What should I eat when taking prednisone in the middle of the night?

[gaqke10]

I'm wondering what I should eat with the prednisone when I take it at 4 am. And how

much. I don't want to have to brush my teeth if I can help it, because that will wake me up, so I've been eating a rice cake.

[Laurapc]

Take it with some milk before going to sleep. Prednisone is more effective taken at bedtime. Hope this helps.

[PMRpro Ambassador in reply to Laurapc]

"Prednisone is more effective taken at bedtime"

Not necessarily at all. And many doctors don't like the idea. Not that that matters for us as much but you wouldn't be advised to do it for a short term course of pred as regaining adrenal function would take longer in that case.

[Laurapc in reply to PMRpro]

According to this it is beneficial for those of us who get woken up in agony at 2am. I know we are discussing PMR and not RA but as I’ve said before, I believe my chronic neck, shoulder and arm pain are the result of PMR. I have spent many nights clock watching, in pain, to see whether or not it was too early to take the Pred. Since taking it late at night I have noticed a huge difference. Maybe it can help others.

rheumatologynetwork.com/rhe...

[PMRpro Ambassador in reply to Laurapc]

Oh yes - but what I said still applies. It doesn't work for everyone and for some people it keeps them awake. You have to experiment to find the best time for YOU.

It is something mentioned on the forums regularly as the result of a study done long before this which, as this mentioned, resulted in the development of the prednisone formulation sold as Lodotra(Europe)/Rayos(USA). The times quoted aren't quite right - you take it at 10pm within 3 hours of food, it automatically releases at 2am and is at its peak at 4am, not 3am. But some people don't need it then, taking pred at 4am and settling down for a couple more hours is enough and then lets the effect last longer at the other end. I use Lodotra since it is the only steroid other than Medrol (which caused horrendous side effects) available where I live - but its effect lasts the full 24 hours for me.

There are a lot of doctors who have a fit at the idea of taking pred in the evening because of a study done in the Netherlands which showed 5mg at 10pm leads to more adrenal suppression than 15mg taken at 8.30am. It doesn't really matter for us, our adrenal function will be suppressed anyway as we are at above 8mg for long enough. But that often isn't understood by the doctors.

[Linny3 in reply to PMRpro]

why would it take longer?

[PMRpro Ambassador in reply to Linny3]

Why would what take longer?

[Linny3 in reply to PMRpro]

You said adrenal function would take longer and I was wondering why?

"Prednisone is more effective taken at bedtime"

Not necessarily at all. And many doctors don't like the idea. Not that that matters for us as much but you wouldn't be advised to do it for a short term course of pred as regaining adrenal function would take longer in that case.

[PMRpro Ambassador in reply to Linny3]

What I explained in my other post to Dean. If you take pred at night the body knows there is corticosteroid around and won't produce as much in the early morning.

[DeanSamson in reply to PMRpro]

How does taking pred and different tinws of the day effect adrenal function? Im going through adrenal issues at pressent due to pred. Thanks

[PMRpro Ambassador in reply to DeanSamson]

The body secretes the greatest amount of cortisol in the early morning to prepare the body for the day ahead. If there is enough corticosteroid present in the blood it doesn't produce more, excess steroid is not good for us as we know. It is rather like your central heating boiler doesn't produce more heat while the wood burning stove is warming the living room where the thermostat is. If you take the pred in the morning, about breakfast time, the body has already produced its contribution and most of the pred is excreted from the body within the following 12-16 hours or so. By early morning there is little left, the feedback system works as normal. However, if you take pred before bed the level in the blood during the night is still high enough to suppress the production by the adrenal glands.

[Hidden in reply to PMRpro]

Such a brilliant explanation PMRPro

[SnazzyD]

I would have thought taking it with plain yoghurt would be better because it buffers the stomach acid and doesn’t produce so much mouth bacteria food as rice cake which is very simple carbohydrate, leading to the acid that breaks down your enamel.

[SheffieldJane]

I take mine with organic Greek yoghurt ( a better lining for your tum). What about swilling your mouth with mouthwash?

[enan-illuc]

Gaqke,

I take my Prednisone with either Kefir or Aloa Vera juice and it seems to work for me. I hope this helps.

[Meggsy]

I take mine at 4am with a small banana or half a large one. Haven’t had any problems so far.

[Wyoming]

When I used to wake at 2:00 am to take prednisone, I took it with a couple of spoonfuls of plain yoghurt. I had the prednisone in a tiny container and the yoghurt in another tiny container at the ready by my bed. I became such a pro at administering these in the middle of the night that I never even turned on the light - or even sat up - taking particular care as I am a light sleeper. That went on for a long time, and was a very effective approach for me personally after trying to take prednisone every which way due to suffering "wear off" and other effects during the day. Now in my fourth year, I would like to say that I am off the drug entirely but that is not the case. Nevertheless, dosage is now low at 2mm and I take at night in one go before going to bed. It has become quite a perfunctory act and does not dominate my life. In addition, I have a "plan" for getting to zero and it is working so far. The best thing I learned from this site was to tailor treatment of the disease to my own physical clock (pace) and reactions, and to respect the good and bad aspects of prednisone, and avoid "yo-yoing" with dosage. And when things do not seem to go well, to touch base with all the wonderful mentors and sharers on this site for advice. Very grateful for the collective wisdom gathered from this site. In the end, we all need to find our own path through PMR but the guidance you can get from this site is generous and endless. Good luck with your plan!

[powerwalk in reply to Wyoming]

Find our own way is right!! Yes this forum is a lifesaver - I don't know how I would have coped without it - if I'd listened to my so called doctors. Actually funny - I went to the chemost to get my prescription for the pred the other day and I was asking the pharmacist to give me the dose in so many 2.5 and the rest in 1mgs or whatever (I was trying not to go over my allowance) and he just said "just tell me how many you need of each- it doesn't matter - you know what you need you are managing this yourself". Ha - I thought I was hearing things. Someone with a bit of sense!!!

[Rokerman]

The only tablets I can take with water are those slippery, enteric-coated 2.5mg Preds - so for everything else I eat a piece of cheese; including the dreaded Statins.........

My GP is not impressed!

[piglette in reply to Rokerman]

I have mine with a piece of cheese. I was told Swiss cheese is good. I don’t know why.

[Rokerman in reply to piglette]

I’m like Wallace (or is it Gromit?) - a nice piece of crumbly Wensleydale, lad......!😉

[piglette in reply to Rokerman]

For me any cheese except Dutch cheeses.

[Rokerman in reply to piglette]

I’ve had to adapt - my brother lives in Haarlem.....! By the way Piglette - I know you’re a long-time member of our lovely club - how’re you doing on the Pred taper? Myself, I’ve got down to 2.5mg (stayed there for a couple of months - it’s easy to take the shiny, coated 2.5 pill.....!😉) on a slow taper, DL style. Would try the 2.0mg but have developed a weird, random knuckle-joint pain on the ring-finger and that’s putting me off! Have you had any odd niceties thrown at you by PMR/GCA?

[PMRpro Ambassador in reply to piglette]

There are even good cheeses from there too - the real stuff, not the rubber imitation stuff they export to the UK...

PS, did you know you are better to have cheese at the end of a meal than brushing your teeth? The French have it right!

[piglette in reply to PMRpro]

My father is Dutch and he loves the Dutch stuff, I am not sure if he is just being patriotic or not. Eating cheese with pred in the middle of the night for people who are worried about cleaning their teeth is probably a good idea then. There is a cheese called Gjetost that is Norwegian that I think I like, it is sweet.

[PMRpro Ambassador in reply to piglette]

I doubt it - there is aged Gouda that is just oh so more-ish! And other strange Dutch stuff that is very tasty!! Not that square rubbish they sell in slices! We have it in the supermarkets too - no, I seek out the better stuff!

[piglette in reply to PMRpro]

Even aged Gouda is not for me. I used to live near Maastricht and loved the rijsttafel but not the cheese!

[Telian]

I take mine with yoghurt, if you can stand not brushing your teeth it can wait until you rise later can't it?

[Jeannie29]

I take minewith a spoonful of natural yoghurt, seems to work x

[PMRpro Ambassador]

Tooth brushing within an hour of eating anything isn't a good idea - worse for the tooth enamel than not brushing. As Snazzy says, carbs are worse than a glass of milk or a yoghurt.

[misspops]

I have never taken my pred with food.....didn't know we were suppose to.

[PMRpro Ambassador in reply to misspops]

Probably doesn't make much difference if you are put on a PPI as well - lots of us prefer to use the most natural way of avoiding gastric acid problems. It doesn't bother everyone - so maybe you have a cast-iron gut like me!

[piglette in reply to misspops]

It says to be taken with food on the packet for me.

[Qubbie]

Try yogurt

[PMRCanada]

I discovered yoghurt tubes I believe are made for kids to take in their lunches. I freeze them and before I go to bed take one out of the freezer, snip open the end and stand it up in a tall plastic glass next to my small dish of uncoated pred pills and a glass of water. At dose time (still working on finalizing a time between 2-4am), I simply squeeze the tube, pop the pills and take my dose, and fall right back to sleep.

Because I had stiffness and soreness in the mornings, I’ve tried taking my dose at 8am, then splitting it at 4-6am and morning, then just 4-6am, then most recently at 2am that worked like a charm. However because I only get about 16-18hrs of relief with each dose, I find myself getting sore again around 7pm or so. I may have to split my dose again at supper time and 2am.

Thanks to all on this site that have provided valuable, helpful information about pred dose and timing.

[gaqke10]

Thanks to all for such useful information and tips! Now I have some things to try. Hmmm,

we just got in some Wensleydale for the holidays . . .

[Toenti]

Hi, I have been taking my Pred. With some greek yogurt and honey for a long time at 4am. Works good with no stomach upsets at all.

I hope this helps.

[gaqke10 in reply to Toenti]

I'm being persuaded towards yogurt.

[Asbeck]

Depending on how much Pred. you take, a spoonful of coconut oil coats the stomach and is actually good for your teeth. You don't have to brush them afterwards. Try it. It's not the most appetizing thing. But it works.

[gaqke10 in reply to Asbeck]

Thanks, I will put that on my list of things to try.