Should I split my pred dose

[JEMOK]

I wake up in excruciating shoulder & arm pain around 3am in morning & can't get back to sleep so get up at 6 am to take 10 mg pred. The pain takes around 2 to 3 hrs to subside. Would it help if I took 5mg before bed & 5mg in morning? X

[PMRpro Ambassador]

Only one way to find out. There is no reason why you can't take it at 3am when you wake up but taking it earlier might prevent the waking up. It is possible the 5mg before bed may disturb your sleep so another option is to take about 2/3 in the morning and the rest sufficiently later in the day to carry the effect over to the next morning - early afternoon may be late enough. People do often have to experiment a bit.

[JEMOK in reply to PMRpro]

Thank you. Should I set my alarm & take 5mg at 2am & take other 5mg at 2pm in the afternoon? X

[PMRpro Ambassador in reply to JEMOK]

You can only try - but what I was saying is that the times don't have to be 12 hours apart, they can be closer together than that. And as for setting an alarm - there are people who do that but some find they can't get back to sleep afterwards and that causes problems of its own.

[piglette]

I take my pred at 2am which works well. As PMRPro says why not try at 3am as you are awake then or even split the dose. It is a matter of trial and error. You never know you might then get the perfect solution.

[123mossie]

I guess you’d rather not be woken up with pain in the first place, maybe try 1/3rd early evening & the rest morning? As others have said, see what’s best.

[Bcol]

Good morning JEMOK I take mine around 02:00 with some yogurt and a banana and it has been fine for me.

[JEMOK in reply to Bcol]

Thank you Bcol I will try that tonight. Do you take the whole dose at 2 am x

[Bcol in reply to JEMOK]

I do and have done for many months now. Hope it works for you.

[JEMOK in reply to Bcol]

Thank you. I will let you know how it goes x

[Bcol in reply to JEMOK]

Brill.

[Mondelo]

Jemok:I am currently on 10 Mg, and take mine at 06.30 and 22.00: It seems to have the desired affect, good luck with it,

[bussell]

Hi Jemok Like Mondelo, by trial and error I have found splitting the dose at 10pm and breakfast time works well. The 10pm dose is 2 x coated 21/2 mg tablets. They are delayed action and don't upset your digestion. I found taking pred at 2am woke me up too much!Good luck, you will find a solution.

[Nancydk in reply to bussell]

Are the delayed action prednisones called Rayos or something else? Would love to know.

[PMRpro Ambassador in reply to Nancydk]

The real delayed action prednisone is called Rayos in the USA and Lodotra in Europe. It isn't available in the NHS in the UK so it is possible what bussel means she uses is enteric coated prednisolone which also takes about 4 hours to get into the blood stream but in a different way. It (enteric coated) is ONLY available in the UK.

[bussell in reply to PMRpro]

Thank you for explaining that, PMRpro. I didn't realise there was a difference, and yes, I meant enteric coated pred which is available in the UK through the NHS. Works well for me.

[Flivoless]

I on 15mg Pred per day (only for a week now) and was having the same problem as you. I split the does 10 after a late breakfast and 5 after dinner. So far it has worked.

[Pixix]

I take my pred between 2 and 3 am...and always have! It helps me but guess it’s an individual thing! I’ve never split a dose tbh but probably because I’ve not needed to! Good luck.

[Snnib]

Hi there, I have started taking 5mg of my 71/2mg does at around 2am, and it has really worked for me, get straight back too sleep most nights till about 8am, I normally wake up too go to loo so just take it then, no set time. Give it a try . Best of luck.

[JEMOK in reply to Snnib]

Thank you. What time do you take the other dose? x

[Snnib in reply to JEMOK]

After my breakfast about 9.30am. I've felt much better doing it this way. Hope it works for you.

[JEMOK in reply to Snnib]

Thank you 😊

[NickWarwick]

Hi Jemok.

Just reinforcing what has gone before really. It seemed to me that as i was in pain at 4am it was sensible to take something a few hours before. So i split between breakfast time and bedtime. Was a 50/50 split but now 5mg breakfast and 2.5mg bedtime. There was some suggestion somewhere that it is better to skew the doses, with rather more in the morning but i am not quite sure why that would be.

Trial and error i guess

Good luck.

[PMRpro Ambassador in reply to NickWarwick]

Because the bulk of the problem is created in the early morning when the substances that cause the inflammation are shed at 4am or so. The antiinflammatory effect then lasts between 12 and 36 hours even though you don't take more pred. So it makes sense for the morning to be a sledgehammer to clear that out and use a tack hammer for the top-up if you need it.

[JEMOK in reply to PMRpro]

Are you saying then that the bigger dose should be taken at breakfast in morning say 7 1/2 mg & other 2 1/2 mg dose at night before bed?

[PMRpro Ambassador in reply to JEMOK]

There is no right or wrong way - but that is the usual pattern yes.

[JEMOK in reply to PMRpro]

Thank you so much for all the advice received on this forum it is so greatly appreciated x

[Thelmarina]

Should you up your dosage for a while to see if that helps?

[singingloud]

I take 5mg at 11:30 before bed and 6 mg at 8am. It seems to work for me. My problem is the night sweats at around 3:30am that wake me up. I hope you find the right times for your body.

[JEMOK in reply to singingloud]

I also suffer from night sweats which wake me up 3-4 am