Prednisone dosage /split

[30048]

I read this blog first thing every morning and I think that it it is responsible for my retaining my sanity. The advice given a while ago was to take the medication in the wee hours of the morning to offset the stiffness and pain upon arising. I had been told by one doctor to split my dose and my question is...(.I am on 15 mg. right now and am taking 10 mg at 2 AM and then 5 mg. when I get up. I have both GCA and PMR and right now this is the minimum dosage to allow me to function.) am I doing this right???I am under pressure to reduce and if I can...do you have any formula for a split reduction.?

[PMRpro Ambassador]

I know US doctors often suggest 2/3 in the morning and 1/3 in the evening. I'm not sure - I take mine all in one dose and in a form that allows me to take it at 10pm - but it releases at 2am - but if I were doing it the way you are I think I might try it the other way round, 5mg at 2am and the rest in the morning. Have you tried 5mg before going to bed and the rest in the morning? That would save getting up in the middle of the night! Or what happens if you take it all at once at 2am?

The main reason for splitting the dose is for patients where the effect doesn't last well the full 24 hours so they take a decent amount in the morning for the day and then the rest in the evening to make early mornings better.

If you tried the 5mg at 2am you could then try the reduction on the 10mg part of the dose - not more than 1/2mg at a time and preferably spreading it over a few weeks as in the "dead slow and nearly stop" approach.

[30048 in reply to PMRpro]

Thank you....I will try it the other way around.

[PMRpro Ambassador in reply to 30048]

Do tell me how you get on...

[30048]

just the first try to be sure but woke up at 5AM and had considerable more stiffness when I got up. will continue and let you know how it goes.

[Zoesquare1 in reply to 30048]

Hi there. How's this going? I take 12 mg/day total: 10mg upon rising (~7am) and a 2mg "boost" ~11am. If I forget and take the boost anytime after ~2pm, I'll generally have a restless night.

I find the larger dose in the am kicks the morning pain and the 2mg afternoon boost is very helpful when I'm at work or have afternoon activities that won't allow me to rest.

[30048]

It is hard for me to answer that question. I have good days and bad and never know what it is that sets me off. Yesterday I could barely walk upon getting up . today ..it was not too painful. I take the prednisone during the night and then again when I get up. It does not affect my sleep at this dose (15....split 10 and 5). What I have noticed is that my reaction to the prednisone is much less. I do not get the shaky feeling and burst of the steroid that I did on just one dose. I do not have to wait as long in the morning for it to kick in. I am a "morning person" so it is a benefit in that regard. I do not think that the split affects the disease at all...just my handling of the side effects of the medicine. I have thought of splitting the dosage into three portions to try to copy the time released one not available in the US but have not done that as yet. I have GCA also so my eye is of paramount concern and I am not sure how far I should experiment.

[PMRpixie]

I would just like to affirm your statement about reading this forum each day. It just feels so good to know I'm not alone on this weary journey. A big thank you to all who take the time to kindly answer questions and those also who are willing to share their pain and suffering with the rest of us. I have had PMR 5 months. Like so many of you there are days that are hard to suffer through. You all contribute to my encouragement !