Recommended is usually around breakfast time, but I think she might have to do a bit of experimenting to find what is best for her. Plus depending on what tablets she takes- uncoated ones (plain white) get into the system quicker than the coated enteric ones (different colours).
Initially I would say try splitting dose maybe. - approx 2/3rd am, 1/3rd evening - that may help her first thing.
Or if she’s up at night perhaps she could take full dose around 2am, so they are in system when she wakes. Can be taken with a spoonful of yogurt or small snack.
Can’t give definitive answer, what suits one person may not suit another, so a bit of trial and error may be needed!
The received wisdom is all at once in the morning (it is supposed to reduce side effects like insomnia, which for her it obviously doesn't, and suppress the adrenal glands less) - but really it is more important to find when is best for the patient. Has she tried taking it before bed? For some reason her pred seems to take a long time to get into her system and so it doesn't have to be 2am which was found to be the best time to reduce morning stiffness - just try shifting the time around a bit and I would be inclined to try before bed first of all and see what happens.
I've successfully been taking my uncoated Pred. last thing at night around 11.30 p.m. for the last 15 months. (I was diagnosed with PMR 22 months ago and started on 15mg Pred.). When I took it in the morning I felt like a zombie until about 3.00 p.m. and then came to, like your mum, in the afternoon and evening. I seem to sleep a bit better although I still need to get up several times during the night. But at least zombie time is while I'm sleeping not in the morning. I'm at my best in the morning and in the afternoon now, although I need an after lunch rest if possible. I'm down to 6mg Pred.
My wife finds it more effective around breakfast time. If she forgets to take it in the morning, her body will remind her that she has not yet taken it.
I am on 13.75mg of pred currently (started at 20mg May 1), and found that I was stiff and sore most of the morning if I took my medication at breakfast. As I'm often up at some point during early morning (4-6am) to use the washroom, I began splitting my dose taking 1/3 at that time, and the remaining 2/3 at breakfast (before 9am). This helped a lot and now I have less stiffness/pains in the am and can manage until about 10pm. No trouble sleeping at all. I guess I'm one of those folks who takes longer to get the pred into my system. The idea of splitting the dosage came from a few folks on this forum who had similar success. I believe that under 10mg (if/when I get there), i may be advised by the rheumy to begin taking the full dose all at once (think I read that in one of the posts on here).
I wish your mom all the best as you find a customized plan that works best for you. We are the experts in our own bodies and experience, so as long as we listen to ourselves, we will find our way (along with the resources on this site).
I happen to get up at least once during the night, somewhere between 2:50 and 4:10 AM - ideal time for me to take my 10mg of prednisone is around 3 AM so that I can get up at 6:30 or 7 and be able to move around and get myself off to work.
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