Prednisone query

[Darcy2000]

It seems Prednisone has a time span and it’s not 24 hours .I have been well informed by all the discussions here that this is not a race and that life is short and that by being monitored monthly you can stay on relatively high doses of Prednisone for extended periods When I tapered to 10 I was pretty miserable So I have bumped my self up to 15mgs.That being said I still wake up at 4 am in a lot of discomfort and have to take Tylenol which helps moderately .I take my Prednisone with breakfast at 5 am to get it into my system.It seems that the Pred effects last for about 18 hours as from 4 am til 11 am( when it kicks in again I am quite uncomfortable) I have tried changing the time of the dose but it does wire me so getting to sleep is difficult . It would still appear to only have effectiveness for 18 hours it would just be a different 18 hours .Would increasing the dose to 20 mgs have any effect on the staying power of the dose .This would be done on a short term basis as I have twin 2 year old grandsons with me and their Dad ( thank God) for the summer and need to be at my best .I would try to taper in the fall. Any thoughts on this ...sorry it’s so long

[Hidden]

Hi Darcy, before I increased I would try splitting my dose. Take 5mg as late as possible at night. If you bought enteric/gastric resistant empty capsules (Google) you could make sure that if you took it at 10pm it would release just before the start of inflammation at 4-5am. Then take 10mg uncoated in the morning after breakfast and that should extend the time covered.i am at 6mg and take 5mg gastric resistant pred at night and my 1mg uncoated in the morning. It works for most of the day (albeit with a steroid sparer). Enjoy the visit!

[Darcy2000 in reply to Hidden]

Thanks for that ...just worried won’t sleep it really does wire me

[Hidden in reply to Darcy2000]

That's why I suggest a gastric resistant capsule to put the pred in. That way it doesn't enter your system for 4- 6 hours as the dispersion happens after the tummy. In the UK we have gastric resistant pred otherwise I would sleep even less than I do. By putting pills in a capsule you can sleep through some of the time pred does fully cover you. I will link to a post from a couple of weeks ago.

healthunlocked.com/pmrgcauk...

[Darcy2000 in reply to Hidden]

Wow never heard of that ..I am in Canada ..I wonder if I can get that at the pharmacy

Sounds like a good idea

[Darcy2000 in reply to Hidden]

Oops just the info about capsules after I replied will look into that

[PMRCanada in reply to Darcy2000]

I paid a fair bit for 1000 empty enteric capsules that I stuff my night dose into. They dissolve 2 hours after taking them, then another hour or so to be absorbed.

At the end of my post someone from USA found a similar product for much cheaper and the capsules may even be more delayed in their dissolving time.

Good luck, this really works for me. I take 6mg uncoated stuffed into an empty capsule, around 11:30pm, and I take the remaining uncoated pred tablets around 1pm after lunch.

[Darcy2000 in reply to PMRCanada]

Thanks for the tip

[DorsetLady PMRGCAuk volunteer]

Agree with Poopadoop, don’t just increase the Pred.

We often advise members who don’t get full 24hours relief to split their dose and see if that helps.

Hope so in your case.

[PMRpro Ambassador]

Probably not - but splitting the dose probably would. The usual approach is 2/3-ish of the dose in the morning and the rest later in the day. When depends on how much you need to add to your personal pred-span.

[Purplecrow in reply to PMRpro]

Just started splitting dose, AM and PM, and find it helps. Levels out the pain thru the day and night , and makes mornings better.

[Hollyseden in reply to Purplecrow]

I did the same, splitting dose. When I got down lower, I changed to taking it all in the morning when I read here that it helps with adrenals. Have now slipped back to splitting again because, touch wood, adrenals have seemed ok and I really like the benefit of a dose during the night. Helps me out of bed in the morning ☺️

[Darcy2000]

Wish they sold the gastric restraint capsules in Canada ..not Prepared to spend 200.00 on them ..it sounds like it’ might do the trick

[PMRpro Ambassador in reply to Darcy2000]

It doesn't matter when the pred gets into your system - the antiinflammatory effect won't last any longer. Only splitting stretches that,

[Darcy2000 in reply to PMRpro]

Hmmm...okay will probably try to split tonight and see what happens

[Hidden in reply to Darcy2000]

One of the people at the end of the post said.

I bought size 0 on Amazon, this size fits my 5mg and 1mg, nicely. The capsules were $20.00 US.

"PurecapsUSA Empty Vegan Acid-Resistant (Enteric) Capsules – Size “0” – 1000 Fillable Caps – Kosher/Halal – Hypoallergenic – Vegan - GMO Free"

Darcy...they are smaller than the ones mentioned by pmrcanada but you can use 2 at that price.

[Darcy2000 in reply to Hidden]

I wonder if that is gastric restraint meaning it releases later as opposed to a regular coated capsule

[PMRpro Ambassador in reply to Darcy2000]

Gastric resistant means that it passes through the stomach as the coating will not break down in the acid environment. Then it breaks down where the pH is higher - the usual delay is about 4 hours but it can be much more depending on how your gut works.

[Blearyeyed in reply to Hidden]

You can also get the larger capsules from the same company make from Amazon Canada . Around $ 24.00.

If they are out of stock you can contact them to find out when delivery is available.

[SnazzyD]

Regarding doses for extended periods, yes people can and do take relatively high doses of Pred but this is not desirable and certainly not harmless over time. I would certainly think hard before whacking up to 20mg to get over a busy time, because I can see it could be easy to see each situation as deserving of a ‘little extra’. Life being life probably won’t suddenly see a quiet life come the Fall, things always crop up. Being monitored doesn’t prevent long term problems and only looks for a small subset of them. It is a fine balance.

If you do jumps down that are too large it will certainly make you feel rough and going down in small doses tells you where you were no longer coping with much more accuracy instead of having to leap up a whole 5mg. The trick is knowing whether you are feeling rough because of withdrawal or inflammation increasing. The body does take time to get used to the new regime and the trouble is we need to make time for that when we’d like to do other things.

[Darcy2000]

Thanks for your input .... will definitely give it some consideration

[Cross-stitcher]

I have reduced fairly easily from 15mg to 10mg (via 12.5mg and 11.25mg) over 10 weeks, and also altered the time I now take my Pred. I, too, found that I was not getting a full 24 hours relief from a single daily dose. I, too, felt "wired" (albeit fully pain-free) from about 4 hours after taking the dose and for the next 12-14 hours. I have experimented with the time of day I take the dose but not tried splitting it. Fortunately, Pred does not affect my stomach as long as I take plenty of water with it, so I don't need to take it with a meal. I prefer insomnia at night to pain during the day, so I now take the full dose around 2.00 am (with at least 250ml water) and then find that I can sleep for a further 4-6 hours before the "Pred-effect" kicks in, and I awake without any pain or stiffness. If, subsequently, aches and pains start in the evenings, I can take a nice long bath or simply go to bed earlier, maybe with a Paracetamol or codeine tablet. At least by that time of day, I am no longer "wired up" which has reduced the insomnia - but I do need to set an alarm for 2.00 am (which is a pain but has proved worth it in the long run.)

[Darcy2000]

Very interesting thanks for taking the time to give me the info

[Musiclady18]

Hi Darcy well splitting my dose has meant the world to me, in fact I am even wondering if I have PMR that's how good the splitting has been for me! Pain returned a bit on the weekend so I did have a bit of a reminder! I take 15 mgs currently and here's the split.............10 mg with breakfast and then 5 mg at supper time. Just a suggestion! Good luck!

[Darcy2000 in reply to Musiclady18]

Thanks so much I am excited to try that and it would be early enough at supper that it doesn’t affect my sleep hopefully

[Noosat]

I seem to do better splitting the dose, taking most at about 6a.m. and the rest at 6p.m.

[Linny3]

Might want to look at what other medications you are taking and don't mix them with the pred. I read that taking tylenol with the pred. will affect how the pred. works.

Good Luck

It certainly is maddening trying to time the pred. for max relief.

[Darcy2000 in reply to Linny3]

Good thought thanks for suggestion

[PMRpro Ambassador in reply to Linny3]

If Tylenol is paracetamol/acetaminophen then it is perfectly OK to take with pred

netdoctor.co.uk/medicines/a...

You shouldn't take NSAIDs (ibuprofen, aspirin etc) together with pred - not because they have any effect on the pred but because they can lead to gastric bleeding anyway and more so with pred.