When we get down to 12.5 pred but doc issues 5mg tablets

[pastamaid]

How does anyone cut them? It says you shouldn't on the label and they have to be intact. I'm not there yet, but neighbour was talking and said doc told her to take 15 one day and 10 the next for 3 weeks and then go down to 10. But that doesn't sound right. Do they only make the tablets in 5mg? Asking this for the future when I get there

[Koalajane]

I have 5s and 1s. I believe you can get 2.5 as well but I cut mine to make .5 and .25, which you can do unless they are enteric/gastro resistant tablets as you can’t cut those

[Ambatu in reply to Koalajane]

I have 2.5 prescribed for me.

[Kendrew]

Hi pastamaid,

I have gastro-resistant tablets and I have had them prescribed in doses of 10mg, 5mg, 2.5mg & 1mg. (Depending on the dose I'm on at any given time) These ones cannot be cut in half.

There are also non gastro-resistant tablets which can be cut in half and have a groove across the centre of them to help with accurate cutting.

It's important you know which sort you've got.

[piglette]

It really depends if the tablets are coated or not. The uncoated ones are white. If coated they cannot be cut. My rheumatologist gave me 5mg only which were coated and expected me to reduce in 5mg blocks. I gave up the rheumatologist. Steroid tablets should be available in 5mg, 2.5mg and 1mg.

[Bcol in reply to piglette]

My 1.0mg and 5.0mg are both white. I've got some 2.5mg ones which are yellow which are also uncoated. Had a problem getting 1.0mg tablets at one point, but chemist had 2.5mg ones,so doc gave me another prescription for 2.5mg which when cut was as close to 1.0mg as we could get. Problem didnt last long and have now got the 1.0mg as well.

[papadapadoo in reply to piglette]

My (S--prednisone) 1mg tablets are beige but they are center-grooved and I cut them.

[piglette in reply to papadapadoo]

They must have different colors in the US

[PMRpro Ambassador in reply to piglette]

Depends on the manufacturer. Green in Mexico ...

[piglette in reply to PMRpro]

I quite like the idea of green tablets. Sort of out of this world.

[Caloo650]

I've been chopping my uncoated 5s and 1s for months now. I use a pill cutter and I'm not always accurate. Some of the 2.5 end up uneven. I still use the lot and so far so good.I'm down to 3.5mg for the next month before I start the slow taper to 3mg.

Good luck

[random901]

I'm on 17.5 atm, clumsily cutting my 5mg tabs with a sharp knife on a chopping board. Far from accurate, and I'm often swallowing the crumbly bits with my yoghurt.

[sidra1968 in reply to random901]

Yep, exact same situation here.

[PMRpro Ambassador in reply to random901]

Get yourselves a pill cutter!!!

[random901 in reply to PMRpro]

Will do!

[jarn in reply to random901]

Why haven't you asked your Pharmacist to provide a wee pill cutter? It is a lovely wee box with a blade. My pharmacy provided it gratis.

[Kaaswinkel72]

hi there,

Sensible to be planning ahead!

There is also liquid prednison available , in the Netherlands anyway, I got it and keep it in the fridge.

I DO have to pay for them myself, unlike the tablets that ar subsidised. Handy for tapering up and down. I shake it and hope I mix it then. All the best.

[Omakaat in reply to Kaaswinkel72]

Thanks! Ik was al bezig met minuscule kruimels uit de pillen splitter omdat de kleinste pil 5 mg is in Nederland. Ga op zoek naar de vloeibare. Top tip.

[KASHMIRI1]

Good morning I have 1mg and 2.5 mg pred both are very useful when tapering

[Maisiek]

you can get a cheap pill cutter from the chemist. If you put the tablet at the point of the V, it cuts in half accurately. Good luck.

V section of pill cutter.

[DorsetLady PMRGCAuk volunteer]

There is no reason why your doctor can not prescribe 1mg tablets - they will need to as you get lower…. And as stated they come in 2.5mg as well, but the uncoated white ones are expensive compared to other doses.

Recently a couple of patients have received 500mcg [1/2mg] which is a first - although they are on the NICE/BNF drug list it’s rare to get them [they are definitely expensive]

This brand of pill cutter is very good.

And you are correct in thinking that the alternate 15/10mg daily is not a good idea… too harsh on body - in mine, and others views.

Pill cutter

[pastamaid in reply to DorsetLady]

Thank you so much. I know I have a lot of questions but don't seem to trust the doc knows what he's up to, so nice to have people who have been there and can advise

[DorsetLady PMRGCAuk volunteer in reply to pastamaid]

Never worry about asking us questions... it's why we are here..😊

[YogaJM]

Your doctor should prescribe a range of 5mg, 2.5mg and 1mg (in the UK). I also have a tablet cutter from Boots, but rarely use it.

[PMRpro Ambassador]

Are you on enteric coated tablets (5mg are red, 2,5mg brown and 1mg pale yellow)? It is only those that must not be cut. Plain pred tablets, usually white but 2.5mg are pale yellow, can be cut using a pill cutter and loads on the forums do so without any problem.

[pastamaid in reply to PMRpro]

They are the coloured ones. What is the difference to people, do they prefer one or the other?

[PMRpro Ambassador in reply to pastamaid]

Depends. The enteric coated ones take longer to start working and achieve a lower peak level in the blood but pred is present for longer. Some doctors won't prescribe them, citing the cost but if you take the PPI many insist on using with plain pred into account it evens out. And it removes a layer of adverse effects with one less drug. Enteric ocated ones tend to have less of an effect on the stomach if someone does have problems with pred.

[Rugger]

If the label says they should be taken intact, it sounds as if you have gastro-resistant 5mg tablets, if they are like tiny bright red Smarties? The label should state that they are g-r. G-R 2.5mg tablets (dark brown) are cheaper than plain 2.5mg tablets, so your GP shouldn't mind prescribing them for you. As others have said, 1mg g-r tablets (creamy white/yellow) are available too.

However, if your tablets are plain white, then they are uncoated and can be cut to get your 12.5mg dose - which is cheaper than requesting plain 2.5mg tablets! Make sure you ask for some 1mg tablets for doses such as 11, 9, 8, 7mg etc. What a carry on this is!

All the best.

[Angex05]

they do 1mg tablets too. The chemist sells pill cutters, handy for when reducing. Good luck

[Nagswoman]

Ask for some 2.5mg. If you are using the coated ones, they will be dark brown.

[HeronNS]

That's the second time in a couple of days I've seen a post about this dramatic reduction via alternating 10 with 5. Don't do it. It may be appropriate for those who have been on short term pred for a short term condition and expect to be off pred with little likelihood of relapse, but it is not advised for PMR! With PMR we require a stable dosage day to day in order to control the symptoms. And any reduction when at low dosage (like 15) should not be more than 10% of the dose. So, theoretically, a taper from 15 could go to 13.5, but 14 would be easier to manage and perfectly fine, although some do 15 to 12.5 (using 2.5 tablets, which are not available in all countries). Certainly from 10 and below tapers should be done in 1 mg steps, and eventually if possible half mg.

[PMRpro Ambassador in reply to HeronNS]

"some do 15 to 12.5 (using 2.5 tablets, which are not available in all countries"

Or you can cut plain 5mg tablets - not if they are coated.

[HeronNS in reply to PMRpro]

I think in my mind was if you have 1 mg tablets, why bother with a 2.5 taper (which is too much from 15 anyway)? Just do 1 mg drops!

[PMRpro Ambassador in reply to HeronNS]

Yes, but 2.5 is possible if you have 5mg tablets ...

[HeronNS in reply to PMRpro]

True. Although I don't know why anyone would want to do that if they didn't have to, at least not at doses of 15 and lower. As you know, but for others reading this thread, I tapered by 1 mg a week so did in fact drop from 15 to 10 in five weeks, but then had to slow down majorly after beginning of symptom return at 9. I used halved 5s for a lot of tapers and later halved 1s, but they were to enable tapering by half a mg, not 2.5!

[PMRpro Ambassador in reply to HeronNS]

It isn't always possible to get 1mg a slowed taper and 2,5mg isn't too bad. That was part of the reason for DSNS, people had 5 and 2,5mg e/c, No 1s and can't be cut.

[HeronNS in reply to PMRpro]

I know there are people on here who live in places where they can only get 5s! That must be incredibly difficult when they are getting down below, say, a quarter tablet, which is still slightly more than 1 mg.

[PMRpro Ambassador in reply to HeronNS]

But you couldn't do that with the e/c 2,5s - the slowed tapers cover a lot.

[HeronNS in reply to PMRpro]

Sorry, I guess neither 2.5 nor enteric coated tablets figure in my thought processes as they are unavailable here. Only, as usual, sharing my experience.

[PMRpro Ambassador in reply to HeronNS]

Yes - but you also know I add stuff for others looking at the conversation. Which is also me sharing mine ...