Tuesday, August 18, 2009
Oral steroids are bitter. If you get a chance, smell the pill or taste one drop of a suspension. It is not good. So I understand why young patients may really rebel against taking oral steroids. I may have to prescribe oral steroids for some of my patients to improve the symptoms from allergic diseases (hay fever, hives, poison ivy), severe sinus infections, or asthma. I normally prescribe generic versions of steroids because the efficacy and safety are the same compared to name brand equivalents and the cost is usually lower. There is one more factor for kids: taste. Pharmacists may offer to add: an agent to mask bitterness, something for flavor, and a sweetener. Each costs about $3, so potentially adding $9 to the cost. Without these, generic equivalent of Orapred (prednisolone) syrup is usually the least costly option. Some name brands include: Millipred , Orapred, Pediapred, Prelone, and Veripred. Their costs may be about the same if additives are added and depending on the all important insurance coverage. One other option is Orapred ODT (orally dissolving tablets). They do dissolve in the mouth and have to be swallowed. They have a fair taste. The concept is good. However, their cost is about double on average. So I reserve their use for situations when liquid suspensions won't be taken.