What time of day is best to take Prednisolone.

[Tonysue]

I am taking 11mg. a day and trying to reduce by the very slow method. I’m struggling at the moment. There’s a lot of stress in my life just now and I know that isn’t helping but know I have to keep going. I take all my dose with a light breakfast but feel a bit unwell for two or three hours afterward. I did change to taking it at bedtime but that meant I would need to get up 3 or 4 times to use the loo, every night. Does anyone have these same symptoms? If so is there something I can do to change things.

[SnazzyD]

Yes, same problem. I went for the multiple trips to the loo instead of feeling awful during the day as I couldn't function. However, keeping my salt down means I now go only once. As soon as I have more salt than I should, I stop peeing by day and make up for it by night.

[Tonysue in reply to SnazzyD]

Thank you. It’s always helpful to know that it’s not just me!😕

I have almost no salt in my diet so don’t think that is why I get up in the night. It happens after I take Pred in the morning too so I’m careful about not going anywhere where I can’t get loo.

Oh well .....

Sue

[DorsetLady PMRGCAuk volunteer]

Hi,

Some people take in in the early hours if they get up for a call of nature, or even set the alarm! That way it gets into your system ready to fight the little critters (cytokines) when you are ready to get up. Uncoated Pred takes an hour or two to work. Not sure how successful it is, but I suppose it’s worth a try.

Or alternatively some split their dose, say 2/3rd am, 1/3rd evening. That way the 1/3rd helps first thing in the morning, but maybe not enough to make you get up for the loo.

Sometimes it’s just trying different things and then go for what’s best for you.

[Tonysue in reply to DorsetLady]

Thank you . Think I might have a go at splitting the dose. How do I know if my tablets are coated or not? What difference does it make? Now I know that it really is something that happens when taking Pred. I will have more confidence in deciding what’s best for me.

Sue

[DorsetLady PMRGCAuk volunteer in reply to Tonysue]

Hi Sue, coated ones are slightly shiny and feel smooth - sometimes called enteric and they take long to work because they get down further into your digestive tract before they dissolve . Uncoated are like aspirin - feel s bit dry in the mouth - and may have a line across them. They usually start working after an hour or so and are dissolved quicker which is why you should take them with food, and why a PPI is also prescribed to stop ulcers!

[Tonysue in reply to DorsetLady]

Thank you for that explanation. My tablets are coated so, as I usually wake around 5am I’ll take them straight away. All the info. I get off this wonderful site is enormously helpful.

Sue

[Rugger in reply to Tonysue]

Sue, the wording on the packets of 'coated' tablets is "Gastro-resistant". I've read here that they take 5 - 6 hours to be effective, so the earlier you take them, the better. I take mine at 10pm so they'll be in my system when the cytokines are released. I don't seem to get the urinary symptoms, thank goodness.

The plain pred look like little sweeteners lol!! and take only a couple of hours to get into your system.

Take care x

[Flateric1 in reply to DorsetLady]

I have recently started to take my Pred with some milk about 3.30am ( I'm usually up then to use the loo ) and the difference to how I feel during the morning is great ..... gone is the ''brain fog' and I can actually function ' normally' .... I used to take it on waking up ... about 8.30 and felt awful for the rest of the morning ..... so if you can ... try this .... and I hope it works for you too xx

[Tonysue in reply to Flateric1]

Thank you. I do wake very early so have decided to set my alarm for 3 and will try that. That ‘brain fog’ has been scary. I didn’t put it down to Pred. Thought I was getting dimentia. Think my husband and children thought so too. Feel much better since asking for help on this site.

Sue

[Flateric1 in reply to Tonysue]

I do hope this will help you too Sue ..... please let me know how you get on .... take care xx

[PMRpro Ambassador]

"I know I have to keep going"

No you don't. If you are struggling, stop reducing to a timetable and wait a few weeks and then try again - it may make all the difference. Particulalry if you have a lot of stress - PMR and stress make bad bedfellows. And reducing to a fixed timetable almost never works well.

Several people I know (including myself) have gone through stages where they feel unwell a couple of hours or so after taking the pred. Some have found taking it at bedtime helps as they then sleep through the wobbles but if it make you need the loo that doesn't work. Have you tried at other times? Or splitting the dose? That's fine for PMR, less so for GCA. I just stopped going out to do things at the time I experienced the wobbles - it was because I was out shopping at that particular time

[Tonysue in reply to PMRpro]

Thank you. I try to sort the day out so I stay at home when I have that wobble time. Can’t concentrate when it’s happening. We’re always up early so I am on my feet by late morning. I’ll take your advice and stop reducing for a while. Part of me is anxious as the doctors always seem to encourage us to get off the Pred. as quickly as possible, don’t they? They obviously haven’t seen any one with P.M.R. trying to get out of bed in the morning.😳

[PMRpro Ambassador in reply to Tonysue]

Exactly - they expect everyone to be the same. We aren't - and neither is our PMR or GCA. You will be able to reduce when YOUR body is ready. Not when mine is - and certainly not because your doctor tell you to!

[SheffieldJane]

Golly you live and learn. I didn't realise that Pred made people feel particularly ill directly (after absorbing it). I didn't realise that having to get up several times for a pee in the night was Pred related. It's odd to read posts about symptoms and not be nodding away. Obviously still got an awful lot to learn!

[Tonysue in reply to SheffieldJane]

Glad to have been a help.😕 there’s always something to look forward to. Lol

Sue

[Suedeshayes in reply to SheffieldJane]

Yes, I am like you with no ill symptoms or wobbles after taking the steroids. I take mine st 4.30 am every morning and this works for me. I don’t get up through night for a wee either. We are all so different, as Dorset Lady says and we must try our different methods that suit us personally.

suedeshayes

[Slowdown]

Hi Sue,

I've found that splitting my dose works well. I'm also on 11mg enteric pred and have hit a plateau after a flare so sticking with it for a bit. Diagnosed July 2015. I take 8mg at 9am and 3mg at 9.30pm which kicks in around the time the inflammatory cytokines are active.

I do get up for the loo a couple of times a night but it's worth it to wake without pain.

If there's stress in your life it's not a good idea to try and reduce, PMR takes it as a personal insult - if you can, take a duvet day every now and then, rest and read or watch the box sets, it stops the mind churning things over and is mentally and physically refreshing. Best of luck. Let us know how you get on.

[Tonysue in reply to Slowdown]

Thank you. I was diagnosed in2012 and got on really well. Low dose Pred. and pain and stiffness very low. But after my husband was diagnosed with cancer 2 years ago it’s been much worse and the symptoms are more severe. I do try and rest sometimes and watching tv is good as it distracts. I walk my dog every day and it really helps. Just feel a bit overwhelmed with things. None of which are important as Tony is doing well and that’s what matters. Now I know that it is Pred that is making me feel rotten and have had such good advice from everyone I feel more positive.

Sue

[Slowdown in reply to Tonysue]

So glad your husband is doing well, very stressful to go through that for both of you. In my own experience the effects of dealing with awful events only show up later, we deal with things at the time (there's no other option, is there) and when the situation eases our guard goes down and we suffer the delayed mental reaction, just when you think there's a reason to be thankful rather than overwhelmed. Mysterious creatures, aren't we...

Love my walks each day, blows away the foggy brain. Keep the positive feeling, Sue.

[Tonysue in reply to Slowdown]

Xxxxx🙂🙂

[SheffieldJane in reply to Slowdown]

I second that Slowdown. I was under unrelenting stress in the years that preceded PMR. As soon as the stress relieved Bam! I got PMR.

[Slowdown in reply to SheffieldJane]

Sometimes it makes you feel like wailing it's not faaaaiiirrr, doesn't it.. then on we go!

[marciahiatt in reply to Slowdown]

I love all these comments and a real help in learning about PMR.

[SheffieldJane]

I think the Calcium ( Adcal) causes urinary symptoms. I left it off for a few days and they went. I'd been thinking it was Pred, no infection present. I think PMRPro told us about the chalkie nature of Calcium supplements caused bladder irritation. Not sure how to get round that.

[Tonysue in reply to SheffieldJane]

Never thought of that. I only take them on and off. I’ll experiment. Thank you.

[Oldman-1 in reply to SheffieldJane]

Just a foot note, Calcium thickens Blood. The more taken the worse it is.

[Brandon47]

I have always taken mine in the morning with light breakfast and no ill affects. I'm now down to 5 going down to 4 this week - it's taken me 19 months from 20 - keep going

[Tonysue in reply to Brandon47]

Will do. Thank you.

[SheffieldJane in reply to Brandon47]

Can't take them too near Pred though Brandon.

[SheffieldJane in reply to SheffieldJane]

Sorry the bizarre order that replies appear in make this a bit of a nonsense . I thought you were talking about Adcal Brandon.

[Telian]

I was told to take in the morning as soon as you got up

[marciahiatt]

After reading many of the messages for 10mg and under, I'm starting to get nervous. I've gone down from 20mg to 15, very slowly, and I break it up into morning and evening. When I took the full dose in one go, I was a total mess.

[SheffieldJane]

I'm sorry marciahiatt. I think everyone is in a moany mood today. What specifically makes you feel nervous?

There are people who glide like swans through a taper. 7 mgs seems to be a bit of a sticking point for some. I'm going to rest there for a bit until my Adrenals catch up. There are a lot of happy bunnies on 4 mgs or less.