Is there any evidence to support the use of enteric coated (EC) over uncoated prednisolone tablets?

Publisher: London and South East Regional Medicines Information Service

Date published: 01/02/2010 17:45

Review date: 31/01/2012 17:30

Summary
by: Yuet Wan

Data on this subject are sparse and the last overview, which was published in the Drug and Therapeutics Bulletin (DTB) 1987, concluded that uncertainty remains as to whether enteric coating decreases the tendency of steroids to cause ulcers. This was also the conclusion of the previous DTB on this subject in 1977, i.e. “there is no evidence that EC prednisolone is less likely than the plain tablets to cause peptic ulceration (PU) and the evidence that it is less likely to cause dyspepsia is not satisfactory. Since the DTB, a few more papers on this subject have been published but these are limited to pharmacokinetic studies and case reports. As the debate continues about whether the EC formulation provides gastro-protection compared with the uncoated tablets, in addition to the cost differential of the two products (six-fold difference at time of writing based on Drug Tariff Jan 2010), a summary of the findings of the DTB and an update of the literature with a focus on the implications of switching formulations are presented.

About this library entry
NeLM area:  Evidence > Medicines Q & A

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