PMR confusion over drug timings

[Sukian]

Hi, I have PMR and been taking prednisolone for about a year, trying to reduce and now on 9mg daily.

I take Omeprazole in the early morning, before Pred. and then the calcium chew. I have seen on these posts recently that the calcium should not be taken near to the Pred as they do not react well with each other - is this right? also I have heard that Omeprazole should not be taken close to Pred. It is all so confusing.

Any advice please 🤞

[DorsetLady PMRGCAuk volunteer]

See this re Pred and Calcium-

healthunlocked.com/pmrgcauk...

Taking your omeprazole and Pred as you are sounds fine...

[Sukian in reply to DorsetLady]

thanks but now I know it’s not good to take the calcium chew close to the Pred I will change and have it later in the day x

[PMRpro Ambassador]

I don't think that taking the omeprazole and pred at the same time is a problem - a study said

"Concomitant administration of lansoprazole or omeprazole does not affect the absorption, biotransformation, or disposition of a single dose of prednisone. All three treatment regimens were well tolerated."

pubmed.ncbi.nlm.nih.gov/897...

However, taking calcium and pred at the same time does cause problems - the calcium seems to coat the outside of the pred tablets and interferes with the absorption in the stomach. Pred in the system also interferes with the absorption of calcium from the GI tract, This means it is better to separate taking pred and calcium by at least a couple of hours.

[Sukian in reply to PMRpro]

Thanks so much, I’ll carry on with Omeprazole in the morning just before Pred, but won’t have the calcium chew until much later in the day🙂

[BruceBee in reply to PMRpro]

Re. Your comment on calcium and Pred. My uncoated Pred. Label says; 'Take with food or milk'. I take my Pred with 4oz Almond milk each AM (225mg Cal.) Any issue here?

[PMRpro Ambassador in reply to BruceBee]

No, dietary calcium is different, it is supplements that are the problem.

[piglette]

It can be a bit of a nightmare not being able to take some tablets near other ones. I got to the point of having to take my antibiotics overnight recently! It sounds like you are doing the right thing though.

[Sukian in reply to piglette]

thanks, but it’s very interesting to hear that it’s not good to take calcium chews close to Pred. I had no idea, but will change straight away

[Grannymiaow]

I hadn't realised until very recently that we're not meant to take ANY calcium on the same day as AA.

I've been taking it incorrectly for two and a half years!

[PMRpro Ambassador in reply to Grannymiaow]

How were you taking it - it isn't NOT AT ALL on the same day, calcium shouldn't be taken WITHIN 4 HOURS OF TAKING AA but that's the sort of thing we say for pred as well, pred in the morning, calcium and vit D for lunch and dinner.

ouh.nhs.uk/patient-guide/le...

says "Take the calcium and vit D at the same time but not within 4 hours of taking the AA"

[Grannymiaow in reply to PMRpro]

After a comment from a friend who is taking AA (she doesn't have PMR), I checked with the local pharmacist, who said no calcium on the same day as AA.

[PMRpro Ambassador in reply to Grannymiaow]

To be honest - after some of the experiences I have had with pharmacists, I'll take Oxford University Hospital's version ...

[Grannymiaow in reply to PMRpro]

Will do!

[DorsetLady PMRGCAuk volunteer in reply to Grannymiaow]

I took both on same day for over 4 years - and didn't fall apart - just leave requisite time - as advised by PMRpro.

[tempusfugi in reply to DorsetLady]

Although I'm not taking AA, I was told that IF I do, I should not take Calcium on the same day (I hope it is not necessary for me to take AA, though my Rheumy isn't happy with that: DEXA scan said no further action, at the moment). Another friend who developed PMR was told by her medics not to take on the same day (she is following that advise, since she is taking AA). All most confusing🤔

[5031 in reply to Grannymiaow]

what is AA?

[Grannymiaow in reply to 5031]

Alendronic acid.

[herdysheep]

There seems to be a change of advice from the medics. I take enteric coated pred as I could not get on with the 'proles. Recently the boxes have had an addition to the label of not taking ppi within 2 hrs either side of Pred. ( I dont take ppi's) Nothing on the calcium tabs of course.