Prednisone dose

[Walkingwiththewin]

Newly diagnosed by an ER physician

Waiting to see Rheumatologist. I am currently take 40mg of prednisone in the morning seems to take awhile to get relief. Evening are good wondering if I should do a morning dose and and evening 20 and 20mg

[HeronNS]

You should take all your pred first thing in the morning, with food, for at least the first few weeks. Splitting the dose is only needed by a minority of people for whom the dose doesn't last through 24 hours. But the important thing at the beginning is to have a large enough single dose to really zap the inflammation. You won't know for a little while whether or not splitting the dose is really necessary.

You are on 40 mg? Do you have PMR or GCA?

[DorsetLady PMRGCAuk volunteer]

Hi, and welcome,

If you are taking 40mg per day then guess you’ve been diagnosed with GCA - if so, then it is not recommended to split dose- you need it in one hit.

If you’ve been diagnosed with PMR, then it’s a very high dose.

Not sure how long you’ve been on medication, but it can take longer for some to have an affect - so you need to give it chance before you consider amending things. Sometimes we do recommend a 2/3rd am:1/3rd pm split to help with the morning .

A bit more information might help us to give you a definitive answer. For example - date diagnosed, starting dose, whether GCA or PMR or both. And country - helps with different drug name etc.

[PMRpro Ambassador]

How early in the day do you take the pred? The inflammatory substances are shed in the body at about 4-4.30am, the longer you leave it after that to take the pred, the more inflammation has developed and the longer it takes to be cleared by the pred. The ideal time to take the plan pred to minimise the morning stiffness is 2am but one way to help the mornings is to wake early and take the dose before settling down for another couple of hours before getting up.

Until you see the rheumatologist it would be better to stick to once-daily dosing but if he agrees it is PMR rather than GCA you could try splitting then. 40mg should be more than enough for PMR but it may take more than a few days. When did you start the pred? What symptoms do you have?

[Cyclegirl54]

Hi, sorry you’ve been diagnosed with PMR. Keep checking into this forum as it’s a wealth of excellent advice. All the best 🌸