I only spotted this yesterday on the information in the Prednisolone tablets.
In "Method of administration" section it says: "The tablets can be swallowed whole, but they are best taken as a drink after dissolving them in a glass of water."
I did it yesterday and today and felt the morning stiffness/pain improved quicker. But it may just be now I am hopefully on the correct dose I'll get quicker daily improvements anyway.
Interestingly it never mentions in the paper information taking with/after food or a meal which my Dr told me and is written on the pharmacist directions. Which I have been doing.
Interested in what you think. It does of course not taste very nice but that's the least of my worries. 🙂
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MrsNails, thanks for your reply.I was surprised I hadn't noticed it on my first box since usually I read all information thoroughly. Logically I would have thought it may get absorbed slightly quicker but no real advantage since presumably would wear off/be ready for new dose slightly quicker.
Not necessarily. The antiinflammatory effect of pred lasts 12-36 hours, depending on the person. If you are over the 24 hour mark, you'll get to the next dose fine.
Is PPI something like Omeprazole? If so: No I'm only taking Prednisolone 20mg in the morning with/after breakfast. Plus Calcium/vitamin D (Adcal-D3).Originally (before and for a little after being prescribed Pred) I was taking Naproxen 500mg twice a day and was taking 20mg of Omeprazole to protect against that.
Do you think it's more likely to be damaging to stomach lining taking Pred in a dissolved state than whole tablet? I was assuming because my stomach isn't empty that would be protection.
Thank you MrsNails (and Roltuba) - invaluable information. I didn't realise any of that. I've being doing it all wrong! So glad now I know and can easily put it right.
Originally I was taking one dose of Ad-cal3 before breakfast then eating breakfast then taking Prednisolone. So definitely not allowing the 2 hrs suggested.
Recently I'd actually been taking it with the breakfast because I thought I'd read than something in my breakfast (nuts, oats, flaxseeds, cinnamon, yoghurt and fruit) would help absorption (possibly I've made that up 😂). So even less time between it and Prednisolone. Plus since dissolving the pred I've been taking that before my last spoonful of breakfast to take away the taste! 😂
Then taking the 2nd in the evening either before or with food (but I don't take any pred in the evening so not too bad). Though I often include spinach in my dinner meal.
I'll start taking the morning one 2 hrs after the pred or at lunchtime and the other one just before bed.
Yes of course! Oops! Sorry DorsetLady - huge thanks to you too. 💕 Most of the posts and documents I am constantly rereading (including this one on when to take calcium) are of course written by you.
Not to mention your kind replies and generous guidance at all points on this tricky journey.
Your patience at signposting the relevant documents (plus writing most of them in the first place) is unbelievable.
Especially when I assume all the newbies all arrive here equally bewildered.
Hopefully I can claim being so rude to miss you out is down to PMR! 😉
I said to my hubby that I've always liked a slow start to the morning (not hitting the ground running on waking). PMR has now provided me with an actual real excuse! 😂
Actually I don’t know. I wouldn’t have thought it made much difference. Possibly better diluted, but am sure PMRpro wd know more than me about this. I would have thought you’re ok at that dose if taken with food, or just after. I was really just wondering if you found PPI’s necessary.
No I’m not taking PPI’s at moment. But that’s really coz I’m mainly taking Gastro resistant Pred ( now on 9 mg), just sometimes using ordinary pred if I need to have a 0.5 pill amongst dose as I reduce ( gastro resistant can’t be split obviously). I started on ordinary pred plus PPI’s but couldn’t handle PPI’s on top of all other med and also felt PPI’s were contributing to nasty side effects possibly including risk re bone density (?). I try to be on the least meds possible. So just GR Pred and Adcal at moment ( plus my own supplements like Magnesium, omega/fish 3 oil etc.
I suspect the opposite. Pills taken whole might lodge against one spot on the stomach wall. Liquids will be absorbed across a wide area. That's why I use dispersible aspirin when I take a high dose to nip migraines in the bud.
Excellent! AtopicGuy, I wonder if that's why some manufacturers have now introduced and cite the dissolvable option as best?That would make sense to me.
Though I am quickly learning that anything that seems logical to me as regards PMR there is always a lot more too it. 😂
But I'm very thankful there are people able/willing to explain it to me. 🙂
I once read about a case where a patient had swallowed some sort of medication without a drink. A pill came to rest in his gullet (oesophagus) and caused a chemical burn. I think it turned into an ulcer.
I’ve had a couple of occasions when I haven’t swallowed the pred straight away and the taste is awful. I won’t be rushing to try them dissolved in water 🥴
Yes it isn't nice at all! I think if you're coping OK with whatever you are doing you wouldn't even try it.
I was at the stage of waking and rushing (obviously at a very slow stiff/imobile/painful snail's pace😂) to eat breakfast so I could take the steroids. Then all I could do was wait for them to work/the morning to pass so I could be in less pain/stiffness.
I'm now in a much better position so not as desperate but am superstitious so carrying on with taking them dissolved just in case it's making a difference!
I take my pred with a small piece of cheese when I wake for a toilet visit during the night. I don’t set an alarm so it’s anytime between 2 and 3.30 but means the pred gets to work before I get up in the morning so I don’t have any PMR stiffness. I definitely recommend trying it.
Thanks, thank is interesting, definitely something to consider. I have recently had just enough improvement (since swapping from 15mg to 20mg Pred a week ago) so the morning stiffness/pain is now manageable. I'm not sleeping that well at the moment but still hoping for pain improvement which would help.
I'm really missing having a good night's sleep.
But lots to be thankful for now the pain/stiffness is manageable. 🙂
Sorry PMRpro and perceptual63, please can you explain. I don't understand. I've googled and understood that systemic is something that is taken and could effect the whole body where topical is administered to a particular certain area. Am I missing something or would oral Pred be systemic however it was swallowed? Thanks.
The effect of pred which tends to result in thrush is what we were talking about. When pred gets into the blood stream it has a systemic effect and suppresses the immune system and that is thought to make you more susceptible to develop thrush. Would having pred in your mouth while swallowing it in solution increase that risk? Patients who are on oral pred do get thrush all over the place, What does make a difference it occurs to me is the use of asthma inhalers and that is a topical effect as they are dry and would stick in the mouth and throat. Patients are told to drink water to reduce the effect. But I'd think soluble pred would achieve that.
percetual63, I don't understand how liquid vs solid tablets are processed differently by the stomach. Please can you explain why you think the dissolved tablet would be more likely to cause thrush?I love all the knowledge and insight of everyone on this forum.
PMRpro replied above regarding my question of liquid vs tablets and thrush.
I've been reading that some people acquire oral thrush from the tablets and my thought is that a liquid would encompass your mouth even more so and not just on your tongue from the tablets.
PMRpro was saying one was systemically and the other is topically and then I thought afterwards that taking prednisone is systemically overall so maybe there really isn't a difference whether you drink prednisone that is diluted in water or that you take prednisone tablets.
I’ve been dissolving my preds in a little water for months after reading that instruction. Some are from Relonchem and some from Wockhardt. I only use a small amount of water to dissolve them then follow it up with a larger glass. I’ve got used to the slightly bitter taste and because they are in a small amount of water they aren’t in my mouth for long, one swallow. I still take them after breakfast though
My pred is the soluble type but can also be taken whole. I found it very difficult when tapering (I’m currently on 3mgs). The tablets are 5 mgs so, I have to dissolve the tablet in 5 mls of water, wait for it to dissolve, then take out 2mls of the liquid and drink the rest. As it is quite a strong flavour I then add some more water. It’s a bit of a pain. When I get down to 2.5 I might think about cutting the tablet in half, however, they are very small tablets and I don’t have a pill cutter. Do pharmacies sell them?
I understand that there are non-dissolvable and dissolvable tablets. The latter are more expensive and so are not so widely prescribed. I have the pink dissolvable ones, as I’m dairy intolerant and the non-dissolvable contain dairy products.
I always take mine in the morning with food to reduce any reflux issues- although I haven’t had many issues with the reflux. Having dissolvable tablets are quite handy as you can measure out a known quantity of liquid, dissolve say 10mg tablets, and just drink the proportion that you need (I.e. 75% for a 7.5mg intake).
You could always disguise the taste with a bit of orange squash perhaps - I have never bothered.
I was given soluble Pred once when my pharmacist had trouble sourcing the usual ones. He told me that they usually give them in this form to children or people with swallow issues. It was virtually tasteless and there was no discernible difference in the efficacy. Sorry I didn’t take note of the brand.
Yes, the pink dissolvable ones are lactose free. I would normally take the solution which come in 5 ml phials. Unfortunately they have become unattainable so I mess about each morning with a syringe and little measures of water (in an egg cup). I have today gone down to 2.5 mgs and have noticed a line across the middle of the tablet. I will go and get myself a pill cutter!!
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