Timing Prednisolone : Hello, Can anyone help with best... - NRAS

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Timing Prednisolone

Inanotherlife profile image
25 Replies

Hello,

Can anyone help with best time to take 10mg Prednisolone with please?

I’ve been on it several times before, I’m on it now until I get new medication.

My RA pain is hideous in the morning but I have to be up for school run so I was taking it at 10pm ish which helped me in the mornings but was stopping me sleeping which in turn worsens my RA.

So I’ve changed it to morning but I’m in agony pretty much until after lunchtime now. Any suggestions, should I split the dose? Thanks in advance x

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Inanotherlife
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25 Replies
Amnesiac3637 profile image
Amnesiac3637

Hi. Have been on prednisolone for over 30 years and was advised to take it in the mornings as this mimics your body’s natural production of cortisol which the steroids enhance. If you take them at night you’re out of synch and it can, as you’ve found, affect your sleeping patterns. If you get into a routine of taking the whole dose with your breakfast that’ll be the optimum time. You probably need a much better pain relief than you’ve got now as steroids are not pain relievers - they reduce inflammation overall but don’t necessarily do much for targeting pain. Hopefully your new medication will be the answer.

I am a retired practice nurse and there have been studies in America pointing out taking a low dose steroid at three in the morning ( eergh!) may help stiffness in the morning but in England the doctors don’t tend to use that method and slow release prednisolone is much more expensive than the tablets doled out in the rheumatology/GP practices. Hope you feel better very soon.

Kags1068 profile image
Kags1068 in reply to Amnesiac3637

H AmnesiacJust to back-up what you have said. I have been on Prednisolone for 30 years now, and I was always told to take it the way you do, and for the same reasons. My first rheumatologist was very insistent that was how it should be taken, so I always have! 😉😊

Inanotherlife profile image
Inanotherlife

Thanks both, that’s interesting.

He told me not to take anti inflammatories whilst im on the steroids because of stomach issues.

I might just try the 3am idea.

What do you think about splitting the dose?

Amnesiac3637 profile image
Amnesiac3637 in reply to Inanotherlife

My reply still stands - leave it up to you!

Need2knowN profile image
Need2knowN in reply to Inanotherlife

weren’t you given omeprazole with your NSAIDs? That helps with the stomach issues. I’d get advice from your pharmacist about drug contraindications. Don’t suffer needlessly.

StormySeas profile image
StormySeas

Ditto, just to reinforce Amnesiac's post!

Early am is best.

I made the terrible mistake of taking my 20mg dose in 5mg tablets 4 x day. Big error... 🙄

Mmrr profile image
Mmrr

I've always taken my oral prednisolone in the morning for the reasons said above.Very briefly I tried taking it at 2 - 3 am, but found it interfered with my sleep.

I also take all of my anti inflammatories with oral prednisolone...and always have done.

Are you on a stomach protector ?

Inanotherlife profile image
Inanotherlife

I’ve had omeprazole in the past but I’m not on it now. Perhaps I should ask my go about that so I could take Ibruprofen at night and stick to taking the Prednisolone in the mornings…

Lolabridge profile image
Lolabridge

I was also advised to take it early in the morning for the same reason as Amnesiac mentions.

I take the Omeprazole PPI first then the Prednisolone. If you have not been prescribed a PPI, either ask your doctor to prescribe one or eat something first before you take the Prednisolone to give some protection to your stomach.

Inanotherlife profile image
Inanotherlife

thank you, I’ll do that.

Fra22-57 profile image
Fra22-57 in reply to Inanotherlife

also the sugar coated prednisolone is better

seabreezegirl profile image
seabreezegirl

I take 5 mg AM and 5 mg PM it seems to give better around the clock coverage I feel .

I also take an extra strength Tylenol 500 mg ... 30 minutes either before or after the predisone . It does not bother my stomach at all . And I just take with alittle water as I have noticed taking it with other meds or food makes it not work as well .

Daylesford1915 profile image
Daylesford1915

Hello there,

I have been on Prednisolone for 4 years and have always been instructed by Pulmonary specialists to take the medication first thing in the morning with breakfast. An interesting point for me, I tapered from 50mgs to zero over 2 years, then had to go back on to 20mgs for another attack of organizing pneumonia 18 months ago. I was told very categorically to taper off the medication again only to find my RA go crazy. I've put myself back on 5mg and the inflammation is under control but the pain marches on particularly in the colder months. I have pulmonary fibrosis and COPD and insist on quality of life. I was told by my various pulmonary specialists that taking prednisolone at night would cause major sleep problems. So I agree with Amnesiac that keeping in the body's rhythm is a good idea.

Runrig01 profile image
Runrig01

When prednisolone is taken for its anti inflammatory purposes, it should be taken all at once in the morning, with food or a glass of milk. It will disrupt sleep if taken late in the evening.

I have severe adrenal insufficiency from years of steroids causing my adrenals to atrophy. I do split my dose taking some at 6am then 3pm. However that’s because it only works as cortisol for 8hrs, whereas its anti inflammatory properties last 24-36hrs. I tried taking 1mg at bedtime, as I wake feeling like I have critically flat batteries till my pred kicks in. However even just the 1mg disrupted my sleep. So I accept it’s a few hours before I can function in the mornings. I do have a faster acting steroid I can take in the morning, if I need to be on the move quickly. Thankfully I’m medically retired, so take things at a slower pace. You body naturally starts priding cortisol at 3/4am , so you wake refreshed and ready to go. You could try taking it then, but it may stop you getting back to sleep.

Seatgeorge profile image
Seatgeorge

Take it first thing when you have a cuppa and breakfast , never take them on a empty stomach theynormally kick in after about half an hour.

Inanotherlife profile image
Inanotherlife

Thank you for all the replies, appreciate the advice. I’m just sorry to hear how much you are all having to cope with yourselves.

I’ve been put up to 30mg now, following steroid injections into my ankle bone and tendon that haven’t helped as much as anticipated.

oldtimer2 profile image
oldtimer2

When I was taking a higher dose I used to take some at 3am and the rest with breakfast. I found that suited me best.

I remember many years ago doing blood tests to measure steroid levels normally. For me the natural variation was a low at 4pm, and the deepest low at 4am.

Inanotherlife profile image
Inanotherlife in reply to oldtimer2

Ah right, so everyone can be different then, is that a test you can pay for or is it nhs? Thanks

oldtimer2 profile image
oldtimer2

No it was part of project someone was doing at university - I just tended to volunteer for everything....

Nyreedw profile image
Nyreedw

First thing invthe morning plus you need omeprezole and calcium supplements alongside it to protect bones. RA has given me osteoporosis without the use of steroids so definitely do what you can to protect them. X

Velvet13 profile image
Velvet13

I only take prednisone when I have a bad flare up, but I’ve recently discovered Just CBD ultra relief gel (someone else with RA recommended it as he’s unable to take any of the medication) what a life changer , I apply first thing in morning and throughout day if required and within 20mins pain has gone. Fantastic gel , available from Vapor shops.

Inanotherlife profile image
Inanotherlife in reply to Velvet13

CBD products seem to be gaining popularity with RA patients don’t they.

I believe they help with the pain from what I’ve been told but I’ve yet to try them.

In the early years I tried various diets, krill oil, tumeric tablets etc etc but couldn’t say anything made a difference to the RA.

Acupuncture is something else I’ve heard helps some, I must try that too.

Lizzie3 profile image
Lizzie3

I find the best time to take prednisolone is 4 a.m. It takes a few hours for it to start working. You can request coated tablets which are kinder to your stomach. I sometimes eat half a banana before I take the medication. All the best to all RA warriors xx

Domhem profile image
Domhem

Hi, I used to take 5mg in the AM and 5mg in the PM, I was the same as you immobile (school run as well), the 10mg in one hit didn’t work as well for me. I also always request gastro resistant ones to protect my stomach. I know the guidance is to take in the morning and I understand why but it controlled my pain better. I’ve been on differing levels of pred for many years (sadly) and take ibuprofen when I need to which is thankfully a lot less now (only on 2.5mg now as take azia and biologic). What other meds are you on?

Inanotherlife profile image
Inanotherlife

thanks, taking it in the morning isn’t working for me, I can barely function. I’m going to set an alarm for the early hours tonight and try that.

I take Simponi biologic injection monthly but it’s not working, hence changing again. Also ibruprofen and co-codamol.

What’s Azia and which biologic has helped you get down to 2.5mg if you don’t mind my asking?

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