Prednisolone. Right timing?

[Svete]

Hi guys, was wondering what time do you all take prednisolone? Do you take at the same time every day?

Many thanks for your time.

[Koalajane]

I have mine at 8 with my breakfast,

I have tried taking it a lot earlier in the morning, but find it difficult to take food around 4 a.m. and it messes my blood testing up for my type 2

[DorsetLady PMRGCAuk volunteer]

For plain uncoated tablets, usual recommendation, certainly at the start, is am with/after food.

Some may find a better time for them as they progress, or if they have to juggle other meds.….but yes same time…as with most medication.

[Svete in reply to DorsetLady]

thank you, if these rules only apply to plain ones, how about coated prednisolone?

[DorsetLady PMRGCAuk volunteer in reply to Svete]

sorry -should have explained that better, plain ones take an hour or so to take affect.

Some patients take the GR tabs last thing at night because they take longer to get into the system..and some in other countries may get the slow release version so also take at night…

[Svete]

so basically coated prednisolone would take longer to get into the system and can be taken at night then? Im sorry for more questions its just to mind up my mind, as i was given coated prednisolone due to my problems with stomach.

[DorsetLady PMRGCAuk volunteer in reply to Svete]

see PMRpro has explained.

[PMRpro Ambassador]

The recommended time is to take the entire dose in one as early in the day as possible. The ideal times to take are prednisone at 2am, prednisolone at 3am, which ensure it is at its peak at 4am when the new daily batch of inflammatory substances is shed in the body. The difference is because of the fact prednisone must be processed in the liver to turn it into prednisolone which is the active form. Taking it at this time minimises morning symptoms.

Most doctors will say 8.30am or so with breakfast claiming this mimics the natural release of cortisol and so reduces the effect on the adrenal glands. This isn't entirely true since the peak occurs at this sort of time -- and as explained above, it take 1-2 hours to get from the stomach to working.

Some people shift the time of day and whether they take it in one or two doses for several reasons but initially it is always best to start as recommended, get to know your PMR and your body's response to pred before changing things.

If you are taking enteric coated pred, they take at least 4 to 5 hours to get into the system, they are only absorbed after they have passed through the stomach and then the absorption is more gradual as well. Some people take them before bed so they are in the system in the early morning which often works very well without having to get up in the night to take them.

[Svete in reply to PMRpro]

thanks again for taking time and explaining. Best wishes.xxx

[AshPen9 in reply to PMRpro]

I'm just wondering, does taking your pred before 4am have any longer term beneficial effect? What I mean is, will the cytokines do less damage to your body if they are stopped in their tracks so to speak?

[PMRpro Ambassador in reply to AshPen9]

You would imagine that the less inflammation in the body the better but I don't know if it has been looked at objectively. It also depends to some extent how long the antiinflammatory effect of pred lasts for you - for many it lasts a full 24 hours or more so its effect is still there when the next dose is due.

[piglette]

I take mine at 2am in the morning with a piece of hard cheese.

[HeronNS]

I took mine with breakfast for years but for over a year have been taking it at 2 am with a small helping of plain yoghurt. This has worked better for me in terms of waking up feeling well so I recommend taking whatever version of pred you have at a time where it will have been working before the time you usually get up. I think the idea is to prevent the 4 am release of cytokines from having a pain-causing effect. I only have access to uncoated pred so the 2 am time is right for me.

[Bcol]

Morning Svete, likewise as Piglette and Heron, early morning with yogurt and a banana (assuming I have one!!).

[ubaoz]

I take mine (uncoated, with yogurt breakfast) whenever I get up – which can vary from 6am to 11am – doesn't seem to make any difference! My guess is I'm one of the luckier ones where the dose lasts longer than 24 hours perhaps?

[agingfeminist]

Always taken it at midnight (i.e. bedtime) with yogurt, so don't wake up with any problems.

Now with adrenal insufficiency often fall asleep at 8pm so put alarm on for 2 a.m. and take then

[Exflex]

In the morning between 9 and 10. I tried dose spitting am/pm but it killed me. Also EC takes too long to take effect.

[Kuipersr2 in reply to Exflex]

Hello. What do you mean “it killed you? In reference to splitting your prednisone dose, morning and night?

[Exflex in reply to Kuipersr2]

It’s a colloquial phrase meaning I felt rather unwell. I would describe it now as adrenal insufficiency knowing more about the effects of corticosteroids on adrenal function.

[Kuipersr2 in reply to Exflex]

Got it. Thanks.