Low dose Pred without ppis

[Jbobby]

Hello, me again. Im now down to 6.5mg Pred. I’ve been taking E/C Pred since 2023 when first diagnosed with PMR and GCA . So I’m not taking PPI’s coz of E/C Pred coz I want to be on as few meds as possible. However you can’t cut E/C Pred in half and can only get 2.5 Pred and 1mg ( in E/C Pred) so at 6.5 I can only take 6mg in E/C Pred plus 0.5mg in ordinary Pred. My question is can I take 0.5mg and 1mg ordinary Pred safely without taking PPI’s ( which don’t agree with me as I tried them at beginning of this journey)? ? I have been dissolving my 0.5mg ordinary Pred in water btw…..

[tangocharlie]

Yes, under 10mg there is very little risk of causing stomach bleeds by Pred according to a talk by a rheumatolgist at last year's AGM. That's because the risk is cumulative over time. Still advisable to take the Pred with food though even at low doses. Another option for you or others reading this - I just put ordinary Pred in a gastro-enteric capsule from capsuline UK so then you don't need to take stomach protection meds like PPIs. If you're taking a mix of enteric and non-enteric there will be a slight time difference of when they 'kick in' but probably not much difference with a few mg

[Jbobby in reply to tangocharlie]

Thanks so much Tango Charlie. That’s useful info

[Gc2596 in reply to tangocharlie]

I've taken Omeprazole as prescribed this from the outset. Currently on 9mg. However, started taking Alendronic Acid 3 weeks ago. Would the opinion be that it's wise to continue with the PPI in view of being on this medication?

[tangocharlie in reply to Gc2596]

That's entirely up to you. Definitely don't take any other meds before you take the Alendronic acid though.

[DorsetLady PMRGCAuk volunteer in reply to Gc2596]

There is no listed interaction between the two, but some sites do state taking them together could potentially reduce the effectiveness of Alendronic acid.

I took both during my GCA - with no adverse affects. Post GCA my DEXA scan was fine …

[SnazzyD]

I did the same mix and match and was fine at this level. My stomach was not happy with Pred which is why I had e/c and gaviscon at night. I still needed gaviscon until I was well under 5mg.

[Jbobby in reply to SnazzyD]

Understood. Thank you Snazzy.

[DorsetLady PMRGCAuk volunteer]

how about1 x2.5mg and 4 x 1mg? That makes 6.5mg - well it does in my head..😊

[Jbobby in reply to DorsetLady]

Good point except that 1mg E/C Pred are much more difficult to come by and v expensive so just wondering if I cd supplement with ordinary Pred ( sorry I forgot to explain that)

[DorsetLady PMRGCAuk volunteer in reply to Jbobby]

I know they are more expensive -ridiculous prices… but you did imply you could get them.. 😊. If you can’t, guess you’ll have use plain ones at certain doses. Right pain.

[Jbobby in reply to DorsetLady]

I can get them… sometimes but not always! Anyway thanks so much for response DL.