What would you think they are asking my GP to do from this part of a letter?

[Yourinmyspot]

I saw the dermatologist back in February and they put me on steroids and said they would ask my GP to prescribe me some calcium. They finally sent the letter this week to the GP and a copy to me.

It says ‘I therefore recommend that she continues on Mycophenolate Mofetil and Prednisolone 30mg daily, for 4 weeks, then reducing to 20mg daily for 4 weeks. I have also prescribed Omeprazole 20mg daily. I would be grateful if you consider adding, for bone protection.’

My GP has added Omeprazole to my repeat, i think the letter is poorly worded, missing the key word of calcium!

Isn’t Omeprazole for gastric issues?

Its like they have missed out the word calcium after the i would be grateful if you consider adding. I would contact the consultants secretary and ask them to clarify and rewrite the letter

Yes

The omeprazole may interact with the Mycophenolate Mofetil. Are you clear on why you are taking all these? Or is that why your posting because of the confusion?

Yes the Omeprazole is to protect my stomach from the steroids.

Looks like yet another thing to chase up. This letter wasn’t even sent until six weeks after my appointment and I should have been seen by then. I had to ring dermatology as I would run out of steroids they sorted out my prescription but my next appointment is 15th May which is 12 weeks after my last one, the whole point of going back after six weeks was to see the response to the steroids.

I will contact my GP first and explain it to them, though after all the fiasco with antibiotics recently I’m not holding my breath.

Yes omeprazole will be for gastric protection for the steroids but you will need something for bone protection with that dose of steroids for that length of time. I'm a bit rusty having not checked the guidelines for a few years as I'm retired but you may even need a bisphosphonate such as alendronic acid for your bones. Omeprazole can reduce the absorption of mycophenylate too.

Yes I know why I’m on them all, they said I would be okay with the Omeprazole and Mycophenolate Mofetil at the same time. I wouldn’t be able to tolerate the Prednisolone otherwise as it gives me horrible indigestion.

Is there a Pharmacist at your gp sugery? There is at mine, and they are excellent at this sort of thing-seems to take much less time going straight to them rather than via Gp or back to specialist.

Go and talk to a pharmacist. Ask how much calcium you ought to be taking - you can buy this without a prescription until your GP and/or the dermatologist can sort out your prescription.

That’s a good idea, I will try them.

Thanks I will do this to get started.

Exactly.

It sounds like the consultant has made the error, not the gp.

Yeah they’ve missed off the word calcium.

I was going to suggest speaking to a pharmacist but I see that’s already been recommended 🙂

they've asked your doctor to consider bone protection, not demanded that they prescribe it. If they felt it was vital the dermatologists could (and should) have prescribed it. There are guidelines for bone protection with steroids and round about 3 months is the trigger point all other things being equal so perhaps they were going to see how things were looking in terms of weaning then? Hopefully they'll be able to reassure.

My GP has prescribed me alendronic acid and vitamin D for my bones. He said I don’t need calcium supplements unless my diet is awful, which it isn’t.