This is actually a follow-up to a previous post which I had told DorsetLady I would keep her informed about. I was issued a prescription for Prednisolone 0.5mg, in fact he offered it! I thought it would be refused by the senior partner when I requested it again on Tuesday but this was not the case and I collected the 0.5 Prednisolone today. I had explained to the GP on the first occasion that I was reducing by 0.5mg monthly. When I discussed with the pharmacist today she said if you need 0.5mg that’s what you should get and should not need to be cutting pills! As I mentioned to DorsetLady the 0.5 is more expensive.
Written by
Malaga47
To view profiles and participate in discussions please or .
Just to add I am currently tapering to 6.5mg. My GP gave me 2.5mg tablets on request so I don't need to cut. I hope the surgery will give me 0.5mg when I get to 1.5mg, I say with confidence.
Technically, the pharmacist is absolutely right. Though, I know a lot of us do it, because we have no choice. But patients dividing tablets themselves is not considered good pharmaceutical practice and it would count as off-label use, unless the product licence says that you can do that. And from my regulatory days, I know first hand how difficult it can be to get approval for break bars on tablets.
The real challenge for many of us, as patients, is the difficulty we have in convincing some doctors when we can not tolerate a drop of 1mg, and that the gap needs to be smaller as the dose get lower. You just have to look at the posts in the group and how often doctors recommend unrealistic tapers that we can't achieve because those particular practitioners don't really understand the effect that a drop in even a small dosage can have on the patient.
I managed my last attempt at a taper by making up the right dose from a mix of 1 mg, 2.5 mg and 5 mg tablets, without cutting. It only became an issue when I needed to get below 2.5 mg. Though, I have to say, I find it hard to convince myself that 2.5 mg controlled release tablets work as well for me as the normal ones. Every time, a drop that involved using the 2.5 mg tablets gave me the most difficulty. So, for me, having a 0.5 mg tablet would be great and I am going to ask for it next time. Though, right now, I can't see me getting below 5mg again, any time soon.
"patients dividing tablets themselves is not considered good pharmaceutical practice "
Oh well - Italy is down the drain then!!! I mean, really - what is the difference? I have seen a lot of discussion about it and the manufacturers soon dealt with the claim that the active substance is not evenly distributed throughout the tablets. In the case of splitting them to reduce pred dose though, the crucial part is that the dose is lower than the last dose, it is immaterial whether it is .25mg less, .23mg less or .27mg less. And over 2 days, it balances out anyway. Such tiny differences are unimportant.
Actually, it is not impossible to get break bars approved, but it can be very difficult, and the recommended advice is usually to discard the unused half.
Regarding the smaller the dose the lower we get. I've always understood it to be the case that you don't want to drop more than 10% of your current dose at the maximum, and less if possible.
So if you're on 20mgs per day then you might be able to drop to 18mgs. If you're on 10mgs then either 9mgs or 9.5mgs per day, and so on. Anything else is just setting us up to fail, and then they can tell us off for not complying with their (bl**dy) text books. Humph!
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Statins and prednisolone 
Prednisolone...
Prednisolone 
Prednisolone 
reducing prednisolone
