enteric coated empty capsules

[darkred]

My pharmacist has never heard of enteric Prednisone. Where can I buy empty enteric capsules to put prednisone in.

[Kendrew]

Hi there darkred,

I am on prednisolone, NOT prednisone,

Others will correct me if I'm wrong, but I'm not aware of you being able to buy enteric capsules to "put prednisone in". My prednisolone tablets are actually manufactured with an enteric coating!

I am in the UK though so not familiar with pharmaceutical supplies out in the USA.

I have been taking them for 4yrs.

Instead of a small white 'powdery' looking tablet, enteric-coated tablets have an almost shiny, 'sugar-type coating' look to them.

Different doses come in different colours.

Eg:- 1mg - white

2½mg- brown

5mg- red

[DorsetLady PMRGCAuk volunteer in reply to Kendrew]

Not sure EC are available in US nor Canada -one member from there buys empty capsules online…

[Kendrew in reply to DorsetLady]

I had a feeling things were probably different there. I've not heard of you being able to purchase empty capsules before though.......every day's a school day!!😄

[DorsetLady PMRGCAuk volunteer in reply to Kendrew]

😊

[darkred in reply to Kendrew]

Thanks for taking the time to reply. Yes, it does seem that prednisolone (not prednisone) comes in enteric. Guess I have to move to UK in order to have a stomach that doesn't hurt. Thanks again.

[Lyndaki in reply to darkred]

It’s not necessarily the answer I’m afraid! Since my doctor suddenly gave me enteric coated pred, I’ve been having tummy problems! Seems my stomach may be reacting to the coating…so I’m trying to stick with the original ones I have by me.

[darkred in reply to Lyndaki]

That is interesting! Researching online, I found that one maker uses a type of phthalate included in the coating of a capsule. I'm not a chemist but that didn't sound good to me. Usually, it's a type of cellulose, I believe. Tonight I stuffed prednisone inside peas and then put in gelatin capsules I have on hand. They were 1 mg. tablets. This should give readers a good laugh.

[PMRpro Ambassador in reply to Lyndaki]

It could be the colouring - wash it off gently

[Lyndaki in reply to PMRpro]

Thanks!

[PMRpro Ambassador in reply to Kendrew]

PMRCanada buys capsules to put her plain pred into. enteric coated is a specifically UK thing.

[Kendrew in reply to PMRpro]

I hadn't realised that. I guess I'm pretty fortunate then.

[HamishPMR in reply to PMRpro]

Funny really PMRpro because it was Pfizer who introduced prednisolone in the UK as Deltacortril and Pfizer is definitely an US company.

[darkred in reply to HamishPMR]

Probably we can't answer why the UK gets prednisolone and, in the US, we get prednisone.

[DorsetLady PMRGCAuk volunteer in reply to darkred]

Don’t be so sure ….😊

[PMRpro Ambassador in reply to darkred]

Tradition I think. And what the NHS manages to negotiate with the drug companies/distributors. Oral prednisolone works faster than oral prednisone and is less strain on the liver because it doesn't have to be processed by the liver to become prednisolone which is the active substance, It is very unusual to find people on prednisone in the UK.

[darkred in reply to PMRpro]

So our USA livers are working harder than yours. Hmmm. I have to look into this. 😦

[PMRpro Ambassador in reply to darkred]

Possibly - probably doesn't matter unless you are on a LOT of liver-mediated drugs or have liver damage.

[moonieboy9358 in reply to darkred]

I am on the US and prednisolone is available in tablets and liquid here. I just googled it

[darkred in reply to moonieboy9358]

Thank you moonieboy. I must look into this and maybe ask my rheumy about it.

[Bachfugue in reply to PMRpro]

I’ve been doing the same. Works well as can take my dose at bed time and wake up pain free. I buy them through Amazon.

[DorsetLady PMRGCAuk volunteer]

Online - either from a pharmacy or the ubiquitous Am***n I believe….

[darkred in reply to DorsetLady]

Yes, I may have to try the ubiquitous [ ] not that I want to. I always like your humor.

[DorsetLady PMRGCAuk volunteer in reply to darkred]

Yours is still alive and kicking I see…. 😊..although it may be over optimistic if you’re considering a move across the pond for the sake of your stomach…..

[Sharitone]

I think one of the canadians may have bought empty capsules. It may have been HeronNS.

[DorsetLady PMRGCAuk volunteer in reply to Sharitone]

darkred

Just remembered - PMRCanada- post from 4 years ago -

healthunlocked.com/pmrgcauk...

[HeronNS in reply to Sharitone]

Not me! Yoghurt works for me. But I think DorsetLady is right.

[piglette]

Type in ‘empty pill capsule’ into Google and you will get all sorts, gelatine ones, vegan ones, colored ones. Even eBay do them as well as Am*z*n.

[HeronNS]

Make sure you include the word "enteric" in your search. Regular gelatine ones will dissolve in the stomach. Enteric coated ones don't release the dose until they reach the small intestine.

And it looks like there are many choices of places to buy! Good luck.

[Chockyuk]

Morning

I have gastro resistant ‘ Prednisolone’, enteric coated, I just checked the packet. I’m in the UK though. My GP didn’t want to originally give me the coated ones as they are MUCH more expensive for the NHS than the uncoated ones. But I have GERD and a hiatus hernia and the uncoated gives me terrible indigestion. The coated ones do work better for me, giving me less gastric problems. I hope that helps.

I didn’t know you could buy empty capsules to put tablets in, interesting 🤔

👍

[DorsetLady PMRGCAuk volunteer in reply to Chockyuk]

Not all the EC tablets are -most are similar price to plain-in fact 2.5mg are cheaper -it’s just the 1mg that are horrendously more expensive.

[Chockyuk in reply to DorsetLady]

Oh ok, I’m just going off what GP told me, she openly mentioned that they were told not to prescribe them because of the expense., mine were 5mg, I practically had to beg her!

[DorsetLady PMRGCAuk volunteer in reply to Chockyuk]

That seems to be an edict from many health authorities to GPs unfortunately -but once you add in PPIs alongside plain ones it’s often not the cheapest option.

[darkred in reply to Chockyuk]

Thanks, Chockyuk. I also have GERD and we do need to protect our stomach and esophagus. Cancer of the esophagus is no laughing matter. I bought things online to elevate the head of my bed (they go under the "legs" or casters ) and my headboard is about 8 inches off the floor. I'm lucky (maybe?) to be a night owl so my dinner is out of my stomach when I go to bed. I've now omitted my favorite foods (like a big bowl of Italian spaghetti with red sauce). I try to avoid pain killers like naproxen, although it's very effective for arthritis. Not everyone wants to have surgery but my hip surgeries have been a godsend, so I seldom have a need for NSAIDS like ibuprofen. (I'm blessed to have found a very experienced ortho surgeon!) But, I digress...sorry.

My point is that some of us can tolerate the stomach effects of prednisone more than others, even though we take with food , with cheese, with yoghurt, etc. Of course, the stomach effects are dose dependent, too, so as I lower the dose (fingers crossed), my stomach may be happier.

Chockyuk, even though the coated ones are more expensive, your stomach thanks you!!!

[Chockyuk in reply to darkred]

Oh yes definitely, the pain I experienced with GERD (and I also had gallstones, which were eventually removed, but the GERD was still there) was on a par with giving birth, I kid you not 😂. I eventually saw a gastroenterologist and had the tube down my throat procedure and he found lots of ulcers on the esophagus and then prescribed Omeprazol. I actually have RA, not PMR, and when I was prescribed Pred I was so happy to be out of pain, then a few days later the GERD kicked in, even with the PPI. have since used Kefir, that seems to soothe it, and gave up acidic drinks, alcohol etc, and now I’m on Methotrexate and Sulphasalazine I haven’t taken Pred for a while. When I have my flares my Rheumatologist gives me a Depo injection, which is much better for me anyway than oral Pred, as it bypasses the stomach and is just absorbed into the body; but I do understand PMR is different as two of my friends have it and have been on daily Pred for years. It’s a minefield isn’t it 😖

[darkred in reply to Chockyuk]

Good suggestion about the kefir. Will buy some again. Lansoprazole does not seem to agree with me. While many complain of diarrhea, it's enlightening that the opposite effect can occur, which I found hard to accept, given the many complaints of diarrhea. If possible, solving things through natural means seems the way to go for many of us. I must make better efforts to stay hydrated!

[Viola1]

I buy gastric resistant vegan empty capsules from Amazon and take my prednisone at 11 pm. I feel less side effects such as jitteriness that way.

[darkred in reply to Viola1]

Sounds like you have received some effective gastric resistant capsules! Happy for you, as jitteriness or any other pred side effect can be discouraging.

[PMRCanada]

Sorry for the late reply.

Here is the link to the Capsuline website where I purchase empty vegetarian capsules that are acid resistant, size “0”, 1000 capsules per bag.

capsuline.com/

I split my pred dose and started utilizing the empty capsules that I stuff uncoated pred tablets into not because of stomach issues, rather because I was finding it difficult to wake up at 2am to take one of my doses before the cytokines arrive at 4am. This also alleviated the morning stiffness I was experiencing. So now I take part of my dose at 11pm (which is on board by 2am), and my other dose at 11am (plain uncoated pred with food). Works really well for me!

Here is a picture of the back of the bag of capsules I purchase. All the best.

back of blue plastic bag

[darkred in reply to PMRCanada]

Thank you!!! I found these online yesterday and considered ordering them because this product seems to be "the real thing" as far as preventing gastric pain from a med such as prednisone. (I found some negative reviews about other capsules at the "ubiquitous" [...] online dealer.) I truly appreciate your much -needed evaluation of capsuline, which seems to back up my assessment of the product. Oh, how I appreciate this forum, where "those who've been there" offer insights and experience one cannot get in a visit to the doctor. 👍

[Bachfugue in reply to PMRCanada]

They work well for me too 😍

[Yorksman]

Interesting discussion - are the empty capsules to avoid taking a PPI such as Omeprazole? Does it make any difference to its effectivity if the Pred is absorbed in the stomach or the intestine?

Also does taking Pred with yogurt really work? How much yogurt does it need to protect the stomach given that people are on different size doses?

[PMRpro Ambassador in reply to Yorksman]

Not only - and no, enteric coated pred is absorbed in the lower part of the gut where the pH is higher, not so acid. Some doctors claim it doesn't work as well - I used it for a few years and it was fine. It also takes longer to get into the system as it must first pass through the stomach.

The capsules also delay the pred being absorbed in the same way as a formulation of pred called Lodotra - it has a specially formulated coating which, in the right conditions in the stomach, takes 4 hours to break down so you take it at 10pm before bed and it releases at 2pm which is the optimum time to take prednisone for the best management of the inflammatory substances released in the body about 4am.

[Yorksman in reply to PMRpro]

Thanks for prompt reply and information. What is meant by 'formulation of Pred called Lodotra'? I've searched for Lodotra and it seems to be associated with Prednisone and not with Prednisolone which I take. Also any thoughts regarding my query about yoghurt and its effectiveness?

[PMRpro Ambassador in reply to Yorksman]

Formulation is the way it is made/presented. It is one form of prednisone. developed and made in Germany. Prednisone and prednisolone are dose equivalent, same dose for both, and prednisone must be processed in the liver to form prednisolone which is the active form. Some countries use one, some the other,

Plenty of others say that yoghurt works to avoid stomach problems - I don;t know, never had a problem, or a PPI!

[Viola1 in reply to PMRpro]

I am taking naproxen along with prednisone to get maximum pain relief. I have been taking prednisone in gastric resistant capsules, and wonder if I should do the same with naproxen to protect my stomach. I am not on a PPI.

[PMRpro Ambassador in reply to Viola1]

You maybe ought to - it is an NSAID and not good to mix with pred.

However; Naproxen usually does zilch for PMR - IS it helping? If so, the doctor should maybe rethink his diagnosis.

[Viola1 in reply to PMRpro]

The combination of naproxen and increased prednisone is giving me the best mobility and pain relief from shoulder, hip, and carpal tunnel pain, but not complete relief yet. I increased from 6 mg pred to 7 yesterday and today and today is a bit better. I have an appointment with my rheumatologist next week and will advocate for diagnostic help.

[darkred in reply to Yorksman]

Maybe you and everyone else already knows this but....Lodotra is not available in the United States.

[PMRpro Ambassador in reply to darkred]

It was - at a price!!!! But it isn't the gastroresistant form. It is delayed release, still in the stomach.

[PMRpro Ambassador in reply to darkred]

Yes, sorry, forgot to mention it has a different name in the USA as Sofarbrnun says

[Sofarbrnun]

I'm in the U.S. and I had a script for Rayos. It's the same as Ladotra, I think. Some insurances will pay for it, but copay will be high. It was easier on my stomach. The only problem is, if you need to reduce your pred, you cannot cut them into. It gets tricky after a while.