Hi all,
A quick question please. I am currently down to 1.5mg pred & I spoke with my GP about reducing the dose of Lanzoprazole to 15mg & eventually coming off them. She’s given me the 15mg Lanzoprazole along with enteric coated 1mg pred. (I’ve never had these before) It says on the leaflet inside that you can take these pred tablets before or after a meal. Does this mean I don’t need the Lanzoprazole now?
Thanks!
No! You must come off them slowly in order to avoid rebound acid production.
Here is a nice clear schedule at the bottom of this information sheet
covwarkformulary.nhs.uk/doc...
Regards the enteric coated Pred, I trust they told you that it takes longer for the peak blood level to occur. It is more like 4-5 hours rather than 1-2 to for uncoated.
Snazzy has already explained tapering the PPI,
I appreciate the idea of the e/c pred but since you can't cut them, how would you do a 1.5mg dose without normal pred? I didn't know that you could get e/c pred anywhere but the UK - are you sure they are e/c and not Lodotra which are delayed release, also can't be cut and still release in the stomach?
Strange this as the GP knew I was on 1.5 a day, & the packaging says take that dose daily!🤔 But I’ve checked the package & I may have got it wrong….it says gastro-resistant…is that different? The chemist label says 1mg EC pred. And this is from a U.K. chemist because I can only get 2.5 in Spain 🙄
Oh right - yes, same thing. That's what I did when I was frequently in the UK until I got a dodgy batch of 5mg enteric coated/gastro-resistant and had to switch to what was available here. Methyl pred at the time and it was awful!
Might need a bit of juggling or use one of the slowed tapers to get to 1mg with the odd 2mg dose on the way.
You will be limited to 1mg or 2mg with enteric coated. Perhaps you should ask for some uncoated tablets? Pity she did not give you the enteric tablets earlier!
I have enteric coated prednisolone but have now reached the stage where I need to take a half of one m.g. to add into to my new dose on the DSNS (Dead Slow Nearly Stop) regime.
Obviously, I cannot halve an enteric coated pill, so have asked my GP for a supply of one m.g. plain prednisolone. I halve the one m.g. and take it with the enteric coated pills. I have not had any problems so far (several months).
I was taking Lansoprazole when on a high dose of ordinary prednisolone but it disagreed with me (swallowing and oesophageal issues), hence I was switched to enteric coated, losing the Lansoprazole. I trust that taking half an m.g. of ordinary pred for a relatively short amount of time (I will soon reduce back to a round number of pred) will be OK. I did run this past a GP but it was a very quick telephone consultation. She didn't advise me not to do this which is why I presume it will be OK......!
What dose are you at? e/c pred comes in 5, 2.5 and 1mg tablets, down to 2mg you can combine the 3 doses to get 1/2mg steps. Below that, the use of cut 1mg tablets is usually such a small dose that it's fine.
If not, the DSNS taper was partly developed for patients on e/c pred where at the time there was no 1mg option. if you repeat each stage a few times before proceeding to the next, most people managed to reduce in 2.5mg steps.
Hi PMRpro and thank you for your reply.
I am on the second round of reducing from 6 to 5.5 mg of prednisolone . I had an issue with a shoulder and arm, exactly (but not to the same degree) as when diagnosed with PMR some 21 months ago. I was puzzled as the pain/stiffness was not bilateral. I thought I would try carrying on and not treat it as a flare and I may have been fortunate as it is only late at night that I have any problem and that is minor. I hope to carry on and if I feel any twinges by the end of this round, I will repeat it for a third time. After that I will treat it as a flare!
One of the reasons I asked for 1 m g. ordinary pred tablets is that I had several packets of 5 m.g.* pred and wanted to use them up before they ran out of date. I am trying to do my miniscule bit for the NHS!
I have almost exhausted these and will then request 2.5 tablets if I require any halves.
I also have a stock if 1 m.g. enteric coated pills that are produced in the most irritating packaging known to man! I find it impossible to open (small stubby plastic child, nay, human-locked container) and reluctantly have to ask for a strong man to help. Perhaps it's not all bad...
*I had 5m.g. prednisolone prescribed for another illness.
If you are on a half dose above 1.5mg - and concerned about taking plain tablets you can mix and match 1mg and 2.5mg EC tablets, provided GP will prescribe…
You will, of course have the same issue once you get to 1,5mg & 0. 5mg…..
Hi Dorset Lady
Many thanks for your kind reply.
I have replied to PMRpro (and Gawd bless the pair of you for taking time to help 'PMR people', every day) and I will indeed request 2.5 m.g. pred when my stash of pred is exhausted. I am currently reducing from 6 to 5.5 m.g. 21 months in now but taking it very slowly (from 20 m.g.).
I was very silly during the past few months and have not kept an eye on my carbohydrates as, of course, I should. As my clothes appear to have shrunk in the wash, I am now in the second week of being 'good' i.e. sensible. Already there is a small reward: my trousers are looking a little less like leggings, so I shall keep on going!
Those washing machines have a lot to answer for! 😊
A very young pharmacist at our doctors group told me to halve the enteric coated Pred! Obviously I ignored it!
I have heard of pharmacists telling patients that both forms of pred absorb in the same time ...
Shortage of 1mg enteric coated Prednisolone?
Better results for pain relief with non-enteric coated prednisolone tablets?
Coated and. On Coated Prednisolone
COATED PREDNISOLONE 
