taking steroids at night?

[Ancestry1234]

Has anyone experience of taking steroids at nighttime? Am sure I’ve read somewhere that it was quite successful and am keen to give it a try. Am in the process of reviewing my medications and the timings.

[PMRpro Ambassador]

It depends on the type of pred you take.

The optimum time to take plain white, non-coated pred is 2 to 3am. so that the blood level is at its peak about 4-4.30am when the inflammatory substances that cause the symptoms are shed in the body. Some people manage to take their pred before bed - especially if they are late to bed without it affecting their sleep. There are other considerations when you get down to low doses with regard to adrenal function.

If you are on enteric coated pred it takes longer to get into the system - they pass through the stomach and aren't broken down until the lower GI tract where the acidity level is different, so they can be taken before bed and will be working nicely by the time the inflammatory substances appear on the scene and won't have an adverse effect on adrenal function.

[piglette]

I take mine at 2am with some hard cheese.

[Omanain]

I take enteric coated pred just before I go to bed around 11pm.

[LemonZest11]

I’ve been taking my plain white pred at roughly 2am for two years now, and it has meant that I awaken without the stiffness I used to have. It’s not really a problem for me because I usually need to pee during the night, so I take my pred with a small tub of yoghurt, at the same time. It doesn’t have to be exactly the same time every morning, I have learnt. I don’t awaken completely, just get up and try to stay sleepy while going through the motions. I leave the pred out the night before because I used to be so sleepy that I couldn’t remember in the morning if I had taken it!! This way I know. It has made a world of difference to me, and I got this idea from the experts on this site … you know who they are. 🤞

[krillemy]

I changed from taking all AM to take 1/3 before bed, and the rest when I wake up. If I wake to use the toilet or something, I take it if it is after 3 AM. I makes me fell much better in the morning, and not so speedi.

[Alebeau]

I started doing that 2 years ago and no problems for me in terms of sleeping.

It helps with pain management as the pred wore off too quickly when I took it all in the morning. By morning I was always in pain. Not so after I split the dose. I was reborn 🙂

[Joan-E-D]

I took my plan Preds last thing at night with a bit of supper. Then I got over the weird lightheaded feeling during the night and was fine in the morning. Only disadvantage was feeling somewhat achy in the evening, but it was O.K. as I was tired by then anyway.

[PMRpro Ambassador in reply to Joan-E-D]

That is where splitting the dose can help.

[marionofnorwich]

It does seem to help me. I normally take 5mg between 2am and 2.30am and the 2mg later in the morning usually at about 11am. Hard to tell for sure but it seems to suit me

[Bcol]

Hi, I take mine around 02:00 with some yogurt and assuming I have one, failed that test miserably this morning, a banana. This has generally got me through the day with no problems.

[Marko666]

Hi, I was setting an alarm for 2am but now take my 15mg before bed at 10 pm and wake up much better less pain .

[singingloud]

I have split my full dose forever. I currently take 4.5mg non-coated at 11pm and 5mg at around 8am. Seems to cover my day well.

[Karenjaninaz]

for a while I tried taking my higher doses at 2 AM. But now that I’m tapering down to 8 1/2 I decided to split the dose 1 mg at suppertime and 71/2mgm with breakfast I haven’t had any PMR pain in years ; my main problem is tapering and attending to my adrenals. I started to think if I take too much before 2 AM, before the adrenals start trying to work, then they will not be triggered on their own, I would be counteracting, what I want.

The absence of early morning, 2-3 AM prednisone, would help stimulate them to wake up.

This is amy recent experiment and I actually feel better waking up.

[PMRpro Ambassador in reply to Karenjaninaz]

The 2-3am pred won't affect the morning cortisol production - it is the level at midnight that is significant.

[Karenjaninaz in reply to PMRpro]

Thanks! That’s interesting.