Good morning everyone. I hope you are all keeping as well as possible.
A quick question. I fell asleep early and missed my 5 1/2 mg Pred dose last night which I take at 11pm. I’ve taken it this morning at 7am as soon as I realised. I wondered why I felt achy! I take enteric coated so it will take a while to work. ☹️
My question is, should I take my next dose at the usual time at 11 pm or will that be overdoing the dose? Thank you in advance 😀
Hello, what is the reason you are taking it at night? The achiness may have been some withdrawal rather than all PMR. If it were me, I’d be trying to look to taking the dose in the early morning anyway. This is the preferred time from the Endocrinologist point of view when you are at doses like yours where the adrenal glands need to work a bit. I used to be a late evening taker on E/C Pred but was made to change my ways when I saw the Endo.
Thank you for speedy reply. I take it at night because it’s my understanding that because it’s enteric coated it is slower to release into bloodstream and deals with the early morning inflammation? Maybe I’ve got this wrong? If I change it when is the best time? I could begin this with my next dose? 😀
No you haven’t and this is what I worried about too. However, you are getting into a different phase of recovery where adrenal rehabilitation needs to be considered also. I would also hazard to say, if the timing is that critical for inflammation at low doses now, perhaps your dose might be getting a bit too low. However, I wasn’t dealing with PMR though withdrawal and adrenal dysfunction gave me plenty aches and pains.
Thank you Snazzy. I feel my dose is ok and so far my reduction has gone well. I don’t want to jeopardise this. Is it better to take my dose early morning for example 2am or could it stay at around 7am as per today. What is best in terms of adrenals? 😀
You can take next dose normal (for you) time, but you may like to consider SnazzyD’s comments.
Thank you
Back to normal tonight - happens to everyone at some point. The gentle reminder you still have PMR is useful really ...
How late are you able to take it at night? The aim is for the lowest point of the pred in the body to be about midnight - and enteric coated pred takes a good 4 hours to be broken down and into the system. As long as you are taking it after 10pm it shouldn't affect adrenal recovery at all. I use Lodotra - the sort you take at 10pm within 3 hours of food and it releases in one burst at 2am. Enteric coated just doesn't have the sudden release - but at 10pm it won't start to be absorded until about the same time. Prof Mackie and I discussed it years ago - apparently there was a request to do a study to compare enteric coated with the delayed release formulation but the Lodotra company didn't want to play. We thought because you can achieve the same morning effect for far less cost using enteric coated and their sales might fall.
Thank you. This is really helpful. I’d rather keep to the same routine as much as possible as this has worked for me. However I would of course change things if I was hampering my adrenals recovery. My usual time of taking Pred is 10:30-11pm. I could move it to a bit later? 😀
whatever suit you is the answer, maybe you can adjust to a little later...
Whatever fits you best
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