Hi , wondering if anyone can throw light on this. Im currently on 8mg enteric coated Pred having reduced from 70 mg back in Jan '23. Seem to be doing OK, so far. In order to make up my 8mg dose I have 1 x 5mg plus 3 x 1mg - all enteric coated. There is some scepticism amongst a few of the NHS docs and rheumatologists about the efficacy of the 1mg EC Pred and whether it's actually being absorbed. I can only go by how I feel which is pretty Ok , no serious symptoms returning so far and Ive been on 8mg EC for nearly a month now. Im therefore planning to come down to 7.5mg asap - once Ive had blood tests etc - which wd mean having 1 x 5mg plus 1 x 2.5mg EC Pred. However, Im concerned that IF the docs are right that would mean I was Increasing my dose rather than Decreasing it, if you see what I mean. In other words, IF NHS is right I have actually been on more like 5mg Pred for the last month. I feel somewhat sceptical about their scepticism(!) but wondered if anyone had had experience of the 1mg Pred working - or not working - before? I'm not keen on going on ordinary Pred as trying to protect stomach as much as possible and can't manage PPI's. Would be grateful for any feedback.
1mg enteric coated Pred? Efficacy?: Hi , wondering... - PMRGCAuk
1mg enteric coated Pred? Efficacy?
Well I'm dismissive of their scepticism too - if you are doing OK it suggest it is doing its job and if they were right and it weren't you'd have dropped more than 1/2mg and our experience is you would have noticed.
You say you can't manage PPIs - increasingly doctors are going back to good old-fashioned H2 antagonists. Different mechanism, different adverse effects and almost equally as effective in fact, The PPI marketing was very persuasive but they are starting to realise they aren't as good as they claimed.
Thank you v much PMRpro. Thats interesting about H2 antagonists..... I think Im going to continue with EC Pred, eating yoghurt etc with or before. So fat I don't seem to have stomach problems. Im interested youre dismissive of their scepticism, and reassured. I have suspected, as DL has just said, that its a cost thing.....
There is some scepticism amongst a few of the NHS docs and rheumatologists about the efficacy of the 1mg EC Pred and whether it's actually being absorbed.
Based on what evidence?
Being a sceptic-I’d say their decision was affected by cost … EC 1mg are £30 plus for 100, whereas are less than 70p for 28.
My suspicions too DL. Thank you very much for your reply...Im going to keep going and come down to 7.5mg EC asap, and then 7mg EC which will again include the 1mg EC Pred, and see what happens.
They may belong to the same school of thought as those don’t think 1mg (of any sort) makes a difference. But many on here would disagree..
Good luck
Thank you DL! Will keep you posted.
I agree with DorsetLady that it’s probably more about the cost. I’m currently on 3mg and on EC so, at my current dose, ALL I’m taking are 1mg EC ones. They’re working for me!
Thats great to hear, Highlandtiger. And reassuring. Thank you. I'm going to forge ahead!
I've been on gastro-resistant pred for almost all of the last 8 years. I've had relapses along the way, but almost certainly due to too low a dose for the level of disease activity, rather than the type of tablet. Currently on 4 x 1mg tablets! Good luck!
I have worked with the pharmaceutical industry for over thirty years and I am sometimes quite gobsmacked at the lack of knowledge of some doctors regarding medicines. Mind you I know one consultant who got muddled up between PMR and fibromyalgia.
Thank you Piglette. It is a bit concerning. Whilst having huge respect for those in the medical profession I know I have a tendency to be sceptical about docs’ recommendations and advice at times and I question everything and drive them mad…. But it seems that so often they arnt right and/or don’t have time or inclination to look at individual cases and just think same size fits all. ‘NOT the case’ I cry!
Just to add you can get a 2.5mg enteric coated pred. That's what I used to get the half doses.
I'm now on standard pred as I'm between 1mg and 1.5 and that was an easy swap from EC to normal.
Thank you so much. Hope all goes well for you 🤞🏼
what is enteric coated pred ? Does it look different?
Yes, they are shiny, coated, coloured tablets like tiny Smarties! 5mg are red, 2.5mg are brown and 1mg are pale yellow. They are "gastro-resistant" and the pred is absorbed lower down the digestive tract.
It has a coating that protects it from the stomach acid so it passes through the stomach and is absorbed further down the gut, reducing possible gastric effects. It is only available in the UK, no other countries I know of use it. The tablets are coloured not white: 5mg are red, 2,5mg are dark brown and 1mg pale yellow. They look a bit like small Smarties, more rounded than most pred.
I’m in the Uk and my pred. are all white and I only have 5 and 1 mg. Never been offered 2.5 so I always reduce by 1 mg
Uncoated 2.5mg are very expensive which is probably why you’ve never been offered. But so long as uncoated as yours seem to be the 1mg can be cut…if you need to reduce by 0.5mg a time.
You can cut 5mg plain pred to get 2.5mg and make up with 1mg. Probably easier to cut 5mg than 1mg.
What are your thoughts on cutting 1mg of EC coated? They've just changed mine from the white ones? 🤔
Not possible and no point. It ruins the whole idea of the coating which is there to help pred reach lower gut and if you cut it in half you’ll be exposing the Pred too soon.
I thought this and have avoided doing so...however due to my Gp switching to the yellow I'm going to struggle tapering 🙄 ...given I have Adrenal insufficiency I've to be super careful when tapering so I'll be better with white 🤔
Defeats the object of having EC ones…
I'm stumped here ... I need to 0.5 but only getting yellow 😐
As said -it’s odd you’ve suddenly started getting them. Either they have a stockpile -although I doubt it, pharmacies are the same as other businesses and work on the “Just in time principle” or surgery have specified GR/EC which also seems unlikely!
Bit of sleuthing required methinks… 🕵️
Yes ... I'm sleuthing right now 🧐
Not supposed to do that - as the others say, no point in having them if you cut them because it makes the pred exposed to your stomach just as a plain pred would be. And the EC 1mg tablets cost about 30 times what the plain ones do.
I thought this! I must have a very rich GP 🙄 ... they've switched suddenly from the white to the yellow! Very odd 🤔
Did they specify EC on the prescription? Does it say gastro-resistant on the pack? Occasionally there are different manufacturers that use yellow for some reason? Or it is getting to the end of the batch life of the 1mg EC and they are being dumped to use them up. Which would be fine if it weren't for the fact they are absorbed at different rates - there can be up to 5 hours difference so you won't get it all released at once if you are mixing ordinary and EC.
Yes... they say gastro-resistant ... it's the 1st time I've received them
Wonder if they are dumping them - what is the expiry date on the pack?
Ah.... under the label the dates are from Mar 23 to Mar 25! Looks like your theory is right!
And you say you want 1mg plain to cut for 1/2mg doses? Go to the pharmacy and complain - they should ask if it is OK before giving you them. It isn't ...
Thank you so much!!! Yes I'll be going to complain (just tried ringing my surgery and they're closed for training!) Typical!
Hello , I’ve been taking Enteric coated Pred for many years now after developing gastritis. I also take Omeprazole, have to occasionally add Famatodine.
I’ve never had any problems with them, the most annoying thing is we have to wait longer for them to take effect.
I’m more concerned with tapering off the Omeprazole which I’ve tried many times.
I will get there eventually. Have recently had to slightly increase Pred again and now I have a nasty uti so may need a further temporary increase.
You’ve done extremely well, keep doing what you’re doing.
Wishing you well.
Have you tried swopping to an H2 antagonist, famotidine or one of the others? They also stop the acid but after a few months are easier to discontinue as you don't get the rebound acid production.
Thank you PMRpro , i managed to reduce the Omeprazole to 10mg and added Famatodine.
It was successful for a week but then had several nights of severe gastritis pain, it’s not unlike how you’d imagine a heart attack , resorted back to 20mg Omeprazole.
When this first started I saw a cardiologist, he said they often point patients with this pain to gastro. Had Endoscopy, lesions and sores in oesophagus , Duodenum, stomach. Extremely disappointing when I’d always taken Pred with yogurt.
I will try again with Famatodine, the reports on Omeprazole are quite worrying. Pepcid A2 used to be brilliant, relief within minutes.
As if we haven’t got enough.
Thank you for your welcome advice as always. x
hi I’m currently taking 8 mg dose as 1x5mg and 3x1mg with no rumblings so far. Last time I tried reducing from 8.5mg as 1x5mg, 1x2.5mg and 1x1mg I had to up the dose and wait a month before retrying. Based on this I’d say that the 1mg enteric coated pred are working. If they weren’t they wouldn’t be available.
Long ago there was a study using EC pred in inflammatory gut disorders thinking that might be adantageous that it is absorbed in the lower gut. It wasn't and it was also established that the absorbance of EC was a bit variable. But this is in patients with lower gut inflammation. Not patients with healthy guts but needing pred for something else. But I am sure that this has percolated through as "EC is unreliable", I reckon if it works for you - that is all you need isn't it?
Not what you're looking for?
You may also like...
Is enteric coated pred more expensive? Exploding a myth:
Enteric coated Prednisolone
Enteric or Non-enteric coated Pred
Coated versus uncoated Pred
Switching from partial enteric coated
Related Posts
1mg coated Pred
Prednisolone 1mg enteric coated shortage?
Cutting Gastro coated Pred. 
Prednisolone enteric coated
Enteric Coated 1mg PrednisoloneModeration team
