Splitting Pred Dose Morning/Night: How many people... - PMRGCAuk

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Splitting Pred Dose Morning/Night

Ozark profile image
21 Replies

How many people who happens to see this are splitting their pred dose morning and night and to what effect? I am currently on 9 mg pred, which I've been taking with breakfast every day, and I had a horrible day yesterday with not so much pain and stiffness but rather extreme fatigue and brain fog which has been pretty consistent over the last six or seven months. While grocery shopping yesterday I could barely concentrate on finding what I needed because I felt almost detached from my surroundings I was so out of it with fog head. So...I decided last night to split my pred dose to see if that would help in any way. I took 2 mg at bedtime and 7 mg this morning and I must say that at least for today this has had a beneficial effect as I feel much more alert. This could be just coincidence but I will try it again tonight, this time with 3mg. If I consistently show this level of improvement, say over a week or two, then I will know that this split dose method is not just a one time fluke. So, again, I return to my original question, has anyone else who is splitting their dose morning/night noticed improvement in either their level of pain and stiffness or a lifting of fatigue to whatever degree?

Addendum: I have just read some of the "related" posts and seem to have gotten some answers there, but if you care to leave an additional comment that would be appreciated as well.

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Ozark profile image
Ozark
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21 Replies
SheffieldJane profile image
SheffieldJane

Those really bad days happen though. Sometimes, if you do a bit of detective work you discover a bit of stress that’s triggered it. A phone call, worry about an event, anything and you get one of those horrible good for nothing days. You may have got over it anyway. Splitting my dose has never helped me. Extra would at the end of a hard day, slippery slope though. Others swear by it, so good luck!

Hi Ozark

I split my dose as a trial before l went on a Special Holiday for my Ruby Wedding Anniversary.

I’m not great in a morning & we were going on a Cruise that meant a lot of early mornings to go on tour (l couldn’t do it now) so l split my dose 2.5mg Coated Pred at Night & 5mg regular Pred in a morning but at 6am instead of my usual 8am.

I did it for a couple of weeks before, during our time away, almost four weeks & a couple of weeks afterwards.

But l returned to taking it each morning as l was having issues with fatigue etc.

Kept us updated with how you get on.

Kind Regards

MrsN

PMRCanada profile image
PMRCanada

Splitting my dose greatly helped with morning stiffness and aches. I too am on 9mg and takes 2/3 of my dose (6mg) at 2am, and the other 1/3 of my dose (3mg) at 2pm. Hope this helps.

Ozark profile image
Ozark in reply to PMRCanada

I'm doing the same amount of pred as you but in the reverse order--6 mg at around 1pm and 3 mg at around 1am before I go to bed. But this experiment is in its early stages so I may adjust as time goes on. Thanks for the reply.

I split my dose right from the beginning (last May) as the preds made me so sleepy. I take 5mg at around 2am and 2 1/2 lunch time. I am tapering my lunch time intake, so far so good though I always have some stiffness and muscle aches I don't seem so fatigued and have been able to dispense with my afternoon nap!

Soraya_PMR profile image
Soraya_PMR

Just had a look through my doses notes. Seems I was on a single dose when at 10 months I was messing around at 11/12mg and getting stuck. Split doses and decreased successfully. Got stuck at 8 (was on single dose again ?why) split doses and got through again. Now I’m at 5.5 and as dose has lowered I’ve maintained the ‘go to bed’ 5mg dose, the morning dose has lessened to 0.5. I definitely function better when I take my (coated) pred at bedtime, recent trial for 5 days of morning doses was awful, I think I’d have upped my dose, but instead went back to bedtime and felt better

Have just asked for ‘script with 2.5’s and 1’s and so may split to more even doses from here onwards. But TBH I find feeling stiff in the evenings more acceptable at the end of the day than a slow non-functioning morning.

DavidMF profile image
DavidMF

4.5 years into PMR, In the first year I found I was getting pains around 11.00pm and wondered if I was taking too much at once and it being wasted. Changed to 2/3rds in the morning 1/3rd at night. Great improvement, stopped waking up with stiffness and pain.

Move forward to present day, now on 4.5mgs morning & 3mgs evening. Tried to cut out evening by 0.5mg (16%) when I was on 7mgs day, ouch immediate reaction, hung on for three days as I didn't want to believe it. Changed to 4.5/3 and it cleared, holding at present.

Lochy profile image
Lochy

I’ve been splitting my dose for a couple of years now as I could never quite get through the day pain free. Has definitely helped me. I take a few mg before bed and rest at breakfast. Currently on 10mg - 2 at bed and 8 in morning. Diagnosed March 2016.

Ronnie101 profile image
Ronnie101

4 years into GCA/PMR and recently started splitting my dose 5 GR mg at noon and 5 GR at 5 PM. Great improvement.

parnelly1 profile image
parnelly1

Hi and sorry to hear your having such a bad time. I was suffering with chronic brain fog last year it was totally debilitating. After much research online that was incredibly hard to do I gave up all carbs and sugar for one week and it completely disappeared it was utterly amazing how much better I felt. I now eat some carbs and no sugar and its never come back. Splitting the dose did not make a difference to me but I have found when getting worse adding 2mgs before bed helps enormously the next day I do this for 3 or 4 days. There is always some help on this site from others I do not know what I would do without it. Hope next week is better for you.

Ozark profile image
Ozark in reply to parnelly1

Thank you so much.

bunnymom profile image
bunnymom

I take uncoated pred and it was taking me at least 3 hours to feel good in the morning. I was taking 2 at 8 PM and the rest at 230 AM (I wake up anyway) but it didn't let me sleep well at night. After trial and error I take my whole dose at 230 AM with crackers. I also take CBD oil which allows me to fall back asleep for 4 hours and not wake up groggy. Other sleep aids had side effects.

Lauren103 profile image
Lauren103 in reply to bunnymom

Hi

What is CBD oil? It helps you to sleep? That sounds very helpful.

bunnymom profile image
bunnymom in reply to Lauren103

It is cannabis oil without the thc. Will not make you feel high. In the U S we can order it online. It's expensive. I don't think it helps pain or inflammation for me but does for others. If you put it in the search above you'll see lots of discussion. I may not have had all the relief from it I hoped for but I also don't notice side effects so it was worth a try. Does give me 3.5 to 4 hours of sleep at a stretch.

Lauren103 profile image
Lauren103 in reply to bunnymom

Hi

Thanks for the info.

Lauren103 profile image
Lauren103

Hi

I know exactly what you are talking about. The feelings I got were much the same as yours - the brain fog and weakness were awful. I had to try something so I decided to try splitting the dose; I did and I feel much better. I am taking 5 mg in the morning. I take another 5 mg at 8 pm. I am moving to 9 mg next week. I will take 5 mg in the morning and 4 mg at 8 pm. This regimen has really helped - I hope it does for you as well.

Ozark profile image
Ozark in reply to Lauren103

Thank you for your reply. I'm currently taking 3mg at night with food before bed and 6mg in the morning with breakfast. This is only my second day but so far it seems to be working. I'm much better when I get up in the morning, I feel like I actually slept and not as exhausted as when I went to sleep. I will be experimenting with the dosing split to see what works best for me.

Lauren103 profile image
Lauren103

Hi again,

I forgot to mention that before I tried splitting the dose I moved to taking the complete dose in the evening. That was an improvement as well. I did some more investigating and decided to try splitting it into morning and evening instead. Splitting works better for me; it is working better for my tapering too.

Joydeck profile image
Joydeck

On a 50:50 split dose, I tapered to 7 mg last July, 9 months after PMR diagnosis. (Split dosing had been marvellous on high pred.) Attempts to taper further have failed and, since mid November, I have settled on 7.5 mg. In the weeks after Christmas, I phased out the split dose and now live happily on just a morning dose.

Taking pills are much easier on a single dose. If you do choose to revert to a single dose, I strongly suggest you do so when not tapering and when you are PMR symptom-free.

artfingers profile image
artfingers

I have been doing split dose almost since the beginning. I currently take 2 1/2 prednisone at 10pm and 2 1/2 prednisone at 9am or whenever I get up. With food always. I'm thus at 5 total and trying to get down now to 4 1/2, slowly. Works well for me. I did bump it up to 6 for the week or two after surgery, but back to 5 now. Rayos (timed release) was nice as it released at 2am but I'm ethically opposed to the outrageous prices a bottle cost so I refuse to purchase it - even tho my insurance covered it totally.

Sailormo profile image
Sailormo

hi,Ive tried splitting my dose this week for four days,it seems to be working hopefully,I was getting a lot of pain in my hips and legs couldn't sleep,I'm taking5mg in the morning and 5mg at 9pm.Im not stiff and aching today so I'll see how it goes.

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