Just a short post. After a very long time cutting my one mg tablets in half I was telephoned by my surgery yesterday asking why I didn’t request half mg Pred? My rheumatologist had contacted the surgery to ask them to supply me with them. So, for those who struggle with all that fiddling about you don’t need to (in the UK at least) . Half mg Pred are available - just ask. 😊
Half mg tablets : Just a short post. After a very... - PMRGCAuk
Half mg tablets
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Janet57
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Yes, they are available but wickedly expensive compared to 1.0mg ones. £10.20/28 compared to £0.77/28.
bnf.nice.org.uk/drugs/predn...
I didn’t know that but have been offered them 😊
Then accept - but as I said, when the bean counters realise you can successfully cut the 1mg and get 56 tablets for 77p as compared to 28 for £10.20 they might object..😏
Except that the UK licensing authority would go mad if they knew that we were all breaking tablets in half, as they do not believe that there is uniformity of dose between the two halves. Manufacturers have to be really careful how they describe "breaklines" in the licensing documents and it is usually only allowed to break big tablets for people who cannot swallow the whole tablet in one go. So the bean counters at NICE might not have it all their own way.
Anyway, that is probably by the by, because we all know that we will carry on breaking them in half, since so many docs seem to find it difficult to understand that patients really do need to taper in very small amounts. 
I've been using the 2.5mg to get the half mg dose, and atm, I am trying to convince myself that the gastro resistant tablets work as well as the normal kind.
Good point… the difference in price is mind boggling- but again Pred is a heck of a lot cheaper than many drugs, so I doubt it makes a dent in the finances for NHS…
I don't know how they got away with the discrepancy in price tbh, as the price would have had to have been agreed before they were allowed to go on sale for prescription, unless it is to do with how many they sell, and economy of scale. The company must have good negotiators, is all I can think. They might not continue to get away with it when they come up for the next review. But I have come across plenty of other sneaky little pricing discrepancies during my career. I won't start giving examples, as I don't want to go any further off topic.
same reply further down --healthunlocked.com/pmrgcauk...
DorsetLadyPMRGCAuk volunteer
Please ask... but the surgery may do a quick intake of breath when they realise the cost - as Bcol has advised...
and let us know how you get on.. you could start an avalanche of requests... 😲
Had no idea 😱
As PMRpro has said... think they might be quite recent...
My pill cutter chops straight through in one go - no bother. Maybe Amazon where I get most things having been captured by them “Prime”.
My pill cutter uses a scalpel (OH) enjoy your holiday🤗
Can you recommend a pill cutter please. I've had 3 so far...none of which I've found to be particularly useful!
Sorry Kendrew, I will have done an Amazon search and bought the one with good reviews. Lucky fluke maybe. The blade looks like a razor blade.
I use the one that Dorset Lady recommends and it’s great. Use it at an angle so the pill fits snugly in the V and it works well. 😊
This brand has always worked for me - I’ve had the one on the left for years…
Pillcutter
Thankyou.
Pillmate Pillcutter from the pharmacist. 9 times out of 10 gives a neat cut!
PMRproAmbassador
Blowed if I can see why it is too much to cut a tablet!!! Being outside the UK I can't see BNF but pretty sure they weren't available in the past. They also cost a lot more than enteric coated tablets which they often refuse on grounds of cost.
I had no idea. I would have been happy to continue cutting the pills. I was thinking of those who have manual dexterity issues in particular. Shall I delete my post?
No don't delete it.... might be useful for others to see if they can get them prescribed...
No, not at all. Anyone can only ask! But given the fuss some practices make about enteric coated it will be interesting to see if they cough up with them. You only need them for under 2mg doses - you can get 2,5mg plain pred so down to 2mg there is no need to cut anyway. And under 2mg is often difficult.
That seems a bit OTT for non coated tablets. Looking at the price they are over 13 times more expensive if you compare 1mg to 1mg, that is over 26 times more expensive. Looks like a marketing ploy by the manufacturers. If they had done it for enteric coated that would make more sense as they cannot be cut.
Wonder what conditions they are used for? Obviously not PMR/GCA...
I thought that too. The suppliers must have seen some opening in the market for themselves. Perhaps there was something in a paper somewhere recommending a small dose and the suppliers leapt onto the band wagon!
Yes probably…..
Join the Cynics Society!!
Founders members aren’t we!
Absolutely 🤓🤪🥸
Lining already rich investors pockets - sorry is that too political?
Let’s not go there - try to keep to PMR. I’m now wishing I never started this thread 😱😂
Don’t worry… threads very often go off at a tangent - you asked a very valid question… and the replies will soon die down….
I've just tried to find them on the eMC website to see what indications are given on the SPC. Oddly, they aren't listed, or they did not come up in my search, at least.
I had a look yesterday for PIL and couldn’t find anything - and I’m sure they weren’t listed on BNF-NICE site when I first looked at a few years ago..
Interestingly the 2.0mg ones are the same exorbitant price.
Anything that isn't a standard dose will be expensive - not enough sales to spread the manufacturing costs. Pred doses are almost always multiples of 5mg and we are an outlier in how we use pred. It completely flummoxes doctors as we know - and the small changes in doses are a problem.
I tend to think of my dosage on a weekly basis so when cutting a 1mg tablet if it is not exact it does not matter as it evens out through the week.
Interested to read all the replies - but surely the real question is WHY are they so prohibitively expensive - on what grounds can the manufacturers justify it when Prednisolone has been around for years - they're the ones at fault and making a quick buck!!!😡
Purely economic factors……. compared to other doses, probably manufactured in limited numbers…. a matter of scale.
Hi, I had a situation where rather than prescribe 4x1mg, 1x5mg and 1x2.5mg the GP insisted on prescribing 2x5mg 1x1mg and the 0.5mg to reduce the number of 'boxes' of controlled drugs being prescribed. They were delighted to discover that the 05mg are not regulated, the cost didn't seem to be an issue, this is in UK. Maybe the cost is due to the unregulated thing ie they easier to prescribe and maybe the cost isn't regulated either. It will be interesting when I get to 9mg to see if I can get 5 boxes....... I was asked if I would take 11mg rather than 11.5 to reduce the number of 'boxes' of CD they were prescribing......
Whatever! 🤔🙈.. just so long as you get what you need…
Exactly 😊
Mine have never worried the dose I'm on they just give me the 5.0mg and 1.0mg tablets I ask for, then leave the rest up to me.
I had no idea they did 0.5mg doses. I have recently purchased a pill cutter as had to up my dose after a flare so now trying to come down in half doses! Seems to be working so far! Just been diagnosed with breast cancer and about to have surgery for that so have a lot to cope with right now!
Oh no I’m so sorry to hear that - as you say a lot to go through but I’m sending hugs and I hope it all goes well.
Thank you. Total shock and found from a mammogram and caught early so I am hopeful for a good recovery. xx
So sorry to hear that and hope all goes well. I had the same diagnosis 5 months after GCA diagnosis. I had more trouble with GCA flairs than my surgery but came though it okay. That was in 2014.
Best wishes for your surgery. 🌺
Very best wishes for that, I hope it goes as well as it can!
I also was diagnosed with breast cancer two years ago. (Caught very early) I had a mastectomy for peace of mind. It was very straightforward and the following day I was back to normal duties at home! I had no pain and the wound healed very well.
I wish you all the best.
Yes I got mine last week. No more dividing 1mg 🙂
I rather enjoy cutting pills for my 0.5mg dose. It's an opportunity to remember how far I've come 😊
Very true!
To save the NHS money maybe it would be better for those who can successfully use a pill cutter to continue doing so rather than requesting a change to the very expensive 1/2mg.
Every little helps!
I didn’t request these, I was offered them by the Health Centre and I had no idea they were more expensive.
it’s very interesting there at 0.5mg pills available, thanks for raising this.
For others’ info - I find cutting quite easy with this - basically a razor blade in a case which saves the other half for tomorrow. If sometimes not perfect it balances out over 2 days anyway. Bean counters, yeah, but we pay for those beans.
Cheap Pill cutter
I wonder if they are scored and easier to cut in half, than cutting the 1 mg in half, and then in half again for 0.25 mg?
I’ll let you know when I get them 😊
Hi Janet57 Thank you for this information Very useful indeed .I have a friend of a friend who is a GP and has told my friend that I always have to push for what brand suits me as apparently they have been told to prescribe the cheapest alternatives and different brands affect me differently
Well I've just just asked for 1 or 2mg and the lowest they can give me is 5mg !
Rubbish… who is saying that the GP or the pharmacy?
It’s a supply issue as 4mg was ordered but seeing GP on Monday and hopefully something can be done. I’d just stay on current dose but know I’ll face the wrath of the rheumatologist in January
Hardly your fault though!!
You could say that about my initial dosing regime too but they cannot hide their anger
... at being found out? Arrogance ...
4mg are a ridiculous price as well, so obviously not as many produced. 4 boxes of 1mg would be a darned sight cheaper...
I sure learned something.....I thought you got your meds for free~! Plus, here in the states, if I was paying for Pred, it would only be about $11 US for 100....it is really inexpensive. So sorry😟💞
Over and under a certain age [or with some illnesses/circumstances] we do get medications free at the point of use through the NHS… however most people of working ago do pay a prescription fee which is a lot less that the face value of the drugs..
The prices quoted are what the NHS pays the supplier….. and those costs are ultimately paid for by the taxpayer… so we do pay indirectly [hope that makes sense].
You pay indirectly indeed~~~my son, DIL and grands live in Nova Scotia. The last time I was there the sales tax (to pay for health +) was 16%, I believe. I don't know what it is now. Cha Ching$$ 💞
In Scotland our medications are free for everyone. We do not have prescription charges here.
A very high proportion don't pay anything - Scotland and Wales have free prescriptions for all, in England there are age exemptions, chronic illnesses of certain sorts provide exemptions and also if you are in receipt of certain benefits. And if you get more than 3 scripts in 3 months/11 per year, it is worth getting a pre-payment certificate so that the fourth/12th is cheaper and all the rest free.
It also depends on the pred dose - 5mg and 1mg plain pred is cheap as chips ...
Thanks...I just thought it was part of a national health program.💞
You don't pay anything like what the medication costs, it is a standard prescription charge. The pharmacist is supposed to say if buying the stuff OTC would be cheaper such as for ordinary painkillers.
The health insurance I have is good coverage and not expensive; only because my husband was a union electrician in a steel mill. It was $50 per month and yesterday I received notification that as of January 2024 it will be reduced to $15/mo, I will no longer have a deductible and no medication will be more than $11. So far this year, I have had over $380,000 in claims and pay at least $120.00 out of pocket each week.
They must have peeked into my savings.....I'll take the reduction~!💞
Actual figures - no-one in the UK need pay more than £112 per year for prescribed medications, that is what an annual pre-payment certificate costs. You don't get billed for any medication used in hospitals or administered at the GP practice. But as I say - that is in England, Wales and Scotland are free anyway.
Wow...that is terrific. I'd love that~!!💞
And here in my region of Italy (not sure about the rest) we pay 2 euros per script normally, 1 euro for exemptions, nothing for medications in hospital. But a lot of things that can be bought OTC, such as painkillers, eye drops and the like, can't be covered on a script, you pay the cost.
good to know, thanks
My pill cutter is Safe and Sound Health and came free when I bought the dosset box several years ago
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