Good news for patients with adrenal insufficiency
You no longer need to break up your tablets.
It has taken us three years, but at last Genesis Pharma, the company that we commissioned to make low dose prednisolone and hydrocortisone has obtained a marketing licence for the lower strengths. This study has had the added benefit of causing the price of hydrocortisone to fall.
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It won’t be long before you can get hydrocortisone in a 2.5mg tablet and a 5mg tablet so that if you are on a standard dose such as 10mg first thing in the morning, and then 5mg at noon and 2.5mg at 4pm, you no longer need to break up your tablets.
They will soon also have available a single tablet with the exact dose of prednisolone that you can take in the morning, so that instead of taking 3 x 1mg tablets, there will be a single tablet that you can take.
The study comparing a single dose of prednisolone in the morning with three doses of hydrocortisone is ongoing if you want to take part. Briefly, patients spend 4 months on a dose of hydrocortisone titrated to them (eg 10 + 5 + 2.5 or 15+ 5 + 5, or any combination that they have been on in the past), and a further 4 months on prednisolone (3mg in a single tablet, and then a placebo 0mg tablet at noon and 4pm). We need more patients who are willing to take part in it. At present we have equipoise, in that there is no evidence that one is better than the other. Until we did this research, the price of hydrocortisone was huge, and this was the reason we started trying out prednisolone. Now the price has fallen, but we have a large number of patients who have switched to prednisolone who are unwilling to switch back. Also preliminary data suggests that prednisolone has benefits, provided the dose is LESS THAN 5mg once daily. (Details of the study and the full story on youtube where Prof Lightstone has an interesting take on the use of hydrocortisone if prednisolone is safer).
If you are a patient with adrenal insufficiency on either hydrocortisone or prednisolone, and are willing to take part in a research study to compare them, please contact us on: firstname.lastname@example.org