Spaced out

[nicolahg]

I am three weeks in and doing well on 15mg. But I feel pretty spaced out during the morning. (I take my meds with breakfast.)

Is there a case for dividing the dose and taking, say, 5mg with supper.? Could the omeprazole be the cause if the spaced out feeling?

Advice welcome. Thanks

[DorsetLady PMRGCAuk volunteer]

I would plump for the Pred being the culprit..,. More cortisol (albeit synthetic rather than normal) coursing around your body....bound to be a bit strange!

You could try splitting dose, but TBH it will probably settle soon anyway - once body acclimatised to Pred.

Maybe give it another week unless it’s causing a real issue - always loathe to alter Pred timing etc if they are generally working okay.

But others may have a different view, and of course it’s your choice.

[PMRpro Ambassador]

Most likely to be the pred - some people find taking it before bed deals with that problem!

However, PPIs can have an adverse effect on cognition, especially in older patients:

ncbi.nlm.nih.gov/pmc/articl...

If you are taking your pred with a proper breakfast - do you need the PPI? You could try not taking the omeprazole - depending on how long you have been taking it, if it is a long time you will have to taper the dose - and see if that improves it.

Dividing the dose may be needed if the antiinflammatory effect doesn't last the full 24 hours until the next dose is due. Otherwise, taking it all at once is recommended.

[nicolahg in reply to PMRpro]

Thank you very much.

[Kendrew]

Hi nicolahg,Just a quick comment on the omeprazole. I've been on pred almost 2yrs and so far I've not needed omeprazole. I take my pred every morning after a really substantial (but healthy!) breakfast. I also have the gastro resistant tablets. Seems to work for me.

[Petcut]

Morning Nicolag I also was diagnosed 3wks ago and taking 15mg Pred I’m spaced out permanently all day,when I get up I the morning a lot of the effect has worn off but then after taking Preds it’s all back,but looks as though we have to wait and see if things settle with time,just wanted to let you know your not alone feeling the way you do.