Best time to take Prednisone???

[vnett]

One more question.....when is the best time to take Prednisone? I’ve recently read that very early is best because one’s body builds up inflammation early in the day. I turn to the wise ones!

[Hollyseden]

Recommended to take full dose first thing in the morning, especially if you have GCA. You will find though, that quite a few people split their dose. The baddies are released into your system around 4am so I have found that taking 2mg last thing at night helps me to be less sore when I waken up, then I take the rest of my dose in morning. You will work out what suits you best over time. There will be lots of advice coming you way too. I'm a newbie but lots of people here with lots of knowledge they happily share. This is a good place to be for help and advice. 😊

[vnett in reply to Hollyseden]

Thank you so much! I had read that it was in the wee hours of the morning that all the trouble begins. I was trying to decide just how early I had to get up to head them off. I like the partial dose before bedtime soooooo much better!

[Hollyseden in reply to vnett]

As you read through comments you will find that some people do make a point of taking them at a set time etc but I also prefer the just before bedtime. Trial and error really to figure out what works best for you. Remember that you should also take with or after food. At night some folk find taking some yogurt does the trick. I have some milk with mine, I'm lucky not to have a delicate tum because I don't take omeprazole either and manage fine without it, even though doctors expect you to need it. Hope you find what suits you best.😊

[vnett in reply to Hollyseden]

I already have GERD and take Pantaprazole for it. Yogurt has become my new best friend and my carb friends are very jealous!! Insomnia may serve me well! I can dose and snack in those early hours and get a jump on a pain free day!😂

[PMRpro Ambassador]

A study found that the optimum time to take pred to minimise morning stiffess and pain is 2am - so the pred is at its peak in the blood at about 4.30am when the inflammatory substances are shed in the body and so they never get to do anything.

I have a form that I take before bed and it releases at 2am, not generally available though, very expensive in the US unless you are lucky and only available privately in the UK. But splitting works for many people and as Hollyseden says it really is a question of experimenting a bit.

[Soraya_PMR in reply to PMRpro]

Are the cytokines ONLY released at 04.30ish? I get the feeling that there must be some release throughout 24 hours?

Those that feel the resurgence of symptoms after say 12 hours of pred would have cleared the inflammation early morning. So why a return of symptoms later in the day? More cytokines?

[Soraya_PMR in reply to Soraya_PMR]

ncbi.nlm.nih.gov/pmc/articl...

This is an interesting read.

Lots of snippets, but worth a look to see how CRP is reduced by pred, and that does not indicate an ‘end’ to PMR, just control (may be useful for some rheums who are addicted to CRP levels?)

Also the daily variation of CRP: lowest at 08.00. Highest at midday. Might be worth considering the time of blood tests? Or at least keep the timing consistent for comparison.

Another comment re melatonin levels, raised in PMR but normal in fibromyalgia. Would be helpful for those rheums who think PMR morphs into fibro!

[vnett in reply to Soraya_PMR]

Thank you for the article! I’m attempting to go into my rheumatologist appointment armed with as much information as possible and holding a long list of questions! In the past few days I’ve felt more confident in this forum!

[Soraya_PMR in reply to vnett]

Just an irrelevant comment, re timings of blood tests: one of my dogs has Cushings, the vet INSISTS that her blood tests are ALWAYS done at 12.30, exactly 4 hours after her medication. This despite the fact that the surgery is actually closed at that time. He was very clear even before she started treatment (he did a ‘control’ Blood test at exactly 12.30) that he didn’t want any variations to affect the trends.

I’ve never come across such specifics with a doctor.

[vnett in reply to Soraya_PMR]

I am thoroughly baffled by all doctors most of the time and now with my Pred Head fuzziness it’s an even greater challenge!

[Soraya_PMR in reply to vnett]

Not right is it!

Your body, your pain. The least you deserve is an explanation. IF they do know what they’re doing, it would be nice if they shared their thoughts.

[PMRpro Ambassador in reply to Soraya_PMR]

The antiinflammatory effect of pred lasts from 12 to 36 hours depending on the person. So the effect wears off at some point. There are lots of different cytokines, the main ones involved in PMR tend to be shed in quantity in the morning I think. I use Lodotra - and while it is difficult to say as I have used alternate day dosing in the past, providing I take enough pred I have no return of pain in the 24 hours at all.

[vnett in reply to PMRpro]

I will continue to experiment and if I do get a definitive diagnosis this week from the rheumatologist I will ask about the 2 am release form you’ve mentioned. Thus far taking it early helps with morning but has left me hurting in the pm. That, however, was also due to the drastic reduction my GP ordered which I am ignoring for now. May I ask the name of the Pred you take?

[PMRpro Ambassador in reply to vnett]

Where are you? In the USA it is called Rayos, in Europe it is marketed as Lodotra.

[vnett in reply to PMRpro]

I am in Chicago. Thank you. I will look into it once I know if my doctors give me a diagnosis and treatment plan. I hope to know something tomorrow. The waiting is not easy!

[Joydeck]

For me, a split dose with most after the evening meal (5/7) is working just fine. I did try a single dose at 2 am but was crippled by evening.

[Soraya_PMR in reply to Joydeck]

I experienced similar Joy.

[vnett in reply to Joydeck]

I too had a great deal of pain by evening. Am experimenting!

[Lochy]

I have also trialled splitting my dose and am now taking approximately half mid evening, after dinner and the rest in the morning with breakfast. Doctors didn’t think this was a good idea but as I struggled through the day previously and am now much more pain free they are happy for me to do what suits me. It is definitely worth experimenting.

[vnett in reply to Lochy]

Hello Lochy. I tried taking a partial(higher) dose at 2:00 am reserving the remainder for later today. It did help with the worst of the morning pain and stiffness. I’ll see how my evening goes now! I’ve learned from this forum that experimenting according to your own body signals can be enlightening!