How to take Prednisolone

[Glama]

Diagnosed with PMR a week ago and put on 15mg Prednisolone and told to take 5mg 3 times a day. Felt fantastic first two days then my GP told me I could take the 15mg all at once with breakfast. This change coincided with me having a nasty fall over uneven paving stones injuring the whole left side of my body. Now each morning I am very stiff and it is taking me an hour or two after my medication before I am more mobile. It is difficult to know if this is the change in how I am taking my medication or still the after effects from the fall. Does anybody know if it makes any difference how you take your meds.

[Theziggy]

When I was first diagnosed I was told to take the 15mg in the morning with food. I sure that the fall has caused a bit of trauma and stiffness, but other more knowledgeable people on here will have more advice - maybe after the festive season.

Merry Christmas Glama

[Harbel in reply to Theziggy]

Hi. I started on 25mg but found while it was fantastic I could only get about 18 hours out of it. I then took two thirds in the morning and one third 6 hours later at lunchtime. This works for me and gives me twenty four hours pain free. The downside is that I don't sleep as well. Everyone is different, but it is I think no harm to experiment to see what works best for each of us. Happy Christmas.

[Mary63]

To be told to take %5mg three times a day is unusual. Most people take 15mg in the mornings. Some people find that does not last the full 24 hours. And they do 10mg am and 5mg in the evening.

The fall, however will have caused a lot of bruising, and that may be the reason for your pain.

Try splitting the dose and see how things are?

[Mary63]

Sorry...should have read ‘to be told to take 15mg’ in my last post

[Berylholley]

I have tried splitting the dose with success but am now down to 7mg prednisolone which I take about 7am.

[JulianJ]

Welcome to the wondeful world of PMR!

When I took mine in the morning I has stiffness for a while.

At one point I did a 50/50 split morning and evening, but gave up as my dose got smaller.

I did manage to get my doctor to prescribe Gastro Resistant pred and take it at 10pm, thanks to the aunties for their suggestions and help. One advantage of gastro resistant pred is you can get 2.5mg tablets, this helps when you start to reduce in .5 steps without cutting tablets.

Now down to 5.5 with a few hiccups along the way.

[PMRpro Ambassador]

The received wisdom is that pred should be taken early in the morning and all at once. That is supposed to minimise the side effects. In some people the antiinflammatory effect doesn't last the full 24 hours and so there is a return of symptoms in the morning until the new dose kicks in. For those people splitting the dose may take the effect over the 24 hours - and that is most likely what was happening for you. 2/3 in the morning and the rest at some later point is the most common approach - when later depends on you. If the symptoms return during the day you should take the other bit a couple of hours before you'd expect the pain to return. Taking some too late in the day may affect your sleep - but everyone is different and you have to experiment a bit.

[Glama in reply to PMRpro]

Thank you all for your very helpful comments. Tomorrow I will try 2/3 with breakfast and 1/3 with evening meal and see if that helps. Wishing you all a very happy Christmas Day.

[Hindags]

If you are having significant morning stiffness, you might get relief by taking 5mg of your 15 at around 2am. Take it with something to line your stomach. I started doing this and found it made a difference. I wasn’t rigid about timing. Just took it when I got up to use the bathroom. The goal is to habpve some Pred on board and active before the inflammatory dumping that occurs between 4-6 or so. You can search on on this forum re splitting dosage.

There have been quite a few discussions.

Sorry you hurt yourself.

[HamishPMR]

Best not to split doses and you should take your pred early in the day.The reason for taking the pred as early as possible in the morning is to come as close as possible to when the body naturally secretes a corticosteroid, cortisol, which is shortly before you wake, and this, it is felt, reduces the overall rate of side effects. Also the substances that cause the inflammation, cytokines, are shed in the body about 4.30am and taking the prednisolone as soon as possible afterwards hopefully controls the inflammation before it really takes hold.

[PMRpro Ambassador in reply to HamishPMR]

It really makes little difference for PMR patients who are on pred above 10mg for so long that there is adrenal suppression. It probably is helpful for anyone at moderate doses for a limited period of time, up to 3 weeks to a month. Beyond that - splitting often achieves better symptom control at lower doses. If a patient has a pred anti-inflammatory duration of nearer the 12 hour end of the 12-36 hour window, they will have returning pain long before the next dose of pred is due. Then the morning dollop of inflammatory substances adds to it.

[PMRCanada]

Welcome Glama.

I do not get a full 24hrs of relief when I take one full dose in the morning. Like others on here have mentioned I’ve tried many dosing approaches and currently I am on 9.5mg, so I take 6.5mg at around 2am, and the remaining 3 around 5pm. That way I am usually free from pain/stiffness the whole day/evening.

Sorry to hear of your fall. Things like that, stress, and over exertion of exercise, can negatively impact us who have PMR/GCA. Wishing you swift healing.

[Stifffingers]

I was told to take my 15 mg at the same time after / with Breakfast.

Coincidently I felt good at first, then bang !!

Needed several hours before it kicked in .

Doubt your fall has made any difference

Regards

[Meggsy]

Hi Glama, I have taken my pred with a banana at 4am since diagnosed in Feb. Never wake up with stiffness. Currently on 9.5 down from 25mg. I’m sure with some experimentation you will find your comfort zone. As has been said before we all have our differences.

It has been hot here over Christmas, though bearable. Thank goodness no 40+ degrees YET! I noticed that where my niece lives in SA, it was 47 degrees (116.6F) yesterday.

Once when we were away for 2 days it hit 45 and we came home to cooked tomatoes on the bush. C’est la vie!