I expect much has been written about this but just wondering if this works?
This morning I woke at 3.15 a.m. and decided to take my Pred dose then, today I'm having a much better pain control day than the previous couple of weeks and wondered if this could be down to the fact that by the time I woke up again the Pred was in my system and working . . . . but now I'm thinking it will wear off before bedtime . . . has anyone successfully split the dose and found it works for them . . . higher dose at, say 5.00 a.m. and then the rest late evening? Many thanks.
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Fiddlersmum
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The ideal time to take pred is 2am - then it is in the system ready and waiting for the 4am shedding of the inflammatory substances so they never get a hold and no inflammation develops as long as you are on enough pred. In some people the antiinflammatory effect of pred doesn't last the full 24 hours after it has cleared out the morning lot. Sometimes taking it early it has less to do and the effect lasts longer. So maybe you wouldn't needto split.
The usual suggestion for splitting is 2/3 or so in the morning and the rest later enough to carry the effect over the full 24 hours. It may not need to be late evening - sometimes lunchtime is late enough.
Many thanks for the info - my hubby usually wakes up at around 3.00 and quietly reads his kindle . . . I tend to notice him doing this but turn over and go back to sleep but this morning I thought why not try taking my Pred and seeing if it makes a difference, and I think it has - I woke up with stiffness around 6.30 a.m. but but daily pain/discomfort has been nothing like it has been for the past 2-3 weeks . . . and as the day has gone on I've been able to do so much more . . . my kitchen is actually shining!!!
Don't go mad!!! That is NOT the idea - the pred only relieves the inflammation and the actual disorder is untouched by that and chugs away in the background leaving your muscles intolerant of acute exercise and they get sore more easily and take longer to recover. The form of pred I take releases at 2am with the idea of preventing the early morning stiffness - and for me it works brilliantly. Not available on the NHS though (I'm not in the UK).
. and as the day has gone on I've been able to do so much more . . . my kitchen is actually shining!!!
Don’t get too carried away just because you feel better....it may come back and bite you on the behind! Polite version 😉
If you are going to take Pred early morning when disturbed by hubby make sure you have a biscuit, a small slice of bread or spoon of yogurt - not on completely empty stomach.
I started a split 5mg @ 2 am and 5mg @ 2pm as reducing from 12.5 to 10 caused flair up. Had to increase to 7.5 @ 2am and 5 @ 2pm. Mostly pain free now so will continue to the end of the month before tapering to 12mg on a 7/5 split. Due for a GP review in 2 weeks and possible ref to Rheumatologist. Next job is to book an overdue eye test, I've been waiting for covid -19 rates to fall in my area before booking.
My post is for info' only as clearly what suits one may not suit another.I used to take the whole dose in the morning but eventually picked up on this forum from such as PMRpro/Dorset Lady that a 2/3 to 1/3 split wasn't uncommon. I gave it a try and it worked,in fact my rheumatologist suggested some months later that I should return to taking the full dose so that he could carry out a few tests,his few tests caused me enormous pain for a few weeks and I have never returned to it.
Like you I felt so much better and considered this as a licence to go mad on the activity front ........ mistake number two.
I haven't suffered with this "systemic inflammatory disease," for very long,( that's what my rheumatologist calls it because no one seems to know what it is,) but I sometimes wonder if we could produce a gauge that shows how much cortisol/cortisone whatever it is might be used up with different activities.
Be very careful but pleased you feel better for your discovery.
I began to split my dose late last year. I was struggling to get down below 10mg and feeling very frustrated as mornings were awful again. I remembered a conversation here and began to split them and hey presto mornings were so much better. I even managed to get to between 7 and 8mg. Have subsequently had to go back up to 10 as I think 7mg is too low for me at the moment but even that is a win. Previously I have had to go to 15mg. I am heading back down again to 9mg on my split dose and it is working for me. Best advice ever to split!
I did similar times and very successful for me. Took the am dose when I woke to go to the loo after eating a ramekin of natural yoghurt to line stomach and evening dose after food.
I tried that method today - woke up around 5.00 am so decided to bite the bullet, or the yogurt. I had a couple of large spoons of yogurt then took 2/3rd dose of Pred, taking the rest this evening so will be interesting to see how it goes.
I was having so much fatigue in the mornings and a week ago I decided to split my does, taking 1/3 at 10.30pm and the rest at breakfast time. This obviously works for me and I've had a very much better week. I would like the slow-release pills but was told they were not available in UK (as confirmed by PMR Pro) I wonder if the enteric pills have a 'slow-release' mechanism associated with them.. does anyone know? Very glad I have split my dose anyway.
Yes, the enteric coated, gastro-resistant Prednisolone is available in UK in 5mg, 2.5mg and 1 mg. It bypasses the stomach so no need for PPI and releases around 5 to 6 hours later in the gut. I take mine two-thirds early morning, one-third bedtime which takes care of the inflammation dump at 4a.m.
There isn't a "slow release" mechanism as such - unlike Lodotra which release all at once but 4 hours after you take them, as Slowdown says, enteric coated/gastroresistant don't start to break down until after leaving the stomach which, depending on how much food was in the stomach and the person, means it can be 4 to 6 hours later before it reaches its peak in the blood.
Many thanks - I'm pleased its working for you - Im on my second morning after sitting and I have to say it seems good so far - a little difficulty dropping off to sleep but definitely much less discomfort when I wake up! The down ride to that iscit means I get to make my own cuppa instead of my lively man doing it for me !
After some early problems, waking up at 3.00-4.00 am in pain, I have always split my doses.
Started August last year on 15mg, currently 8.5mg split 3.5 when i go to bed around 11.00 and 5mg for breakfast. Seems to work ok so far.
I have the uncoated white pills. Tried some coated jobs early on but only because you can get them in a 2.5mg size, but didn't get on with them at all. Probably took them at the wrong time.
I take the majority of pred (16mg at the moment) at 6 - 6.30 am and 1mg at 6.30pm which helps during the night/early morning. Most of us need to sleep at 2am as going to the toilet constantly during the night loses some of us enough sleep as it is !
I struggled to control the pain before splitting which now works a lot better.
Since my PMR journey began 2+years ago I have always split my dose between morning and evening and it seemed to work for me. I just completed my first slow taper method of .5mg that was recommended on this forum and so far so good! I'm currently taking 6.5mg prednisone split 4.5. in the am and 2mg in the pm and if all goes/stays well I hope to begin my next taper in 30 days. The plan is to cut the evening dose to 1.5mg at that time. I'd love to hear from anyone who has always split doses and what their experience was when and if they eventually cut to one dose. Also, I'll repeat what many have said...this is a great forum with such caring people! Thanks
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