production 2.5mg stopped??

Don't know beev - but it wouldn't surprise me if Big Pharma were getting their own back for the NHS deciding to try and stop the use of enteric coated pills. To the best of my knowledge the enteric coated versions are not used in mainland Europe and people in the USA seen unfamiliar with them too. Here in Italy you have a choice of two versions, as far as I could tell yesterday there is Medrol which is methylprednisolone and prednisolone itself. What is more, the doctor said only a 16mg tablet of Medrol is available here - although I know it does come in 2 to 32mg tablets - and you have to use a pill cutter.

When the NHS made its decision to stop the use of enteric coated for price and reliability reasons, the response of the pharma industry was to increase the price of ordinary pred to a very similar level - now where have we seen that action before :wink: :roll:

As for reliability of the enteric coated sort - well, I now seem to have personal experience of that! It has been said in the past that the enteric coated pills are not absorbed as evenly or reliably as the ordinary sort so you get varying doses or apaprently need a higher dose. I just started taking a new batch of loose 5mg pills - the entire time before I've had blister packs and mostly from the same company. Within a few days I felt stiffer and had a bit of pain. After 2 weeks I couldn't lift my arms and felt awful - very PMR-ish though rather than adrenal crisis type problems luckily. I upped the dose the next day and it didn't make much difference - and then made the association of new pills and problems. I swapped to the 2.5mg pills and that has worked.

I'm now about to try the Medrol at 8mg (though I don't yet feel up to dropping back to the 10mg equivalent I was on before so I'm a bit dubious) as the doses aren't quite equivalent. We'll see.

Eileen

Hi

My last prescription for them was 2 weeks ago and no mentions was made of withdrawing them but it could be another cost cutting measure !

I asked my Chemist today when I was picking up a prescription and he said he hadn't heard anything about 2.5mg enteric problems and had plenty :? . I put a new prescription in straight away! I can only take about 3mg uncoated before I feel really rough and I'm not great with Omeprazole, so I've got my fingers crossed. I find the 2.5mgs really useful.

Love from Lizzie xxx

I wonder if there is some body we can complain to if it is the case?? Ombudsman or something?

Beev

I can't find anything online about a notification of supply problems or discontinuation of manufacture. I found a notification from Oxford PCT about other supply problems from earlier this year so I would have expected something like this to show up. The real people to ask are the pharmacies - GPs come up with some very strange ideas as we all know :roll:

I've just had a very strange batch of 5mg enteric coated and I have no idea who made them as they were loose packed, not even an indication of use by date which I think is appalling - there may be manufacturing problems and, in the final analysis we are at the behest of Big Pharma. There are severe problems with supplies of certain patches of drugs which dry up oral secretions which are pretty much essential to life for some paralysed/partially paralysed patients. One went on short supply, so the next was put under pressure and it has now run out to all intents and purposes. The lack of an enteric coated 2.5mg pred is minor in comparison in that cutting a 5mg ordinary tablet is always an option.

Almost noone else in Europe uses enteric coated pred - maybe the UK is next in line. The NHS discouraged their use so effectively the market has disappeared - if there is \"no demand\" the manufacturers cannot afford to keep producing them.

Eileen

I have just checked my new 2.5s and they say gastro resistant and have a leaflett about twice as long as usual !!

Has anyone had 2.5s uncoated tablets ?? I have had 5s for ages but my Dr was surprised when she went on the computer and found the 2.5s were still coated

I'm with you here Eileen, my last batch of 2.5mg enteric were loose in a pot. No sell-by date :shock: ! I took some 1mg ones back to the Chemist a few weeks ago as they had less than a month left on them. He said 'well most people only take Prednisolone for 6 days or so' to which I replied 'well I'm not one of them and I want ones with a long date'. Chemist: they'll be fine. Lizzie: then why put a date on them, please replace!! Cheeky wotsit!!

I'm surprised you can get enteric in Italy as they're not available in Spain at any strength.

Just a thought Eileen. You mentioned that non-coated tablets take a lot less time to get into the blood stream than enteric (may have been on the other site, can't remember!). I take a mixture at the moment - 1 x 2.5mg enteric and 2 x 1mg uncoated. Is there a conflict, could this be why a drop of just .5mg makes such a difference. Just a thought.

Love from Lizzie xx

I have always had my enteric coated from my GP in the UK - we have officially been on holiday a lot until now as Italy hasn't been as sensitive about the number of days you are in the country as Spain is :wink: and have been UK resident and paying tax and self-employed NI. We now have an Italian residence permit, an Italian ID card (saves taking all the rubbish to show to prove who we are and where we live) which cost 1 euro plus the cost of 3 passport-sized photos (11 euros for 4 :roll: ) and nearly have our Italian number plates :D and medical cover.

I posted the other day about here and methylprednisolone only allegedly being available as 16mg plain pills - they come in 2 to 32 mg formulations according to the manufacturer - so cutting is essential! How you are meant to reduce in tiny steps with that - and yet the German rheumatologists are pushing that now as the best way to go with PMR! Don't know what happens there though.

I found a paper a few days ago with comparative graphs for how pred from ordinary and enteric coated pills is absorbed - it's the difference between a spike and a long slower climb up a hill with a similar descent but they reckoned the highest level reached was similar. I imagine if you mix them, then there will be a lower spike followed by a longer and possibly lower sustained blood level. So there is the difference between a higher short pulse and a longer one - which is more effective at knocking the inflammation on its head? They did suggest that the longer presence of the enteric coated might have more side-effects - but I've had very few so far. However - that is all about to change as I've had to reject the use of the enteric coated stocks of 5mg in case all of them are the same (my body didn't like them or they're dodgy) and will have to embark on using ordinary and cutting them. At the moment I'm on 12.5mg prednisolone and the rheumy wants me to switch to 8mg methylpred which is meant to be equivalent to 10mg prednisolone - fingers crossed!!

As for the use by date bit - I went back and asked and was told the loose stuff had a use by of 2013 which was fair enough, but why wasn't it put on the bottle? I always used the same chemist so they knew I have been taking the darned stuff for years and always got a bulk supply as we were away a lot. And I can't imagine anyone taking pred for a few days would need 1mg tabs anyway - you get short courses of doses that are multiples of 5. For all I've said about pharmacists knowing more than GPs about drugs I have begun to wonder over the last few months :roll: having heard some strange comments and come across some utter disinterest in teir job.

Eileen

LizzieEllen

[quote:4966dded04][color=indigo:4966dded04]I'm not great with Omeprazole, so I've got my fingers crossed. I find the 2.5mgs really useful[/color:4966dded04]. [/quote:4966dded04]

There is another one called Lanzoprazole (spelling).

But have you tried the lemon juice theory (MrsO's) it worked for me and others.

Update: I have found that earlier this year there was a warning issued by Lincolnshire PCTs to GPs that Delacortil (2.5mg enteric coated pred) was subject to severe supply shortages - this was a blister pack version of pred that, strangely, was a quarter of the price of generic blister packs of pred. Something rings a bell about that name for me though I could be wrong - so maybe that's the source of the \"not making it\" comment - it's actually the case it is difficult to get and, in fact, indirectly, possibly the reason for my \"loose\" and useless enteric coated stuff :roll:

Ah well...

Eileen

PS: on close reflection I realise that even the 2.5mg EC pills I have do not take effect anything like as quickly as the version I have had for the last 2 and a half years. I feel OK-ish, but there is pain and stiffness most of the day and it isn't until the evening that certain bits of pain disappear, reappearing during the next morning. Before, any morning discomfort disappeared well before lunchtime.

OK - back to the drawing board :roll:

Eileen

Not heard of this to be honest. But this is of interest to me as I am on 3mg at the mo and hoping to drop to 2.5 soon.

I have a few boxes of 5mg left over, so I have bought a pill cutter simply to use them up when I get to 2.5. If they are taking the 2.5 tabs off the market maybe this is what we will have to do.

Gilly.