PMR and colds


I recently had great advice regarding alcohol consumption while taking prednisolone and also managing time differences while on holiday.

I am currently in a 12 hour difference time Zone to UK while on holiday and my GP recommended that I stick to taking my medication on UK time. I suggested what DL recommended but was told that my recent blood tests was normal but white cell count up so must be repeated when I get back to the UK. I developed a cold a few days ago so that may have been the reason. I am worried about what I can take for a cold while on prednisolone. I have been told that the slightest infection could cause problems & require increased dosage. I am on 9mg & hoping no increase necessary.

Taking the prednisolone about 9pm US time is really affecting my sleep. Also it coincides with evening meal times & makes me cautious about mixing alcohol with it at that time. I have stuck to a glass of wine or cocktail. It was less of a problem when I took the medication in the morning.

Any advice regarding coughs and colds appreciated. Apart from that, I am having a good holiday

20 Replies

  • How long are you going to be in the current time zone? I'd be tempted to switch to accustomed morning dosage; that is in fact what nearly all travellers do so GP's advice a bit puzzling. The transition day either way may mean you get a bit more or a bit less than usual, but pred is flexible that way, not like some meds which have to be very carefully titrated to keep heart ticking right for example. I'm sure someone who has actually done this will be along soon to give advice, because as far as I know the only times you need to pay attention are the days you are travelling across time zones to make sure you get enough over a 24 hour period.

  • I will be in current time zone for a week which is 12 hours behind the UK. I usually take the prednisolone about 8/9 am UK time so have been taking it about 9 pm here to sync with time in UK. Took normal 9 mg last night. Now nearly 9 am here & just contemplating biting the bullet and taking full dose about 10 am. This will put me on track to take it in the morning for the rest of the week and hopefully improve my sleep pattern. It would mean that I would have had 18 mg in 24 hours but hopefully will be ok. Might even help with my cold symptoms.

  • Good griefs suggestion to move your dose further away from bedtime but not necessarily to morning makes sense as you've only a week to go. Hope you are having a great time in spite of it all!

  • I've fortunately avoided getting a cold since I started Pred, but I would head to a local pharmacy and ask for a consultation with the pharmacist. Wherever I've traveled in the Western world, these folks have made good recommendations for OTC medicines that relieved the symptoms of whatever ailed me. Make sure to tell them everything you're taking and everything you're allergic to or had a bad reaction to (including any food allergies).

    As for changing the time of your dosing, moving it back an hour or two shouldn't make a whole lot of difference overall, and might make it easier to sleep.

  • Hi,

    As Heron suggest goes back to taking it your usual UK time. That's what I was trying to tell you previously, but obviously didn't explain it very well.

    If you can manage on half a dose tonight, then take full dose in morning so you're back in your normal routine. Won't do you any harm, but don't try and go without anything tonight especially if you have a cold.

    You can take paracetamol with Pred without any problem. Don't bother to buy cough mixture, just have honey & lemon in hot water to keep your throat lubricated.

    The cold will increase your blood markers slightly but if you know why then don't worry, and don't increase Pred unless you feel the PMR is getting worse. You may feel a bit more achy but the paracetamol should address that - if it doesn't, then take an extra 1mg of Pred for a few days.

    Alcohol is okay.

    Enjoy the rest of your holiday.

  • Thanks DL. Thinking of taking my full 9 mg this morning about 10am & then each morning while here. Have a stop over on way home for 3 days which is 5 hours behind so moving it now might help.

    Trip was booked before diagnosis made so have to work with it. The extra dosage this morning may even help reduce the effects of cold virus. I have been taking paracetamol and sucking throat lozenges but missing the honey and lemon remedy. Will have to go in search of a supermarket.

    Thanks for advice

  • Ok,

    As I've said before, not sure if it was to you, but I always put my watch on to destination time as soon as I get on plane, and sort my tablets accordingly.

    If necessary, depending on whether you're going forward or backward in time, take an extra half dose to get you through, or even a full dose. Won't do you any harm, and it's a stressful business anyway!

  • Thankfully alcohol is okay. I never thought of alcohol so fondly before PMR and Pred. I tell you it is the most effective medication for me for the late afternoon aches, weakness and wobblies. I don't know why these symptoms hit me at that time. They go away of their own accord later in the evening, but some time between 4-6 I get these uncomfortable symptoms. They make me think I'm heading for a flair or experiencing some bad Pred. side effect. But a few sips of alcohol really sets me straight. Is it the sugar in the whisky? PMRPro posted that the vasodilation effect of the alcohol may increase the bloodflow to PMR affected body parts and so brings relief. (Wine bothers my stomach and can give me a headache sometimes.)

    Maybe I don't need to know. Just that it's ok to drink with PMR and Pred. At least in moderation.

    Before PMR I rarely drank at all. In 2014 I developed something that looked like Rosacea but wasn't. Never was diagnosed. Just a lot of persistent facial flushing if I was in a stuffy warm place, or if I drank alcohol or had caffeine. The alcohol effect was immediate. The caffeine effect was when it was wearing off, in the late afternoon, usually at about the same time I get the achey wobblies now. How strange. Since the Pred I'm more heat tolerant and whisky tolerant. ;) Haven't tried caffeine except what I found in the Kambucha I started drinking with dinner.

    I was wondering why I started staying up until 1am and not sleepy . Then I read the Kambucha label. It has caffeinated green tea. It also has traces of alcohol from the fermentation. I drink it a lunchtime now and am ready for bed at 11:30, my old time.

    Apologies for the long winded/rambling post. And I haven't had any whisky at all today. I'll just blame it on the witching hour, 5pm my time. Still dealing with a bit of the aches and wobblies. No alcohol for me though until I'm home from ferrying grandson from one activity to another.

  • Hi,

    Think many find that time of day a bit "odd". May be something to do with our usual body clock, if my memory serves me right that period is a bit of a down time. Can't remember why, but expect someone will!

    I rarely drink at home now despite all the jokes about it, but in company never say no to something bubbly!

    My late hubby was in Military - and there was a lot of social drinking for a good number of years, so when he came out we eased off considerably!

    White wine can be a bit acidic sometimes and reds sometimes a bit heavy. Can appreciate most spirits except whisky - not to my taste! But each to their own!

    Take care

  • I wonder what it is about our diurnal rhythms/biological clock that makes that time of day so off. Kids get whiney or hyper and regress, elderly sundown, mental patients tend to exhibit more psychotic symptoms.

  • Naturally speaking we should have a post-lunch siesta - most of us don't so by tea time our bodies are complaining and when ill it is more noticeable

  • Hi,

    Here's the reason -

    People naturally experience dips in energy levels because of circadian rhythms. Research reveals there is one major dip in energy and alertness when we need that dip most - during the hours between midnight and dawn, when most people sleep. And the second smaller dip occurs around 1 p.m. and 4 p.m known as the post-lunch dip, the postprandial dip, or the secondary sleep gate. The extent of this energy dip varies a bit with each person, but typically people experience an abrupt drop in alertness and concentration at this time.

    As PMRpro says in days of yore, we would have had a nap after lunch, but not any more!

    Mind you we also got up with the sun, and went to bed when it got dark!

    Now everything is 24/7 - how I hate that expression!

  • ...and also slept in 2 bites overnight!

  • Regarding your problems with kombucha, it is so very easy to make your own and then you can use any green tea you like and any flavouring. Certainly no need for caffeine. I like to make it with ginger or cardamom. You just need somebody near you to get you started with a "scoby". You could save a fortune!

  • What is a "scoby "?😀

  • "Scoby" is actually an acronym: Symbiotic Culture Of Bacteria and Yeast. And that's exactly what it is! A scoby is the living home for the bacteria and yeast that transform sweet tea into tangy, fizzy kombucha — think of the scoby as the coral reef of the bacteria and yeast world"

  • Thanks. Now I will Google how to start a scoby.

  • "I have been told that the slightest infection could cause problems & require increased dosage"

    I think that is really rather over-egging it! I have yet to have problems with a cold or minor infection and I've been on pred for 8 years. Most of it at doses higher than you are on - 8mg is the amount the body normally makes of its own in-house corticosteroid, cortisol, and the body doesn't make it when unnecessary so you aren't really at a much different status than someone not on pred.

    And I really do think your GP has made life unnecessarily uncomfortable saying to stick to UK time - I take an extra but smaller dose 24 hours after my last dose at home to carry me over to next morning (on the long way travelling, (i.e. Europe to USA) to adjust the need for the next dose to early morning where I am staying.

  • Since my post, things have improved. Cold is getting better with paracetamol, plenty of fluids and menthol throat sweets. Also changed medication time & took my normal 9 mg dose USA morning time and did not experience any significant effects. No change with the sleeping (waking at 4 am) but could be the 12 hour time difference and not the medication.

    Thanks for all the replies. Been a great help.

  • Just a note about sleep. When I started taking the prednisone at night I found sleep difficult. The Actemra also caused me to itch . The doctor told me to take a benedril at bedtime.. I cut it in half and that allows me to sleep.

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