How do I swap from taking prednisone in the morning to the evening ?

[katiemills]

I think I’d benefit from taking my prednisone in the evening rather than my usual 8 am . Please advise me as to how to make the changeover. Do I double up one day or do I skip my morning dose? Also will it increase my insomnia? I’m on 9.5 mg pred , omeprazole, 15 mg methotrexate a week ,5 mgs folic acid 6 times a week and Calici-D daily .

[Hidden]

Hi katiemills, I doubled up but at 6mg. I took 5mg coated pred around 10pm or later and the extra 1mg after breakfast bet 9 and 10am.

[katiemills in reply to Hidden]

Thank you for replying .

[SnazzyD]

Going from day to night Id just take a double dose in that 24 hour period if it was me. I went from night to day and took half a dose in the evening and the full dose in the morning so I would be asleep for any kick back from a lower dose instead of the day . Just a note, that when you get to about 5mg it is considered better for the adrenal axis function to take a morning dose.

[katiemills in reply to SnazzyD]

Thanks for your answer. Interesting about a lower dose being better taken in the morning .

[DorsetLady PMRGCAuk volunteer]

First question - why do you think it will benefit you?

Depending on that, it might be better to split dose rather than move whole dose 12hrs.

Yes it might affect your sleep, but you won't know until you try.

[katiemills in reply to DorsetLady]

I have more pain in the morning and have to wait for my painkillers to kick in before I can get up. However , I’m a bit of an insomniac so don’t really fancy having more sleepless nights ! Maybe splitting the dose is the answer . Thanks for replying .

[DorsetLady PMRGCAuk volunteer in reply to katiemills]

Your other option - as you don’t sleep that well - is to take it around 2am (give or take an hour) with a spoonful of yogurt or small snack. Then it’s in your system ready for the 4am onslaught of inflammation.

You might have to do a bit of trial and error to find your best option.

[PMRpro Ambassador]

Having taken a dose in the morning, take another before bed the same day. That night might be a bit ropey - you are likely to be a bit wakeful with the extra pred - but that will soon wear off.

Hope it achieves what you hope.

[katiemills in reply to PMRpro]

Thank you for replying.

[HeronNS in reply to katiemills]

That's what I'd do. You'd only have the double dose for that first day, and you'd likely feel fantastic the next day! I find taking calcium dose shortly before bedtime helps me sleep (this is a former lifelong insomniac speaking!) so something like that might help counteract potential effects of pred keeping you awake. If you do take calcium make sure to have a small snack with it and take it at least half an hour before you lie down.

[katiemills in reply to HeronNS]

Thank you for your advice .