually plain white and have a line across them.

Coated ones should have Gastro resistant or enteric coated written on box [ see photo] and are usually coloured - and cannot be cut.

Should also say on prescription form.

plain ones get into your system quicker an hour or so, GR take longer as the entire tablet passes through to lower down the GI tract and then it breaks down in the slightly alkaline conditions of the duodenum.

Ec pred

[Bedwell in reply to DorsetLady]

oh thanks so much. But is one better than the other? Or doesn’t matter? I’ve obviously got uncoated.. plain white with line across.

[DorsetLady PMRGCAuk volunteer in reply to Bedwell]

Depends, some patients suffer with reflex or gastrointestinal issues - if so, the coated ones may be issued. But it’s usually the pain ones …. Along with a PPI like Omeprazole or similar….

[Koalajane in reply to DorsetLady]

I am on uncoated but was never offered a stomach protector.

I always take my pred with my breakfast and after 6 years have had no problem .

[Bedwell in reply to Koalajane]

yes I take mine with breakfast and kefir! I tried omeprazole but didn’t like it. The kefir helps digestion and I also have a herbal option.

[musclesinflamed in reply to DorsetLady]

I'm a bit confused. I thought the Prednisone took longer, like a couple hours, to have an effect as it had to be processed by the liver. I thought that it was the Prednisolone that worked faster. Now it seems that it's almost the other way around and that the Prednisolone encapsulation is mainly prescribed for those whose stomachs don't tolerate the Prednisone. Please clarify.

[DorsetLady PMRGCAuk volunteer in reply to musclesinflamed]

You are misunderstanding -and thinking about Prednisolone (normal in UK) versus Prednisone (others party of the world).

We are talking about plain uncoated tablets and gastro enteric or enteric tablets -both Prednisolone.

[herdysheep]

I started with plain ones, but PPI's upset my stomach. so switched to coated, and take them with banana and plain yoghurt. Problem solved. Some people can react to colouring agents used, but it is fine to wash that off first, if necessary.

[PMRpro Ambassador]

The main difference is how and where they are absorbed - plain white in the stomach within an hour of being taken, in the duodenum, the other side of the stomach, for e/c, and it takes about 4 hours for the tablet to get there before the coating breaks down in the less acidic environment, It takes about 5 hours to the peak in the blood which is generally lower than with plain white pred,

[Bedwell in reply to PMRpro]

thanks. Am still not quite sure what you are saying! Never had the coated ones… so which are really recommended?

Great to see an article in Saga magazine about pmr this month!!

[PMRpro Ambassador in reply to Bedwell]

Neither in particular - both do their job and if you are fine with plain ones, that's great, There are some specific places where the coated ones are useful but doctors are reluctant to prescribe them.

[musclesinflamed in reply to PMRpro]

I'm a bit confused. I thought the Prednisone took longer, like a couple hours, to have an effect as it had to be processed by the liver. I thought that it was the Prednisolone that worked faster. Now it seems that it's almost the other way around and that the Prednisolone encapsulation is mainly prescribed for those whose stomachs don't tolerate the Prednisone. Please clarify.

[PMRpro Ambassador in reply to musclesinflamed]

Exactly - there are differnet formulations. Plain white prednisolone is absorbed immediately and is in the system in under an hour ready to work. Enteric coated pred resists the stomach acid and the coating is not broken down until it reaches a much more alkaline pH environment in the duodenum, As DL has said, the vast majority of patients in the UK are on the plain white uncoated version, It still doesn't have to be processed by the liver, once it is absorbed it is ready to go.

There is also a version of prednisone with a coating - but it is designed to break down 4 hours after taking it with some food. This is to allow for release at 2am without waking in the middle of the night - 2am being the optimim time to take prednisone for relief of morning symptoms.

[musclesinflamed in reply to PMRpro]

Thanks for the clarification. In the final sentence of the 1st paragraph of your reply, did you mean, "it still doesn't need to be processed by the liver..." or it still does...?

[PMRpro Ambassador in reply to musclesinflamed]

Prednisolone doesn't have to be processed by the liver whether it is the plain variety or the enteric coated.

[DorsetLady PMRGCAuk volunteer in reply to Bedwell]

Unless you have GI issues, then plain ones are perfectly okay - and probably the majority of people are on them...

[Bedwell in reply to DorsetLady]

thanks all!!

[Purplegloss]

I opened my new pack of 1mg Pred this morning, only to find that they are white and shiny with no line across, however it doesn't say enteric on the box or paperwork!! Not a problem at the moment, as I don't need to cut them in half-I am on 3.5mg so take a 2.5mg and a 1mg.

[Bedwell in reply to Purplegloss]

no idea what to say! Sorry!

[PMRpro Ambassador in reply to Purplegloss]

What manufacturer?

[Purplegloss in reply to PMRpro]

Strides Pharma UK Ltd

[PMRpro Ambassador in reply to Purplegloss]

medicines.org.uk/emc/files/...

The description of the tablets is on the last page, right at the end

[Purplegloss in reply to PMRpro]

Thanks for looking it up for me, they are definitely convex, and not flat with a line across like my other ones.

[PMRpro Ambassador in reply to Purplegloss]

I think many are convex - and they are relatively easy to break in half: place them in a hard surface and press firmly with your thumbs on opposite sides. They will generally snap neatly.

[Purplegloss in reply to PMRpro]

OK thanks