40mg prednisolone - one dose or spread over day?

[dimas62]

Currently taking 40mg pred once a day but wondering if I can split the doses?

[PMRpro Ambassador]

How you take pred depends on why you take it. In PMR and GCA, for example, the dose should be taken all at once first thing in the morning, as early as possible. This is because that is the way that achieves the greatest effect on the inflammation the pred is being taken to deal with and at the same time has a somewhat lower rate of side effects. Your body naturally produces a corticosteroid a couple of hours before you wake up.

In a trial carried out for a German drug company, it was found that for rheumatoid arthritis and other arthritises with morning stiffness the best time to take pred is at 2am - but who wants to wake up and take it then? So the company developed a form you take at 10pm, which is released at 2am so that the highest blood level is at 4am - just before the substances that cause the inflammation are shed by the body at about 4.30am.

Pred is got rid of by the body through the kidneys within a few hours while the effect continues for anything from at least 12 to 36 hours depending on the person. That means your body has most of the 24 hours not under the bad influences of pred if you take it once a day. If you split the dose your body never really has time without it.

But the most important thing is WHY you are taking it so you need to check with the doctor which way is best for your illness (preferably the consultant, GPs often don't know the differences. Or the pharmacist may know).

[dimas62]

Thanks for the advice and explanation. Have been taking pred for 6 weeks for GCA and PMR. Currently taking them at lunch time (not good at getting up and eating in the mornings!) but think I will try to start having breakfast so I can take them then. Have been having a few problems sleeping so hopefully taking the meds earlier in the day might help. PS so glad I found this site!

[Hidden]

Hi dimas,

I too have never been an early morning person and because I believe it takes a good three hours for the pred to get up to strength, so to speak, I think it's important to do as little as possible in the 3 hours after dosing. One way is to set your alarm early - say 8 am, get up prepare your favourite morning drink and, for me, it's a couple of slices of wholemeal toast as well, then take it back to bed with the pred. Take the lot and then snuggle down and sleep for a further 3 hours. I have found that when I get up I feel OK.

The other method for me is to get up at say 8 and eat breakfast and take the pred. Then do nothing much for 2 to 3 hours untill the meds kick in.

I'm a big fan of hitting these horrid illnesses with the full dose. I have never split the doses.

If you need to take stomach meds to protect you then take them with half a pint of water before you take the pred.

All the best,

Pats.

[dimas62 in reply to Hidden]

Thanks for the advice. Fortunately I am well enough at the moment to work so don't think my boss would be very happy with the going back to bed idea! Definitely going to have to make the effort to get up earlier...lol

[jinasc]

dimas62

What you could do, is take a flask of hot water, a jam sandwich wrapped in foil, a tea bag and milk. A pot of natural yoghurt would also protect your stomach. Alarm on for 5am, drink the tea, eat the bread and jam, take the tablets and then stay in bed till you normally would get up for work.