To split or not to split?

[Ana-16]

I have just been reading the posts about when and how to take prednisone. I started on 15 mg which only worked on the first day when I took them in the evening. My gp told me that general advice was to take the dose in the morning. However when I did that the pains continued so I tried splitting the dose which helped. As I couldn’t get an appointment with nhs rheumatologist I made an appointment to see professor SenGupta privately. (On Zoom)He upped my dose to 20 mg and told me it was fine to continue taking two doses as I was and confirmed that for many of his patients this worked well.

I have managed to taper down to 7 mg taking 5 in the morning and 2 in the evening. I’m now wondering if I should try 6 in the morning and one in the evening as part of the tapering programme. I would just like to add that my gp has been amazing throughout and is very happy that I’m with this group as she has been more than happy to hear of the expertise to which it has given me access.

[DorsetLady PMRGCAuk volunteer]

As we say very often, whatever works for you is probably the best option…

Usual split as you know is approx 2/3rd am, 1/3rd evening…..so 4 & 2 would be nearer that.

However there are different views on what is best for helping adrenals at lower levels, so hopefully someone who has been there before you will advice…I can’t because I never split my dose.

[jinasc]

Is that Professor Sen Gupta at the Royal Holloway?

[Ana-16 in reply to jinasc]

Ooos!! So sorry everyone I meant professor Das Gupta

[jinasc in reply to Ana-16]

Ah it is Professor Bhaskhar Dasgupta, the man who dreamt of starting a charity and he did it with 25 other people. Which one, this one PMR GCA UK.

[PMRpro Ambassador in reply to Ana-16]

If he thinks splitting the dose is OK - who is to argue with him?

[PMRpro Ambassador]

The best thing to do is what works for YOU. You have to try it and see if it works - if it doesn't, then it isn't for you yet and you go back. But I would reduce just by 1/2mg now - no hurry.

How late do you take your 2mg dose?

[Ana-16 in reply to PMRpro]

I usually take it about 9.30

[PMRpro Ambassador in reply to Ana-16]

Have you tried it earlier? You are taking such a small amount in the evening I doubt it will affect the adrenal production of cortisol. As I say, I'd just try what you want to do and see how you get on.

[kp60]

I tried taking all of my 4 1/2 mg in the am and skipped the evening yesterday. I could hardly get out of bed this am I hurt so bad. So I will go back to 2 1/2mg am and 2 mg at 4 pm.

[Ana-16 in reply to kp60]

Ah thanks for that. I decided to try taking 6 in the morning and one at night thinking I might be able to eliminate the evening dose eventually. Waiting to see what happens. Fun and games!