When to take Prednisone

Just a quick question. As per my last post, my status is unchanged. Still nauseated +++, losing weight, some vomiting, fatigue +++.....

Anyway I take my Prednisone, 20 mg, in the morning between 7 and 8. My days are terrible, lucky to get out of bed, etc. as described,.....But I think I do feel better in the evening about 12 hours after my Prednisone.....would this make sense? I would rather have a better day as I think I would sleep through not feeling well. Should I experiment with taking it at night?......how do I do the switch over?

Oh, and I got a call on Thursday to go for the special MRI this Tuesday that my rheumy had ordered. Rather short wait considering some of the weight times here, so am very pleased.

Thank you,


24 Replies

  • It does seem that you would benefit from taking Pred at night, it does work for some patients. As to managing the switch-over, you can either not take a morning dose and take it that night, or take the morning dose and another at night. I have used the first method (which was an experiment that didn't work for me).

  • Thank you polkadotcom, I will try that. If I may ask were you trying a switch for symptoms? I had my markers checked yesterday and they were low normal (only my CRP elevates with a flare) and no recent GCA symptoms ......so I don't know how the Prednisone would be involved....it seems towards bedtime the fatigue and the nausea lift the tiniest bit though and I sleep like a log. Would I be putting my sleep in jeopardy do you think? I often think that thank goodness I do sleep because I just couldn't go through this day and night.

  • Some people split their doses between morning and evening. That might suit you as it seems that your Pred takes a long time to have an effect, so your evening dose would still be effective in the morning.

    Its really a case of trial and error - I tried splitting mine, but it didn't work for me, so returned to am only. If you take it all at night, I always think there is a possibility of it disrupting your sleep, which you don't want.

    I think you have to experiment a bit, but whatever you decide you need to give it a chance to settle, and that may take up to a week.

    Good luck.

  • DorsetLady, thank you. I do have gut problems and sometimes wonder how long it takes me to absorb pills and if I do absorb them all. Polkadotcom has also suggested splitting the dose and your suggestions seem reasonable to me. I will do some experimenting .


  • If you have gut problems are you prescribed the coated variety of Pred, I believe that takes longer to get into the system, because it gets further down into your digestive tract before it dissolves.

  • No, I'm just on the regular Pred. Would you suggest half in the morning and half 12 hours later?


  • Some do that. Some do two thirds morning, one third evening. As I said, bit of trial and error, but as yours seem to take some time to work 50/50 might be best.

    Good luck.

  • Animi - just to mention that I could not take Pred (only uncoated available in NZ) as it caused constant nausea, weight loss & gasostrophy revealed erosions in gut lining - had an acid resistant capsule made so that it dissolved in bowel leaving gut alone. You may not have that available to you (I paid handsomely for this but worth every cent) but next best thing would be to try & source enteric coated pred. Also I use Slippery Elm which coats & soothes mucus membranes in gut usually always inflamed - if u try this, take it 4 hours away from meds. It will get you back to eating - your strength is zapped enough without lack of nourishment to feed your sick body.

    Blessings in abundance.

  • Just wondering whether your other symptoms, mentioned in your post are side effects from the VitD3/Calcium I assume you're taking. It might be someone has mentioned this elsewhere, and I could be wrong...but felt it worth mentioning.

  • IdasMum,

    Thank you for your post. What kind of effects of the VitD3/Calcium would these be and from a deficiency or overdose? I was put on a prescription when first diagnosed with PMR but recent levels came back very low so I was told to increase my supplement.


  • Just looked it up and magnesium deficiency can cause nausea and vomiting. This can sometimes happen when we take extra calcium and the calcium/magnesium ratio gets upset. Just another thought.

  • (I Googled and this is the result).

    Call your doctor at once if you have signs of too much calcium in your body, such as:

    stomach pain, vomiting, loss of appetite;

    increased thirst or urination;

    muscle pain or weakness, joint pain; or.

    confusion, and feeling tired or restless.

  • I also found that after taking the morning dose I did not get relief til evening. This went on for months and I finally tried splitting the dose. Taking half in the evening and half in the morning. I didn't get the full effect the next day but the day after was amazing. Pain free. All day. Taking the pred doesn't affect my sleep, which is about the only side effect I haven't got. I hope you feel better soon.

  • Hi I think you've had lots of comments and i would say like they have it's all trial and error. I'm sure you do take you pred with or after food, if not, that's a must. I suffer with nausea, luckily not vomiting, but I take medication to counteract this. Ask you gp/consultant if you don't already have been prescribed med for this. Good luck with MRI and reduction/splitting dose if that's what you chose do do. I tried taking mine in the evening, didn't work for me. We're all so different.

    All the best.

  • I take mine with breakfast food about 7.30 am. I'm fine with that. Also was told to do this by my consultant as it works straight away and keeps me going through the day. Hope this helps you. Good luck with your MRI scan. 😸

  • On the 19/05/16 I had to drive my partner to have a heart procedure and had to leave very early in the morning. Firstly I was pleased that waking at 4.30 am I was fairly pain free, so decided to take my preds at 5am, drove 50 miles, spent the day driving my electric buggy around the grounds of the hospital, then drove 65 miles back (felt so good that we took a detour, to favourite store). Until then I was taking my preds 17.5 mg at around 9-10 am. it had been quite usual to wake with pain and stiffness, which would last until early afternoon. Happened to wake at 5am on the next day and made snap decision to take preds then, went back to sleep and woke in the morning feeling better than I had in months. Since then I have taken them at 5am every morning, eat a biscuit, and go back to sleep, apart from a couple of occasions when I've overslept, my mornings have been mild to good, pain wise. In the passed 2 months , I have flown to Italy for a family wedding, spent 2 weeks socialising with family and sightseeing (I was dreading this trip, as I thought I was going to spend a lot of the time in bed). Since I've been back, I have reduced to 15mg and am doing well. Sorry that this has got so wordy, but the bottom line is, find the right time to take your preds that suit you, it has made the world of difference to me.

  • Hi!

    Yes I take my prednisolone & other medd about 5.00 To 5.30 with some fruit & cup of tea when my cat comes & hits me for food! This gives them a chance to work before I get up!

    If I am on a high dose I tend not to sleep so well but one gets used to most things! Good luck! Cemm

  • It worked for me by taking last thing at night and lasts all day- try it and see if it makes a difference.

  • In extremely rare cases some people cannot tolerate Pred. You need to talk to your Consultant and also your GP. You must tell them everything and that includes losing weight - take someone with you in case you forget to tell them everything or write it all down and let them read it.

  • I am down to 6 mg of prednisone, but as I ususally wake in the night 3:30 ish to go to the washroom so I take my 6 mg then, washed down by a shot glass of kefir. I find I have my best sleep afterwards and dont have that pred. brain fog. I was diagnosed in Feb. have tried to stick to a low carb, gluten, sugarfree diet. Went from 15 mg to 6mg since, still have stiffness and a little pain but can work my way thru the day pacing myself, I quit being super woman for family and extended family and have a afternoon nap quite often.

  • Hi . I am fairly new to all this but was really struggling getting up in the morning on my 10mg and had some rotten mornings as you describe . Whilst awake at 3am about 5days ago I got up and took my pred (enteric coated if that is relivent) with a large glass of milk.

    Next morning was much better and I have done this now every night since . I can get up ,go to work ,I feel much better mentally .the only downside is I get tired and a bit stiff and achey in the evening .

    I know there are so many more knowledgable people out there who know this condition better than me but I just wanted to let you know it was helping me lots changing to nighttime and the enteric coated helped with my nausea as well .

    Good luck with it all

  • My GP told me that Pred takes about 4-5 hours to become effective. I asked the question on this site nearly a year ago did people take their first dose when/and if they woke in the night say around 2.00am (I'm 80 years old and so waking at about this time is normal.) and got an overwhelming response YES. So now go to bed with 5mg tablet of Pred and a yogurt. I've found my days start better.

    Hope this helps.

  • Thank you! I'm 77 so tend not to sleep as much either. Ithink I'll split my dose and take 2.5mg at night & 10 mg in the morning to see if it helps.

  • Thank you for all the suggestions. I think I will give the dose splitting or even taking most/all at night to experiment. It just seems a little strange to me that these problems would start after almost 3 years on Prednisone of varying doses. I will report back with any change.

    And thank you for the advice on supplements. I have a dietician who checks them and also my blood for vitamins and minerals regularly and everything seems to be in order there.

    Another annoying 'side effect' I have from something is a pronounced tremor......as I try to type on this IPad the hand/fingers keep tapping on the screen, and are very difficult to control.

    Thanks so much,


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