Pred split dose tapering help needed, please!

[Sunnyday365]

I started on Pred in April 2021 at 15mg with a split dose. I am now at 8mg taking 6mg at 4:00am and 2mg at 4:00pm. I am not sure how to do the next taper. Should I alternate lowering the split doses? Should I try and combine them into one dose and then taper? I really appreciate any thoughts.

[Koalajane]

I am sorry I can’t help as I have only ever taken it in one dose in the morning

[MrsNails]

Hi Sunnyday, it’s getting late in the U.K. now so you’ll be unlikely to get any answers until morning U.K. Time. I’m a bit Poleaxed following my 3rd Primary Covid -19 Jab & am in bed so l’m not up to much but ideally you’ll need to get all your dose into the morning dose - so taper off the afternoon dose first in 0.5mg drops.

Kind Regards

MrsN 😴

[Sunnyday365 in reply to MrsNails]

Thank you for the reply and advice. I'll remember the time difference next question ;). Sleep well.

[MrsNails in reply to Sunnyday365]

Night 😴 l just wanted to mention why you might not get many replies 😉

[Boss302Fan]

When I tapered to 7mg I stopped doing the split dose and moved to taking it in the morning.

[DorsetLady PMRGCAuk volunteer]

If your body has got used to the split dose, then would suggest you stay with that regime (for now anyway) and alternate, starting reducing with the highest dose. Are you intending to reduce by 1mg or 0,5mg each time?

You may find as you get lower, it’s easier to go back to one dose, but don’t try too many changes at once.

I had GCA, so didn't split dose.

[Sunnyday365 in reply to DorsetLady]

I am doing .5mg about every 4 weeks or so. Yes the multiple changes was my biggest concern. I have enough of those! Thank you.

[cmToddy]

I agree with Dorset Lady. Drop 0.5 or 1mg from your highest dose and good luck

[PMRCanada]

You might want to try dropping by .5mg starting with your 4am dose. So 5.5mg at 4am, and 2mg at 4pm.

I too split my dose and try to keep 2/3 at my early am dose, and 1/3 at my late morning dose. So currently I take 6mg (in an enteric capsule) at 11pm (which comes on board by 2am), and 3mg at 11am. As I taper by .5mg, I take 5.5mg at 11pm and 3mg at 11am. My next reduction I will take 5.5mg at 11pm and 2.5mg at 11am. Hope this make sense and is helpful.

[Sunnyday365 in reply to PMRCanada]

It does. Thank you.

[cycli]

I have both PMR and GCA and have split my dose to 12.30-1am and 12 noon to 1pm I am still on a high dose of 24 mg 15 and 9 but the shift to early morning has really suited my body and I am finally sleeping normally for the first time in ages. I am planning to reduce the noon to 1pm dose to zero so keeping the early am slot for the bulk of the pred. and then tapering off that dose. I feel for me that is the best course. Don't know if that helps .

[NickWarwick]

An interesting question that i had to deal with as well.

Always split my dose. Circa 1/3rd at bedtime and 2/3rds at breakfast.

By the time i got below 7.5mg the maths was going to get complicated, so i just reduced the night time dose by 0.5mg every month.

Now just on 5mg every morning. Zero at night.

Seems to have worked ok for me so far.

Good luck

[Sunnyday365 in reply to NickWarwick]

Thank you. That's what I'm going to try. I appreciate you input.