Prednisone absorbtion

There is a liquid version of prednisolone - it costs about 30 times as much as a tablet dose does. If you put everyone onto a liquid form it would increase the costs considerably. It is used for people who are unable to swallow tablets or have gastric problems that would stop absorption from a tablet. However, prednisolone isn't available in every country so that would also play a role.

Not all substances can be produced as a soluble format - methylpred isn't particularly expensive as far as I know and is sometimes used as injections every few weeks. I know of people who are on the injections. The dose varies, falling from its highest immediately after the injection and falls to quite a low level before the next injection is due - which may not be enough to manage your symptoms. 

Hi Susan. I was just diagnosed with PMR today and prescribed RAYOS Prednisone delayed release 5 mg. I was given samples from my doctor and was left a voicemail from a Pharmacy that my doctors office shared with them that I was prescribed this med and it isn't covered by my insurance but they could mail me 30 day supply for $10. I had people question why my insurance wouldn't cover prednisone, a fairly cheap rx, and I thought that too. Just wondering if this is something new and maybe what you're talking about. The pharmacy did say that a coupon is applied and my copay to them is then $10. ?? I have to look into this with my insurance co.

Prednisone in the form of Rayos/Lodotra is not a "fairly cheap" version of steroid. 30 tablets of prednisolone in the UK cost £1.31, 30 enteric coated (only available in the UK) cost £1.86 and 30 tablets of Rayos/Lodotra costs £25.  I have been told by people in the USA who have researched the cost that it is prohibitively expensive to get - as supported by this extract from an online pharmacy site:

"This Rayos price guide is based on using the Drugs.com discount card which is accepted at most U.S. pharmacies. The cost for Rayos oral delayed release tablet 1 mg is around $2,392 for a supply of 30 tablets, depending on the pharmacy you visit. Prices are for cash paying customers only and are not valid with insurance plans."

Yes, there are discount schemes in the USA - but they are tightly restricted as I'm sure you know. For anyone in the UK - it is not available on the NHS but you could have it on a private presription and it will cost up to £100/month depending on how many tablets you require to make up your dose.

Rayos/Lodotra is not a "more easily absorbed" form of steroid - it is merely prednisone encased in a specially formulated (expensive) coating which, under the correct stomach conditions soon after eating, takes 4 hours to split apart and deposit the entire dose of pred in the stomach where it is absorbed in exactly the same way as plain non-coated forms. It is a convenient way of taking pred at 2am which has been shown to be the optimum time to take it to minimise morning stiffness. 

No - don't get the gastroresistant cpsules confused with Rayos. It really doesn't matter WHERE the pred is set free - it will be absorbed. With Rayos their unique selling point is that taken properly it releases after 4 hours - and that's why it costs more! 

Gastroresistant capsules will delay things for x hours - but how many x is will depend on the person and whether they have eaten and how much they have eaten. So you may have to experiment a bit to get the timing right. That's all.

Thank you EileenH, that is what I was hoping you would say. Then with testing on how I feel I should be able to continue to split my doses right down to the minimum. GREAT! 🙂

Oh, EileenH this morning feeling normal normal almost with the PMR, still a bit shaky from the Phedinsone. Yesterday two good walks, plus a trip to Santa Fe, big box stores. Walked over 9,000 steps in one day. Felt good last evening. Will go for Blood test tomorrow, reduce to 27 1/2 on Tuesday. Thank you so much for your help. 🙂