Enteric coated prednisolone
Posted , 13 users are following.
I had a phone appointment with a GP today (just finished my first month of 15mg pred) and I asked him about enteric coated pred. He said that it's no longer prescribed; apparently research has shown that it offers no further protection to the stomach and it was a 'ruse' by the drug companies to charge more for the drug. Perhaps it's only in Scotland that it's no longer prescribed? Has anyone heard of this?
I feel a bit confused after today's appointment! In a previous phone appointment with the same GP he tried to push the alendronic acid, omeprazole and something else (can't remember!) but I was reluctant to take any of them without looking into it further. Today he didn't try to push any of these. Why the change of heart?! (I'm pleased, but confused!)
The good news is my pred is now down from 15mg to 12.5mg! Heading in the right direction...
0 likes, 66 replies
Anhaga MhairiP
Posted
constance.de MhairiP
Posted
Believe me the enteric coated pred certainly helps my stomach. I take 4 enteric pred at night and (at the moment - after a recent flare) one normal pred in the morning. My stomach usually objects.😏
EileenH MhairiP
Posted
He's lying. OK, maybe he is just misled... It is however possible it isn't allowed in Scotland but only a pharmacist can confirm that - or maybe the Scottish charity.
There was a discussion some years ago which quoted research that showed it was not as reliably absorbed as plain pred - but the research was done in patients with Crohns (or possibly ulcerative colitis, not sure) - where they thought it might be beneficial. It wasn't. But we don't have dodgy guts.
At the time there was a big price difference between plain and enteric coated pred, they claimed 17-fold. GPs agreed they would cut back the enteric coated stuff and prescribe plain plus omeprazole - and promptly had a queue of patients who had developed stomach discomfort with plain pred and a PPI. I have a cast iron gut, it felt like a rodent gnawing away! The GPs weren't amused - and regretted agreeing to give up enteric coated. It was finally admitted that patients who needed it could have it - not entirely unconnected with the fact that the suppliers had in the meantime increased the price of plain pred to a level where there is very little difference - especially when the cost of the PPI is added AND the now 2 dispensing fees that must be paid.
A couple of years ago the manufacturers also added 1mg enteric coated pred - to make reducig in small steps possible, by careful adding up you can reduce 0.5mg at a time down to 2mg before it gets difficult!
A typical costing 3 years ago was:
30 tablets plain pred £1.31
30 tablets enteric coated pred £1.86
30 tablets PPI £1.86
Dispensing fee for each, IRO £1 but it can be higher
The overall cost difference is small - and it saves another level of side effects as PPIs can have unpleasant gut effects as well as not working for about one third of patients.They also contribute to developing osteoporosis in the long term.
Speak to a local, preferably private, pharmacist. In case they haven't heard of g/r 1mg:
https://www.medicines.org.uk/emc/product/2077/pil
Silver49 EileenH
Posted
It's possible that it has changed in Scotland but I was certainly being prescribed it for 2.5mgs, though not recently, but I haven't requested it. Some medications have been stopped recently, one in particular, was found not to be effective for an eye condition but there is certainly cost cutting so whether it's the case with enteric coated Pred I don't know.
MhairiP EileenH
Posted
I think he's more likely to be mislead than lying... after all, he knows he'll get caught out if he lies now that we all have access to info online!
I'll ask at the chemist then report back.
EileenH MhairiP
Posted
Hehe - you'd be surprised at what they realise (or don't realise) about what real info we can find on line
. Lots of them think there is only rubbish...
EileenH
Posted
Forgot to say - doctors in England have told patients some very strange things about enteric coated pred, how it works and what it costs. And on a related point - at least 2 people have been told that doctors do not test for vit D levels as it is a VERY expensive test, one actually named £200. The midlands NHS lab does vit D testing privately too - at a cost of between £25 and £29 depending on the number of tests ordered. So you really are left to wonder about where they get THEIR info from.
constance.de EileenH
Posted
Well, after all, we are only patients - “what do THEY know.” And this is in an age when we don’t think doctors are”Gods”.😏😏
constance.de
Posted
A nuisance when the reply comes after the wrong comment!😡😡
EileenH constance.de
Posted
BettyE EileenH
Posted
On the Guardian readers' comments section there is an option, if you wish to reply to another reader's contribution, to have the original comment reprinted just above your reply which makes it all much easier to follow.
EileenH BettyE
Posted
BettyE EileenH
Posted
I'm thinking about this and feel there must be a convenient answer. I suppose the difficulty comes because there are responses to responses.
EileenH BettyE
Posted
I think it was far better in the "old days" when the new responses just appeared in their turn in the thread. Then I could go to a thread, read all the new stuff at the end and know I had seen everything. Now I really do have to look at every single notification and wait for it to load to be sure I HAVE read it.
And this morning gmail appeared in a ghastly new guise - shouty and crowded with bold type ...
ptolemy EileenH
Posted
MhairiP EileenH
Posted
"Fake news" of the medical world?
EileenH ptolemy
Posted
The £200 was vit D blood tests...
EileenH MhairiP
Posted
ptolemy EileenH
Posted
MhairiP EileenH
Posted
Hi Eileen - I posted this reply to my original post the other day, but I wonder if anyone received a notification because I was replying to myself. I don't want to start a new thread because I think folk have heard enough about enteric coated pred for the time being, but I thought you'd be interested in a Highland pharmacist's take on coated pred, so, in case you haven't seen it, I've pasted my post here:
Update! I checked with the pharmacist today, and apparently enteric coated pred is available here (Scotland, Highlands), but she did say it's rarely prescribed. I asked if that was down to GPs' choice in the local practice and she said yes, and possibly to do with cost. With hindsight I should have asked her what the price difference is!
So... technically my GP was correct when he said it's no longer prescribed - but he should have explained why, or I should have asked him why.
Luckily, I seem to be doing ok without it, so it's not really an issue for me at the moment.
EileenH MhairiP
Posted
It depends on what notifications you have requested - I get notified of all posts, doesn't matter who replied to whom and so will anyone who has clicked on the following box at the top, even if they didn't reply in the thread. And I read them all too! Apart from a few posts I didn't get notifications for at a time when the forum was messing about I have have read every thread on this forum! I started when I first joined to get information about living with PMR and didn't post myself until I had just about caught up. Then there was a question I knew the answer to so I replied.