In changing to prednisolone (which is x5 times more potent than hydrocortisone as some know) this may be better than twice a day dosing with HCT which some doctors still do.  That is on the proviso that your doctor tune’s the med’s to your daughter’s exact needs.  That may mean going with a suspension as it can be better titrated to your daughters specific requirements.  In splitting pills, we have to ask our selves here, isn’t perhaps half or a quarter restricting ourselves with regards to getting to preceisely what we should be?  Tablet’s unfortunately have been something that parents have fallen back on due to the recall of cortef suspension.  However that was due to a specific ingredient in the bottles recalled.  There are countless options if you do not trust manufactured suspension.  Right across the message board I think there are several parents who use suspension made  by their local pharmacies.  Our is made by the pharmacy.  Obviously it is senseless giving 5ml suspension to my son (HCT) in the morning if his dose is set at that and this can be achieved with a tablet.  However his afternoon dose is 3mg and the evening one is 7mg.  So this cannot be achieved by splitting a tablet.  If they move him to the nearest that can be achieved with a tablet, this could be either too much or too little, resulting in under or over suppression.  That is where suspension beats tablets, hand’s down.  If you want to have better control of hormones, you need to mimick as near as possible to what their adrenals would be doing.  I feel that using tablets is a very crude method of dealing with the tuning of a dose.  It may be ok temporarily if you are traveling, or if a major pharmaceutical company has recalled medication, but over too long a period, it is going to result in the problems that we have had.  Not only that, but consider also that when they raise the dose they will need to go up in larger increments, which is not what is necessary in these children.  They just need a little tiny tweak in their dosage.  Too much and you will slow the growth down.   My son is 10 years old and was on tablets for over 6 years before we noticed these things greatly affect his bone scans.  Everything.   I would not say that reverting to suspension is a step backwards at all.  This is not all about unfortunately babies having suspension and grown children being able to swallow a tablet.  If manufacturers took more care in what doses they provided tablets in, then maybe it would be that simple, but that however, is not the case.  A 1mg is needed in HCT and much less in prednisolone and dexamethasone before doctors expect us to be ‘big’ boy’s and ‘girls’ and take their meds in pill form.

 

J