Tablet sizes

[somerby]

I have been studying the tapering advice posts to prepare for my next review following a successful step from 15 to 12.5. What I would like to know is how do those of you who direct your own tapering plans get sufficient quantity and range of tablet sizes? My doctor's surgery only issue a prescription for exactly what they think I need to the next step. If I hit a snag I have no contingency. Do you cut 1mg tablets to make the 1/2 and 1/4 mg doses you write about? Thanks.

[DorsetLady PMRGCAuk volunteer]

In UK tablets come in 1mg, 2.5mg. 5mg, 10mg, 20mg. Note - 2.5mg plain is usually quite expensive compared to others, so some doctors maybe be reluctant to prescribe.

For PMR most get the 5mg size initially - so they can be cut into half for the first couple of reductions, or even into quarters..but its always good to request 1mg as soon as possible..

As for negotiating with surgery for amount, then whilst I understand no-one wants to be on more Pred than necessary, I really don’t understand their problem- they cost very little compared to most medications - pennies in fact per tablet.

Some practices once you are into your journey issue a repeat prescription and trust their patients to adjust that as they reduce. That way you may end with a small cache for emergencies. There needs to be trust on both sides, unfortunately that seems to be lacking in some places…but it’s something you probably do need to discuss.

[CocoaChanel]

I had that problem - at the 12.5mg tapering stage I couldn’t seem to get the message through to the GP that I wanted a supply of 1mg tablets so that I could have more control. I wrote a letter stating why I wanted the 1mgs and how many I needed and the prescription was in my NHS app next day.

After that success I now write a letter when I want to ask or relay or arrange anything. The response is almost immediate which makes me think that somewhere it says that letters have to be responded to unlike phone calls etc. Worth a try?

[BlueKiwi]

I've always found it works to pretend I need more than I do. So if I'm going to be on 9 next month I'll ask for 10 or 12, and this builds up a nice little reserve. If one of the GP's calls me to discuss, I'll ask for a box or two of 5mg as reserve for flares and a GP will happily do that. My problem is the admin staff who will mangle my request before passing on to a GP for signing. A pain.

I had ec2.5 tablets once but they made me nauseous, which is not what should be expected. Nor did they seem to be as effective as expected.

[Birder21]

My GPs have been really understanding and I have 1mg, 2.5mg & 5mg on my prescription so I can manage my reductions. I only drop 0.5mg have not gone as low as 0.25mg so not needed to cut any. They just renew the prescription at one of my reviews so I always have a supply to request, and a small stash just in case.

[byebyebicycle]

My journey on Pred is only 14 months long. But I have learnt a lot from this forum after 3 aborted attempts to go from 12.5 to 10mg. I am not down to 9mg and will start to go to 8.5 next week. All with the DL slow taper. My GP has been excellent and after one Rheumatologist report has just left me to decide my taper. Lucky there 😀. The GP has put Pred 5mg, 2.5mg & 1mg on repeat prescription. I'm in the UK. You do need a pill cuter when you get to 9.5 and they are inexpensive and work quite well - you get the occasional reject and the trick is to put the cutting blade across the line in the tablet and press very gently. Hope this helps.

[Trulyscrumpious]

l have had PMR for 9 years, and had got stuck at 5 mg. Since my diagnosis, l've hardly seen a doctor- neither rheumatologist or GP. Then a year ago l was found to be pre-diabetic and l did an nhs course called Secong Nature. At the end of it l was still pre diabetic, the reason probably as a side effect of taking steroids. So l decided to have another try to reduce. Starting with 4.5mg for l month, then 4.5 alternating days of4mg. I felt more achey and tired so wrote to my GP , asking if l could have 2 and a half pred plus 1,mg tabs. He agreed so l am doing quite well on that dose. In a month or two l may try 4 again. This refers to 2 posts - one that it is worth writing to your surgery, and two, that 2and a half are available. It seems not all Drs will prescribe it so l am lucky. I have used a pill cutter in the past.

[PMRpro Ambassador in reply to Trulyscrumpious]

Yes - but is the 2.5mg tablet a plain pred tablet or enteric coated?

That makes a difference to how you absorb it and although for some people it helps as pred is in your system longer, it is also at a lower peak dose. A 2.5mg plain pred tablet is relatively far more expensive than cutting a 5mg tablet and the enteric coated ones are also cheaper so some practices won't prescribe them out of their budget.

[Trulyscrumpious in reply to PMRpro]

Mine are plain red and don’t have a glossy coating. But so far l am doing well on them.

[PMRpro Ambassador in reply to Trulyscrumpious]

A typo and Plain pred I assume you mean? e/c 5mgs are red so a bit confusing!

[Trulyscrumpious in reply to PMRpro]

My 5mg are white! What do you mean by A typo?

[DorsetLady PMRGCAuk volunteer in reply to Trulyscrumpious]

Think you meant plain Pred .but it reads Mine are plain red 😊

[PMRpro Ambassador in reply to Trulyscrumpious]

What DL said!!!