Split Pred dosage

[Oxford8]

Hi all,

I'm very interested in what some of you have mentioned about split Pred dosage.

I take my pred with my breakfast and it sees me through the day and in to the night but in the very early hours of the morning the pain is back before I am due to take my next (breakfast) dose.

Add to this the fact that my rheumy advised me on Monday to drop from 20mg to 15, which I have done (She has accepted that I want to slow down the taper after this).

The 15mg dose isn't cutting it for me so I'm thinking if going back up to 17.5mg and then down slowly.

I Hooe this makes sense!

So. My question. Could I take 2.5mg of pred this evening (pain already starting) as a first split dose.

Thanks everyone.

[DorsetLady PMRGCAuk volunteer]

Good idea. Although usual split is 1/3rd evening, 2/3rd breakfast time.

If you are considering going back up to 17.5mg then maybe from tomorrow you could do 5mg nighttime, 12.5mg morning.

You won’t know how it works until you try.

Good luck.

[Oxford8 in reply to DorsetLady]

Thanks DL. That sounds very sensible.

[Linny3]

Hi Oxford8

I started taking Rayos and I take the whole dose 10mg in the evening. Sometimes I split it between 10pm and 3am. I was so stiff and sore in the mornings and this works very well for me. It Only takes me about 1/2 hour to get going in the morning. Before it took about 2 hours. If you are hurting then it was too big a drop. I feel a 1/2 mg. decrease.

Good luck

[Oxford8 in reply to Linny3]

Thanks Lynny3.

[SheffieldJane]

I think I may try the same thing. I am on 6 mgs and I start to feel very achey in the evening. Diagnosed 2 yrs 9 months ago. I can feel completely well for short spells during the day which gives me great hope.

[Slowdown]

I'm a 'splitter' which works successfully for me, am on 9mg gastro-resistant pred and take 7mg at 6.30a.m, 2mg at 9p.m., the evening dose takes care of the inflammatory cytokines that occur around 3.m. so you wake pain-free in the morning (experiment with tweaking times and doses until you hit the target).

[Oxford8]

Thank you. I'm definitely going to try the split.

[PMRCanada]

I currently split my dose of 9.5mg, taking 7mg at 2am and 2.5mg at 4pm. That way I’m pretty well pain free until midnight (a couple hours before next dose).

I’ve been wary to take pred too close to bedtime in case I don’t sleep, but ironically I’m up at 2pm taking a dose, and then every couple hours afterward to pee.

One dose upon rising never worked well as I was sore in the morning and stiff for first few hours.

Good luck!

[Oxford8 in reply to PMRCanada]

Thanks PMR Canada. I ve taken my first 'split' tonight so here's hoping...

[Lochy]

I began to split my dose after six months into this journey. It has worked very well for me although not particularly recognised by my GP or rheumatologist as the ‘norm’. Having said that both have been happy for me to experiment to see what works. I’m now taking 2mg at bedtime and 10mg in the morning. Usually sees me through to morning but I can be bit stiff once I’m up although this varies too! I am trying to taper to 11mg at moment and only reduce my morning dose. I might even try increasing nighttime to 3mg and see if that helps the morning stiffness.

It is so much trial and error and then re-establishing what’s right for you after a flare - of which I have had a few!!

[Oxford8 in reply to Lochy]

I did my first split last night and it definitely helped. Much less pain this morning.

Thank you all for your input.

[Joydeck]

A 50:50 split dose worked well for me for a year. Last week I abandoned the spilt-dose, taking all 7.5 mg in the morning. Seems OK so far.

The morning dose is less hassle and might make pred withdrawal (in the near future) easier to manage.

[nickm001]

I am coming late to answer, but you could try 5 in the late evening and 10 in AM, because split dose may actually let you reduce to 15 quicker. It happened to me. I was at 12.5 and by splitting dose I was able to quickly go to 10mg directly.

[Oxford8 in reply to nickm001]

Thanks nickm001.

[PMRpro Ambassador in reply to nickm001]

I wonder how often this happens - I've said it is possible for a while now.

[nickm001]

I was lucky that Dr that treats me actually listen about my unusual schedule ( worked at the time until 1-2AM from home) and suggested to split dose to have better coverage ( I was getting stiff late in a day). I was in a process of trying to reduce from 12.5 to 10 and by splitting the dose I did it in one single step ( one day 12.5 next day 5mg @evening and 5mg in the morning). Had no issue at all. Most of the problems(bad stomach,etc) in first 5-6 weeks I had with PPI and antibiotics that I was prescribed. It all stopped when I reached 10mg.

[Oxford8 in reply to nickm001]

Thanks for That. It"s really interesting.

Taking the split again last night meant that I had hardly any pain or stiffness this morning.

I was able to go and play in a Crown Green bowling match this afternoon. I haven't bowled for months because of the pain.

I t was so great to be back.