Possible interaction between Prednisone and Calcium 600 D

Bones, joints and muscles
1

I have opened a new discussion based on the "Dairy and Calcium" discussion. Since I took all my pills at the same time I could have left myself open to a relapse if this is indeed true.

prednisone ↔ calcium carbonate

Applies to:prednisone and Calcium 600 D (calcium/vitamin d)

Antacids and agents with acid-neutralizing effects may impair the absorption of dexamethasone, prednisolone, prednisone, and other corticosteroids, although data from published studies are somewhat conflicting. The mechanism of interaction and clinical significance are unknown. No particular intervention is necessary during concomitant therapy with these agents, but clinicians should be aware of the potential for interaction.

2

When the pharmacist was filling my first Pred prescription I told her what else I was taking and asked what should be avoided at the same time. Calcium for the reasons mentioned above, I now take one at lunch time and evening, calcium is better absorbed  if taken with a little fat (I guess that's a square of choc then ) antacids, Risedronate Sodium take at least an hour before pred.

3

The simple answer is to split the times we take our pills. As I tend to take my Preds first thing in the morning it is no problem for me to take calcium mid afternoon and evening. However if you tend to split your doses of Pred between morning and afternoon then this could be a problem.

4

Surprised some split pred dose as I understand the reason for taking Pred at breakfast is because that's when our bodies are busy at doing what pred stops.

5

The following may interact with a calcium supplement, my pred label says wait two hours with antacids for which calcium carbonate can be used. (The calcium stops the absorption of the pred being so effective.)

bisphosphonates

sodium fluoride

thyroxine

quinolone or tetracycline antibiotics

thiazide diuretics

corticosteroids

cardiac glycosides such as digoxin

iron

Also it is said that certain foods such as those containing oxalic acid or phosphates should not be eaten at the same time as it causes a locking interaction which neutralises the effect of the calcium. I am not sure how much this has been researched. I am afraid oxalic acid is contained in chocolate! (and beer). 

6

I have been taking asprin at night since I twisted my knee jumping off of the tractor. It has certainly allowed me to sleep and also wake up pain free. I have heard that pred and NSAIDs are also frowned on. Any words of advice?

7

Glad you are doing your own research.  I have been given much conflicting information.  I take 8 mgs. of prednisone, reduced from l0mgs. in January

2014, it is a slow process.  I take no other medication.   I went down to 6mgs.

but found any stressful situation (eye injections for macula edema) necessitated

vacillating between 8 and 10 mgs.   I shall try 7mgs. in another two weeks when

my body is calm and rested.  Listening to my body, eating sensibly, counting my

blessings with a little exercise is the only path for me, look for your path and see

what is good for you, and good luck.  I'm 86 - lasting far too long but as long as I'm

"healthy" then so be it.   Cheers. 

8

I'm told that taking NSAIDS whilst on steroids could cause stomach ulcers, best to use paracetamol.

9

Wow Judygiirl, 86, I'm impressed you're using a computer, most I know of your generation and younger refuse to go near one!

Like you, I'm trying to be good with my diet, I have done so for about 13 years after being diagnosed with MS. Looks like stress is my trigger, it was for the MS and is now for GCA, outwardly people say I thrive on stress, I am good at dealing with situations and problem solving but it looks like internally I implode. Not sure how I can change this since it's not something i consciously do. This is my third auto immune disease, I also have alopecia! Hoping the steroids will help head hair regrowth, don't need more on  my chin!!!!

10

cc23145 and somersetsue

I took a small daily dose of Ibuprofen just to enable me to get out of bed for the loo and for hospital appointments by ambulance and wheelchair for several months during my undiagnosed year and at the end of that time was diagnosed with reduced kidney function!  I will never take them again and certainly didn't take them alongside Prednisolone when finally diagnosed.  It is never a good idea to take NSAIDs such as Ibuprofen alongside steroids - the steroids thin the blood to a certain extent and adding in a NSAID could lead to an ulcer and a bleed.  In fact I was at the AGM of our National Charity, PMRGCAuk, just last week and the Rheumatology Professor mentioned during his talk that he was strongly against anti-inflammatories. 

You've all got it right in advising against taking Calcium supplements at the same time as Pred due to the possibility of the calcium rendering the Pred less effective.  So it's Pred with breakfast, and the calcium supplement with lunch and with supper!

11

Hi Sue - I also have alopecea on and off and have done long before PMR. Its kind of blotchy. At 15mg my hair thickened but now as I cut down, its thinning again. I am on 12.5 and yet that is what has happened.

Question: I have yoghurt in the morning and milk in my cereal - does this count as calcium?

12

I would say breakfast is ok, yes it contains calcium but not in the amounts a supplement would, if it were that drop dead the label would say do not take with calcium.

13

I wish my doctor and/or pharmacy had pointed out the problems with taking prednisolone along with calcium.  I read an article about it a couple of days ago and did a search on this forum and came across this thread - glad I did. I have just got down to 10mg (was diagnosed with PMR in June) and was having problems with some good and some bad days - did a quick check and it seems to tie up with when I took my calcium tabs, as some days straight after the preds and some at lunchtime!   Normally I take all my tabs straight after breakfast to clear the decks, except the evening calcium.  Thanks for the advice will re-arrange my day.

14

Will you post the URL of that article?

15

Sorry it was not from the internet but in a newsletter I received from the PMRGCAUK.   There is a link www.pmrgcauk.com/downloads/1/ where you can download the article, it's on page 3.  Hope this helps.

16

Seems there is a problem me putting an address in, so a search of PMRGCAUK in the usual place will give you the correct address and look for newsletters.