Dividing dose of prednisone

[barbthy]

I am currently on 20 mg a day and have been taking it in the morning. Pain relief usually kicks in about 3 PM and is ok until I go to bed. Cycle starts again in morning. A friend suggested I divide the dose, 10 mg in morning and 10 at bedtime. Has anyone tried this and what were the results?

[PMRpro Ambassador]

I'm really surprised it takes so long - pred should start to work within a couple of hours. Or are you in the UK and on enteric coated prednsiolone? That takes far longer to work because it isn't absorbed from the stomach but much further down the gut once the gastro-resistant coating has dissolved.

Quite a few people split their dose and a good way to start is to try 2/3 in the morning and the rest later - before the effect of the morning dose wears off, you may not have to wait until night time.

[barbthy in reply to PMRpro]

Not in UK, in USA and not taking enteric coated

[GOOD_GRIEF in reply to barbthy]

I've been dividing my 20mg dose all along - 10 at 6am and 10 around 8-9pm. Helps with the morning stiffness, and as the inflammation reduces, I felt better earlier and earlier. It does seem to wake me up, though, very early in the morning.

[Zebedee44]

Hello barthby

I found I was always over excited and had difficulty getting to sleep when I took my daily dose of pred in the morning. I asked my doctor for the slow releasing enteric coated tablets and have successfully taken a split dose which controls my pain all day and improves my sleep.

It's getting more difficult as I reduce the dose as I only have 5mg enteric coated and 2.5 and 1mg plain so I am still taking 5mg at night and 4.5 in the morning and about to taper to 9mg. I see my doctor this week so will ask about smaller doses of coated pred.

Personally I find the taste of the uncoated rather horrid, so much prefer the coated, but they can't be split!

Good Luck if you try splitting your daily dose, it worked for me,

Chrissie

[Jackoh in reply to Zebedee44]

You can now get the I mg coated Zebedee44, even if your doctor does think so!!! Jackie

[Jackoh in reply to Jackoh]

Should read"doesn't think so"

- pred head!!!

Jackie x

[Rugger in reply to Zebedee44]

You can get 2.5mg and 1mg coated pred in the UK. They don't do 2.5mg uncoated as they expect us to cut the 5s! I don't think folk can get coated prednisone in the USA - but maybe they can get the expensive type that PMRpro is on?

[piglette in reply to Rugger]

Hi Rugger, the coated pred available in the US is Rayos, but it does cost an arm and a leg it seems.

[PMRpro Ambassador in reply to piglette]

Totally different sort of coating though - doesn't take it through and out of the stomach like the gastro-resistant sort.

[Lochy]

I began to split my dose after about 6 months on Pred as found my pain through the night caused me to wake. It has worked for me and I'm currently on 6mg at night and 7/6mg in the morning depending on the day. I did try to cut my evening amount as I've tapered but I find I'm so much more sensitive overnight for some reason. The other week I tried to drop to 5mg at night and after a couple of nights it just doesn't work and I was quite uncomfortable. Upped to 6mg again and all OK! I know PMRpro has offered good advice on this topic.

My GP and rheumatologist were both surprised by this but were happy for me to carry on if it worked for me.

I'm in the UK and just using the standard tablets.

[Zebedee44]

Many thanks to all for the replies, which I hope are as helpful to barthby as they are to me