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How long is it safe not to take pred for (hours not days)?

Bombing down the A38 today I realised I had not taken my pred, I blame the new spa pool, I was busy making sure the heater had been turned on again and the cleaning tablet had been put in and it was ready for a day of kid using it and forgot my pot of pills with my actimel! I did not actually take my pred until about 5pm when I got home, this was roughly between 8-10 hours later than normal. I could have stopped en route to a GP I know I got a script but I assumed it was OK to leave them until 5, was I right?


ps is that why I have needed more nebs than normal this evening too?

4 Replies

Not entirely sure on this one missing pred always a bad idea!

I think everyones different depending on your adrenals and how you metabolise your pred.

I know if i miss mine by a few hours i feel really unwell sick faint etc but thats cos my adrenals are fast asleep which is why i need split dosing in the day. Prior to adrenal problems the drs always said could miss one dose, ie 24 hours if vomiting bug or similar without any problems but no longer.



Everyone is different, of course, and obviously things change if you do have adrenal problems as well, but in general, missing a single dose should not be too much of a problem. Prednisolone has quite a long duration of action - it has a what's known as a biological half life of 18 - 36 hours, even though plasma levels are only maintained for perhaps 4 hours (the effect of prednisolone is not dependent on having good plasma levels, unlike, for example, theophylline). However, if in doubt, do check with your doctor - if you have absorption problems or have particularly steroid sensitive brittle asthma then that may change things.

Obviously if you have adrenal issues, whether temporary due to long term pred, or more permanent, this may change things and you might find yourself feeling very unwell after just a few hours off pred.

Theophylline and long acting beta agonists like salmeterol can be more of an issue, as they have a duration of action of approximately twelve hours - certainly, if I miss a single dose of theophylline, I am usually pretty unwell after only a short time.



I have missed it on rare occasions and noticed around 6 hrs later that I am really light headed & feeling zonked - I always have some pred in my handbag just in case. ( Usually notice the lack of theophylline first!)

Even when I have had a stomach upset I have tried to take it later in the day - sometimes it stays down.



I was not feeling right on the way home but that could have been the weather. I normally have pred in my car but used my emergency supply about a week before when shot out of bed to deal with a child crisis and did not have time for any meds. I am not on oral theophylline anymore pred is my only must take.



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