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Enteric coated capsules for pred

Posted , 7 users are following.

Anniecurd
Anniecurd

Hello, I sometimes get really bad heartburn from the preds, so bad that my rheum had me see a cardiologist. Anyway, I ordered some enteric coated capsules to put the nasty little things in before I take them so they will dissolve in the intestines and not the stomach. Has anyone tried this and if so, does it work? I've read that sometimes they don't dissolve and you eliminate them. 

0 likes, 15 replies

15 Replies

  • Nefret
    Nefret Anniecurd

    Posted

    This is something I've never heard of before - I didn't even know that you could get separate gel caps!

    Can't your GP give you the enteric coated tabs?  I have heartburn/acid reflux/hiatus hernia and I've not had any gastric problems with the coated ones.

    So no, I can't give you any info on the gel caps, were you told that you needed to do it like that?  I'm just puzzled.

  • EileenH
    EileenH Anniecurd

    Posted

    Someone on this forum did do that some months ago and I think she said it worked OK. 

    I suppose you can only try it and see what happens.

    Have you tried taking the pred in the middle of meal? Eat half, take the pred, eat the other half? Recommended by a pharmacist and it has worked really well for several people.

  • Anniecurd
    Anniecurd

    Posted

    I asked my rheum about the coated pred and she said they're expensive and told me to take medicine for heartburn. I don't get it, why are docs so eager to give you pills for something that could be prevented.  Anyway, I thought I'd try looking for coated empty capsules to put the pred in. I haven't tried taking the pred in the middle of eating my cereal in the morning. I don't get heartburn right away, I'm usually woken up in the middle of the night with unbelievable chest pain, that often goes away with Tums.
    • EileenH
      EileenH Anniecurd

      Posted

      I would have more sympathy with the concept that enteric coated pills were expensive if it were true.

      There is history to this:

      Guidelines were issued that enteric coated pred was 17x more expensive than ordinary white pred so a PPI should be prescribed for patients who couldn't cope with uncoated pred's gastric effects as that would be cheaper. The manufacturer's immediate response was to increase the price of ordinary pred from pence to closer to the price of enteric coated pred, there is no longer a 17-fold difference in price.

      These figures are about right - I'm remembering them of the top of my head. They were provided by a pharmacist:

      1 month of 5mg ordinary pred tablets costs £1.31

      1 month of 5mg enteric coated pred costs £1.86

      1 month of omeprazole (PPI stomach protection) £1.86

      Each time a prescription is dispensed the NHS pays the pharmacist a dispensing fee. I think (I may be wrong) that it is 90p - that is for every different prescription drug remember.

      So if you get 5mg ordinary white pred plus omeprazole that is £1.31 +  90p + £1.86 + 90p = £4.97  

      If you get 5mg enteric coated pills (no omeprazole needed) that is £1.86 + 90p = £2.76

      Are you still with me? Now when I was in school - that actually makes enteric coated CHEAPER than plain pred plus omeprazole. 

      Into the bargain - by having another medication you are adding another set of side effects to the mix. Plus, taking a PPI reduces the absorption of calcium and increases the risk of developing osteoporosis. So you are more likely to need another medication to deal with the risk of osteoporosis...

      Go to your GP and discuss it with them. Take my figures with you. Anyone would think the blooming rheumy was having the cost of the medications taken out of her salary! Most GPs hand out pred plus PPI anyway! Whether you want it or not.

       

    • Padada
      Padada EileenH

      Posted

      I use the clear empty capsules just to buffer the prednsone a bit in my stomach. I am not sure they are doing anything different, but the one capsule is easy to swallow even with 4 or 5 small prednisone tabs in it. I learned this here on the forum. Yea.

      I also make sure I eat something too of course.

      I also am taking zantc 75 mg in the AM because the prednisone causes me to have continual stomach upset and nausea. The zantac just helps with the upset slightly, but I am glad for any help in the stomach area.   It is just one of the side effects of prednisone that I live with.    So I wonder if zantac also reduces the absorption of calcium?  Seems like it might. 

       

    • EileenH
      EileenH Padada

      Posted

      I don't think that zantac (ranatidine) is as bad as omeprazole in that direction. It also has fewer side effects. It does the same job - but is older so many GPs go for the "new improved" - but like so many things, is it REALLY new and improved?
    • Padada
      Padada EileenH

      Posted

      Fewer side effects - that is why I choose to take Zantac instead of the omeprazole.  Prednisone side effects for me are enough to deal with at this time.  Thanks for your opinion Eileen. 

      Oh, you may find this interesting. I once had a primary care physician who would not order any medication that had not been around for at least 10 years.  She preferred the 'time tested' meds to the 'new and improved'. 

       

    • EileenH
      EileenH Padada

      Posted

      Which has a lot to be said for it - the real clinical trials are not done until any drug is approved and released onto the general market and a lot of patients are taking it! That's when the real rates of side effects appear  - if it was only tried on, say, 1,000 patients (which is a generous number), and a side effect only appears in 1 in 10,000 it might not have been seen at all before. That is also the importance of the yellow card reporting system (there is an equivalent to report to the FDA in the US) - that is how they find the actual rates. 

      There is a great deal of fuss about the risks with pred - but since it has been in use since the 1950s they know all about them. The much newer drugs from the last decade or two may LOOK miraculous as the drug company publishes the bits that suit them, but after being used in a lot of people for a long time they often turn out to have feet of clay.

  • penelope10875
    penelope10875 Anniecurd

    Posted

    Yes, I use gel capsules when my dose of pred necessitates uncoated tablets. They work for me in that it lessens the indigestion a bit. I still take omeprazole and do need Gaviscon at night.

    At the moment I'm on 7.5mg so thats 3 coated tablets. Hurray!

    It is a bit of a faff, but I plant the half capsules in the sugar bowl and feed them with a months worth of tablets, put the tops on and it's done for the month, easy!

    Give it a go!

  • Anniecurd
    Anniecurd

    Posted

    I ordered the empty coated capsules on-line
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