Prednisalone

[Alice70]

I feel in between the devil and the deep blue sea ,I am taking 12mg pred with awful side effects ,mainly with stomache and mood ,I've always had a dodgy stomache ,I am taking 40mg of pantoprazole plus peptac after meals ,also buscopan to stop the spasms in higher stomache,I feel as if I take anymore prednisalone jet I'm afraid to stop them as know the pain will come back, I don't know if there is an alternative to preds

[SnazzyD]

Do you mean you’ve always had a dodgy stomach since Pred or before Pred too? If before Pred, what was the medical verdict on that? Have you always taken Pantoprazole?

Personally, I found nothing stopped the stomach irritation and the Proton Pump Inhibitors made it worse so I had to have coated Pred which was a game changer. I also found high dose calcium supplements didn’t help the stomach and also over neutralisation of the stomach acid.

[Alice70 in reply to SnazzyD]

I've alway suffered indigestion before preds ,I'm just a person that makes a lot of acid never had diagnoses why ,I was on omoprazole for years on and off ,my gp swopped me to pantoprazole when I started taking preds ,I had heard there was a coated type of preds ,when I asked my gp about them the only answer I got was they are not as good, when you say it was a game changer for you did you mean your stomache was better on the coated ,thank you for answering me

[SnazzyD in reply to Alice70]

My stomach issues were so much better such that I could get away with a bit of nightly Gaviscon. I know Drs think enteric coated is not as good. I’ve seen one paper that said the peak blood levels weren’t as high as plain Pred. However, it wasn’t across the board and they still give it to some people. What I did find that it wasn’t as effective if I had it with a meal, especially a fatty one. Therefore I took it on am empty’s stomach 2 hours away from food. On the plus side as well, I found the effect of the Pred on my symptoms lasted 24 hours with the coated Pred instead of 18 on the plain. That may just be me. I guess it was because the coated absorption gives a slow up over 4-5 hours and a slow down instead of a spike of Pred after 1-2 hours and a quicker peak blood level.

You might suggest with the doctor that you have a trial with the coated perhaps.

Over the years I have found that it can be quite easy to get oneself into a mess with stomach acid. Too much of certain gastric meds can cause a rebound in acid. Just stopping a PPI can cause problems too. Too much anti acid can cause indigestion issues because the acidity is not enough.

[Bluey-1 in reply to SnazzyD]

I was given coated pred after the first taper from 60 to 40 mg. I found it easier to take and have had no stomach problems. I too find it lasts a long time. I never have any return of symptoms by the time I take the next day’s dose. It’s hoping you’re at ‘the sweet spot’ of correct dose to keep inflammation at bay. I take it first thing with a spoonful of Greek yoghurt.

[Alice70 in reply to Bluey-1]

I am going to ask GP for a trial of coated pred, thank you

[PMRpro Ambassador in reply to SnazzyD]

It isn't as high a peak - but it's like a humpbacked bridge instead of Blackpool Tower so it remains highish for a lot longer time. And for some people that extends the duration of effect which can be the difference between taking pred 1x daily or 2x. After all, it is to be hoped you need less than the starting dose - so in PMR the peak dose being lower shouldn't matter.

[Bluey-1 in reply to PMRpro]

Interesting

[Alice70 in reply to SnazzyD]

I've often wondered if I have a rebound effect from stomache meds ,I've also read that if you have B12 anemia you may not have enough stomach acid i do have b12 anemia,thank goodness I have had an oppintment to see stomache specialist on the 12th of this month

[PMRpro Ambassador]

If you have PMR and are in the UK, no there isn't. But it isn't clear from your previous posts what you have since RA has been mentioned. If it turns out you have RA then there is quite a range of medications that can be used.

As SnazzyD has suggested - getting enteric coated pred could well sort the stomach pain out.

[Alice70 in reply to PMRpro]

I should of wrote my story really ,when I saw rheaumatogist for first time Feb 7th 23 he diagnosed PLM ,my GP sent me back to see rheumatologist as he was convinced I had rheaumatiod arthritis ,I saw a different rheumatologist pretty quickly 13 April she diagnosed rheaumatiod arthritis, I should of asked did I have both but didn't, so not sure if I have both ,I am having more side effects that I mentioned in my post I.e constant mouth thrush swollen feet even though I take meds for these shake hands ,trying to keep stomach meds awy from other meds I feel as if I'm living in a nightmare ,(bit dramatic I no)what I will do tomorrow is get intouch with my gp and ask for the coated preds ,thank you for your answer much appreciated

[HeronNS in reply to Alice70]

Write down all your questions before your appointment. It really should be up to your medical people to make the connections and make sure you're being treated for the correct diagnosis, as well as taking into account pre-existing conditions, but too often they don't ask the patient enough clarifying questions, or they make assumptions. Good luck! And do let us know how you get on. 🍀

[Alice70 in reply to HeronNS]

I see stomache specialist on the 12th May, I will write down my questions thank you

[Grammy80]

I'm 82 and had bleeding ulcers at age 29 and then again, so I was concerned when I started on Prednisone. I take (States) Carafate or generic sucralfate three times a day and another tablet twice a day...can't think of the name but can get it if you like. I've had no stomach issues from pred these past three years. Sucralfate was the only med that would help. Can you get it over across the pond~? It has been around for years.💞

[Alice70 in reply to Grammy80]

I haven't heard of it ,I will google it thank you

[Seekingasolution]

I took the advice from the group about taking coated prednisolone and it made all the difference. Previously I had a pain in my stomach , was told by drs to double dose of omeprazole and pain increased in response. I think the PMR Pro referred me to a little known ( by drs!) page which pointed out that not everyone tolerates omeprezole well- and- that it is supposed to be a short term medication while other aggravating factors are resolved. I think drs try not to prescribe coated pred because it’s more expensive - but not if you don’t need so much omeprezole. I’m sure you have considered this before but is there anything that can help you regarding an ‘acid’ tummy ? Smaller, more frequent meals ? ( conflicting advice re fasting times these days but I found my tummy needed a little something to work on ) Anything else that might cause an irritation like trying to reduce coffee or alcohol ( very boring !), less carbs ? What triggers these attacks? After an endoscopy I was told that losing 6 kgs would relieve the pressure on my stomach internally and while it’s taken a year to do that and a change of lifestyle I’ve now managed to do that, and reduce the pred . It’s a bit of a fight to makes changes when you don’t feel well. Motivation can be low. Easier to stick to what you know but I hope you get it sorted.

[Alice70 in reply to Seekingasolution]

Thank you for reply ,I've never been able to drink coffee because of stomache ,luckily I have appointment with stomach specialist on the 12th may

[Doraflora]

hi Alice70. I guess you’ve already tried cutting out as much acid-containing foods as possible? Just a thought. I’m sorry you’re having such problems.

[Alice70 in reply to Doraflora]

Thank you ,such caring people on this community

[Omanain]

My acid problems are mostly fine now - coated pred and the odd dollop of Gaviscon. I take the coated pred at around 11pm before I go to bed, Oh and also buy calcium citrate which doesn't seem to affect my stomach the way calcium carbonate did. Good luck!

[Alice70 in reply to Omanain]

I'm defo going to ask GP for a trail of coated preds

[Ebiker]

As others have said long term omeprazole is not good. Doctors upped my daily dose from 10mg to 20mg and finally 40mg after other medications gave me problems. I took things into my own hands recently after an awful gastric infection. I take coated prednisone early morning with kefir and I am successfully slowly reducing the omeprazole but using liquid gaviscon if needed.

[Alice70 in reply to Ebiker]

Thank you I'm defo going to ask GP for a trail on coated preds

[Missus835]

I have to take 2 Rabeprazole 20 mg pills (every 12 hours approx.) now that the esophageal spasms have ramped up. It does seem to help, but those spasms are wicked. I too have a lot of stomach acid which may be GERD, at least that what the ppi's were originally prescribed for. I'm on 2 per day now to protect my stomach from the 30 mg. Pred I am currently taking. Long story.

[Alice70 in reply to Missus835]

It's awful when you get side effects from mrds that are supposed to be helping you

[DBE46]

My original issues were osteoarthritis. Prior to having my 2nd hip replaced I was taking Naproxin 4 times a day, covered well with Omeprazole. I was diagnosed with PMR in July 22. Hip replaced in Sept followed by a PMR flare. I have done the personal medication juggle we often find people go through. Now I take Naproxine morning still taking my Omeprazole. Down to 9mg Prednisolone enteric coated taken around 2am when I get up to the loo on an empty stomach fingers crossed this is all working for me. My osteoarthritis is most severe in my ankle and elbows and I really do need that Naproxine. I continue to wean 6 weekly, my life is very good at the moment.

PS I have never had non coats Prednisolone but that is probably because I was already taking Naproxine

[Alice70 in reply to DBE46]

Glad you are feeling good at the moment ,I have had such conflicting diagnoses from rheaumatogists plus side effect to meds I have felt upside down ,I'll get there in the end ,thank you

[ParoaPrimary]

Hello Alice.For your stomach problems i suggest you start taking Slippery Elm powder in water as a means to settle your stomach.It soothes the lining of the stomach and intestines, decreases inflammation and allows healing.It has no known severe interactions with drugs and should be drunk some minutes before a meal etc. I have used the powder for many years before getting PMR and found it most beneficial after a few days of use. Definitely worth a try and cheap too. Good luck !

[Alice70 in reply to ParoaPrimary]

Yes I will try it ,I'll see if I can get it on line thank you

[PMRpro Ambassador in reply to Alice70]

Actually, it is recommended that slippery elm not be taken together with other medications but at least an hour later or it can interfere with the absorption of the medications.

webmd.com/vitamins/ai/ingre...

[Alice70 in reply to PMRpro]

OK thanks

[ParoaPrimary in reply to PMRpro]

Thankyou PMRpro for this guidance, hadn't realised it affected absorption of medication.Still looks like could be a benefit if taken later, as you say.

[DorsetLady PMRGCAuk volunteer in reply to Alice70]

Please check it’s okay with your existing medication though.

[Alice70 in reply to DorsetLady]

Ok

[Pass7]

Try taking papaya enzyme. Marvelous results for my tummy always! Good luck

[Alice70 in reply to Pass7]

Thank you