Bad Day

[CRW-68]

BAD DAY! Is it normal to be still on 60 mg Prednisone and wake up in the night in pain? The pain was mainly in my right arm and shoulder. I was finally able to go back to sleep. When I woke in the morning my leg and knee were cramping. Also neck is stiff. Once up and walking around it disappeared. Now I just feel a bit off, with some slight headaches. I feel like I want to curl up and in a ball and sleep it all away.

[PMRpro Ambassador]

Whatever it is that is causing that I would stick my head above the parapet and say it isn't PMR. And your doctor needs to put their thinking cap on.

One caveat: try taking magnesium supplements and ask your GP to check your calcium and potassium levels asap. Pred makes you lose more of all through the kidneys and it is easy to get too low - and low levels of one or other can lead to cramps.

[CRW-68]

Thank you PMRpro for your reply. I think I sorted it out just now.

I did a BONEHEADED thing. I decided to try and take my Prednisone in the very early morning hours in the morning as it has been suggested. I have several other meds that I take, some with food, others without, and others 1 hour prior.

Stupid me, I got it mixed and took the Prednisone without food. Not a good idea. So with that said, I am sure my absorption of Prednisone is not what it should be today.

Dilemma, do I just ride today out or take 1 extra pill?

[PMRpro Ambassador in reply to CRW-68]

At 60 mg I doubt the time you take it is particularly important - it may be much later. By one extra tablet - does that mean 5mg? Another 20mg would be a bit much I feel.

But nevertheless - the getting bloods checked wouldn't be a bad idea. Nor a magnesium supplement - the magnesium blood levels won't tell you much. Muscles can be depleted because the blood keeps its levels up.

[CRW-68 in reply to PMRpro]

I am getting full blood work ups every three weeks at this point. I will absolutely look into the magnesium. I take 3x 20 mg tabs of Prednisone , total 60 mg. per day right now. That is what I took without any food just water this morning. As I said, Boneheaded thing to do! Lesson learned!

Thank you for your feedback.

[SnazzyD in reply to CRW-68]

Hello,

I may well be corrected here but I have always understood that the point of food is to protect the stomach, not aid the absorption of the Pred, so an empty stomach shouldn’t make it less effective. Right, I’ll get into my bunker and await replies!😉

[Hidden in reply to SnazzyD]

I am sure you are right because coated ones get absorbed "lower". On the other hand .... If a drug is metabolized in the liver is it better to have with food? Codeine for example works better with food. Crikey this is making my head hurt. 😂

[PMRpro Ambassador in reply to SnazzyD]

Is this a parallel to MB's sofa and Teddy?

In the case of plain white pred tablets you are perfectly correct, although it will take some longer to be absorbed than when taken on an empty stomach. In the case of Lodotra/Rayos the food is to create the right conditions for the coating to break down while still in the stomach after 4 hours. And in the case of enteric coated it will delay its passage down the gut so it will take even longer to reach its peak in the blood.