Time for taking dose : Hi - just wanted to get some... - PMRGCAuk

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Time for taking dose

Slosh profile image
45 Replies

Hi - just wanted to get some input about the best time to take Pred.

When I was first diagnosed - I took it in the morning after breakfast.

Then read somewhere to take it at night - so that its in my system in the morning.

So i took it at about -11pm for 2 years.

A few months ago I read on here that some take theirs at about 2am to make sure it mops up the inflammation and so started doing that.

Confused.com....,

I take 8 mg - 5mg gastric resistant + 3 x1mg non gastric resistant @ about 2am with some cooked Apple.

If it's better to take it then - I will continue to do that - but it's a bit disruptive - especially when I have to commute to London for work.

Thanks in advance

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Slosh profile image
Slosh
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45 Replies
DorsetLady profile image
DorsetLadyPMRGCAuk volunteer

Hi,

I think you have to find what’s best for YOU.

General recommendation is with/after breakfast.

But for some this doesn’t last 24hours, and/or they find it takes too long to kick in - especially if like you they work. So we do sometimes suggest they amend their timings to fit in with their lifestyle.

You may find if you take it at breakfast time that your commute is more difficult - but only you know that.

I can appreciate that if you have to set an alarm to wake you at 2am (if you don’t naturally wake at that time) then your sleep is disrupted.

Unfortunately it’s very often a matter of trial and error!

Slosh profile image
Slosh in reply toDorsetLady

Thank you.

Hi slosh....it can be confusing but it's whatever works for you! I am on 6mg. I take 5mg coated at around 10pm. That means it's in my system 4 to 6 hours later. I then take my 1mg uncoated with a late breakfast ...usually around 9 to 10am. I have done this for around a year. Previous to that I took it all in the morning. I will say I have better mornings now but run out of steam earlier at around 5pm. But that doesn't matter for me. I could take the 1mg at lunchtime I suppose. Like I say it's whatever works best as long as it's a routine.

Are you getting symptoms, is that why you are asking. It could be you are struggling on that dose if you are. I am sure lots of different approaches will be posted!🌻

Slosh profile image
Slosh in reply to

I'm not having symptoms taking it at 2am - But feel like I'm not sleeping properly and waking early.

I was ok too when I took it at night and probably slept better.

It's usually stress (any kind) and overdoing it that makes me flare.

Little more tricky at present with the histamine intolerance.

in reply toSlosh

Yes stress etc can put me on my back for a few days. As long as I get to 4am I am ok.

Slosh profile image
Slosh in reply to

Do you mean take it at 4am?

in reply toSlosh

No at night. 4am is my natural end to first sleep cycle. Hopefully I can get back to sleep then. Between 10 and 11pm seems to work for me.

Slosh profile image
Slosh in reply to

Oh ok - thanks.

Hi Slosh

The recommendation is that we should take it before 9am each morning, however, a lot of people find that doesn’t fully manage their pain, so they try different options.

Some split the dose 70/30 some take it in the early hours, it’s what ever is best for you.

The purpose of taking it in the morning before 9am is to mimic when our own bodies would produce Cortisol.

The only time l have ever split my dose was when we went to the Far East & had to up n dressed & in the dockside by 7am so l took 5mg Coated before l went to bed & the balance at 6am but on our return home, l went back to taking it in a morning.

So, my advice is, whatever works for you & your lifestyle.

Kind Regards

MrsN

Slosh profile image
Slosh in reply to

Oh ok. Thank you.

Now I'm more confused.

I have a fairly slow metabolism. Wonder how long the coated and non costed takes to kick in?

Maybe I will move it slowly to the morning.

jaycee444 profile image
jaycee444 in reply toSlosh

Hi Slosh, Im currently on 12mg and take 7mg uncoated and 5mg coated between 5/6am. The uncoated kicks in a bit later and has stopped the early hours symptoms that I was experiencing.

Slosh profile image
Slosh in reply tojaycee444

Thank you - that is good to know.

SnazzyD profile image
SnazzyD

If pain management is working I’d say sleep is debatably more important for healing than trying to hit the sweet spot in the night. If you’re working being properly rested is essential short and long term. When you get lower the advice from Endocrinologists is to take it in the morning for the best chance of restarting adrenal function. I was an evening taker but changed to am at 5mg.

Slosh profile image
Slosh in reply toSnazzyD

Thank you - was wondering about the whole adrenal thing.

I also take thyroid meds in the morning.

I think I am going to try shift it to the morning.

More or less what time do you take it? It needs sometime to be absorbed.

SnazzyD profile image
SnazzyD in reply toSlosh

I’m on a combination due to not being able to cut the coated Pred. I take the coated about 6am then the non with my breakfast about 2 hours later. I assume about 4-5 hours for the coated and 2 hours for non. I don’t have pain to consider so the only consideration has been feeling very lacking in oomph until about 11am. I don’t get that every day now because I think my adrenals have perked up a bit.

YuliK profile image
YuliK in reply toSlosh

Someone said we shouldn't take our Thyroid meds together with Prednisone. I take 5mg 👏 Prednisone at around 2am, with a tablespoon or two of yogurt. ( usually wake to go to the bathroom) and then on waking around 7:30am my Thyroid stuff before eating breakfast.

Yulik

Slosh profile image
Slosh in reply toYuliK

That is what I have been doing.

Slosh profile image
Slosh in reply toYuliK

Maybe will carry on with that.

Slosh profile image
Slosh in reply toYuliK

Yulik - do you know how many hours the two should be separated by?

YuliK profile image
YuliK in reply toSlosh

I give it at least 4 hours

Slosh profile image
Slosh in reply toYuliK

Oh ok.

PMRpro profile image
PMRproAmbassador

The right time to take pred is when it works best for you ...

It's funny you should ask that. Always split my dose taking the majority in the night. A few weeks ago when reading about adrenal glands kicking in on this site, the recommendation was 8am. As I'm down to 6mg I switched to that time no longer splitting the dose. I went downhill fast, stuck it out for a week to give my body a chance to adjust but when I started to use walking sticks!!! I was reluctant to return to the early mornings, so nice to have undisturbed sleep, I tried taking the pred last thing before bedtime, around 10 ish. The difference is amazing, I feel better than I have since this thing started, my knees are almost normal and I'm no longer walking with a limp. True come the evening things start sparking but I can cope with that. Hope this helps xx

Slosh profile image
Slosh in reply to

How long since you started Pred?

It's so difficult to know what to do for the best long term adrenal function return.

in reply toSlosh

Try not to worry too much. I think slow taper is more important. If you take 5mg coated pred at 10 or 11pm it disperses between 2 and 4am. Then you can take the 3mg left at breakfast and you still get that morning boost.

Slosh profile image
Slosh in reply to

Oh right - thanks.

in reply toSlosh

Started taking pred 25/05/2018.

in reply to

Hi ChrisMCT ...do you ever find you have to make frequent trips to the loo through the night when taking pred with dinner? I was pain free with taking the dose at night...but I developed insomnia plus waking up once or twice to go to the loo didnt help! After switching to taking it with breakfast the night trips eased...but the pain has never completely disappeared!

in reply to

Yes but when PMR started I was almost completely incontinent. I have to watch it at nightime so get up 3/4 times, pred makes me sleepy so I usually drop off again easily. I've never been pain free it's all a bugger isn't it!!

in reply to

Glad to hear pred makes someone sleepy!

Daffodilia profile image
Daffodilia

I was told to take after a substantial meal so took in evening but pharmacist told me to take in morning to mimic body (adrenal glands produce cortisol at 3 am?) so I take after breakfast of large bowl of porridge to stop sickness - hope that helps

Mimma profile image
Mimma

For what it’s worth I take my pred between 7-8 am with breakfast then two hours later I take Tamoxifen. Vitamin K and chewable calcium with lunch and second tablet of chewable calcium with Omega 3 fish oil at supper time. I am hoping two hours gap between medications is enough.

Darcy2000 profile image
Darcy2000

I really find that if I split the dose it gives more thorough coverage ..so I take 10 in the Am and 5 after supper ....smaller amount at night helps with sleep

PMRCanada profile image
PMRCanada

I can only get uncoated pred here in Canada, and was getting up at 2am for months, finding it disruptive of my sleep (along with a few trips to the bathroom). Then I purchased empty coated capsule online and stuffed my pred dose into them, so now I take my capsule around 11:30pm and it works dandy.

If you already have coated pred you should be ok taking it before bedtime and the medication will be on board for the 4am cytokines rush hour.

Slosh profile image
Slosh in reply toPMRCanada

Thank you for that.

Slosh profile image
Slosh

Everyone's valued responses are so diverse.

I am thinking that perhaps I may revert to taking my Pred at 11 / 11:30pm - but perhaps splitting the dose 5mg coated at night and 3 mg in the morning after breakfast.

My thoughts are what about the impact on adrenals that may want to start waking up?

PMRCanada profile image
PMRCanada in reply toSlosh

I neglected to mention I take a split dose....6mg in coated capsule at 11:30pm and 3.5 at around noon, with lunch.

SusanEleven profile image
SusanEleven

Like others have said, it's going to be individual to you. When first diagnosed I took it in the morning. That was great for the first few months but then it seems the pain relief would sputter out by end of day.

At my rheumatolgist's suggestion, I split the dose between night and morning and that worked really well.

When my taper got lower I switched back to morning. It was a bit of trial and error!

Slosh profile image
Slosh in reply toSusanEleven

Ok - that makes sense. At what dose did you start taking them in the morning?

SusanEleven profile image
SusanEleven

My rheumatologist started me at 10mg. When the pain relief eventually stopped lasting all day I split the dose between morning and night. I went back to once a day at (I think, oh my memory!) 5mg. I'm currently at 3mg/day in the morning.

(She starts everyone on 10mg and quickly raises it if the response isn't good enough within a few days. Her PMR patient starting doses end up being between 10 and 25; she had one person who needed 30. She says if anyone needs more than 30mg for relief she starts thinking it isn't PMR. I was nearly completely pain free six hours after the first dose. She's kind and open minded and really likes to hear about the discussions in this group. )

maria40 profile image
maria40

I had to stop the small hours pred taking as I couldn't get back to sleep easily and was feeling shattered the next day. I'm back on the post breakfast routine and feel better - except on those days when the deathly fatigue strikes anyway. (I'm now on 7mg). I think, as DL says, you have to find the right time for you and your daily routine.

Slosh profile image
Slosh in reply tomaria40

Thank you

Slosh profile image
Slosh

Interesting.

Smokygirl profile image
Smokygirl

I’ve only been on Pred for a month, but I take it at 10:00 am after a walk and breakfast. This suits my lifestyle as I crash out in bed at 2:00 pm for an hour and am out at bridge clubs four nights a week.

I guess everyone has to find what is best for them and I suspect it might change as one tapers.

Thaiboxing profile image
Thaiboxing

Hi Like you I now take my Pred at 2pm I used to take it with blood presure tablets in the morning but now takr it at 2pm I think that is the best time Take care your kickboxing friend

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