Prednisone - Halfing the pills

[Andymegv]

Someone posted earlier how they halved the prednisone and took them twice daily. Recommendations on the best time to take the two halved prednisone pills. We are trying this as an experiment to see if it makes any difference. Thanks all!!!

[Andymegv]

I think I misspelled that in the title: halving the pills. Spelling errors drive me nuts...which is a short drive. 😂 Posting for my husband with PMR.

[Mamamia21]

I did this for a while and it certainly helped. I took half my dose in the morning and the other half in the evening before bed. (make sure you eat something when you take them)

[Andymegv in reply to Mamamia21]

Thank you Mamamia21!

[OldPenny]

The timing of taking pred, and in what proportion, is down to the individual I'm afraid. I used to split mine - say, 3mg before bed and 5mg with breakfast when on 8mg. I also tried the 2am dose favoured by some. Personally, I've never found the need to eat yoghurt or something else considered appropriate with pred. Now, I've realised that, for me, it makes little difference when I take it, so I take it the way my GP suggested initially, with breakfast, and hope for the best 😏.As I said, it is a personal thing but probably best to check it out in the FAQs on this forum. OP.

[Andymegv in reply to OldPenny]

Thank you Penny!!

[Missus835]

Hi there. I take my full dose (35 mg. and tapering) at bedtime with a little food (around 10:15pm). I take the pills around 9:30pm and sit up for a bit. This way I sleep through most of the side effects, like sweating and shakiness. Still getting up to the loo, though I do go right back to sleep.

Waking up pain free, still sweating a bit and more functional for the day and evening. This has been the only change I've made and it works for me. I believe it's different for everyone. This was an experiment which has worked. When I took them in the morning, I was a write-off for hours and usually ended up laying down, one of the reasons I had to lay off work.

[Andymegv in reply to Missus835]

Missus835, hate to hear that you had to lay off work. Hang in there. Actually, hubby is experimenting with the split dose this week and it seems to be working, but we are watching closely, but very excited in the meantime.

[PMRpro Ambassador]

The first question to ask is are you getting good symptom relief with the dose taken 1x daily? Then the second question is does that good result last a full 24 hours until the next daily dose is due?

If you are getting good relief that lasts 24 hours - there is little point splitting the dose. On the other hand, if you are finding symptoms return before the 24 hours is up, splitting the dose may allow the symptom relief to cover the full 24 hours.

The usual recommendation is about 2/3 of the total dose in the morning and the rest taken a couple of hours before the symptoms would start to reappear. It is better to take the pred as early as possible in the day so the level in the blood is at its lowest by midnight to reduce the effect on sleep and later on on the adrenal function returning.

[Andymegv in reply to PMRpro]

Thank you PMRpro, as always your responses are thoughtful and informative. Actually, this week hubby decided to at least try the split dosing. The last 2 days, he has been like a new person. Not exactly like Superman, but pretty close. We are monitoring this method and watching and cheered in the meantime. 😀

[PMRpro Ambassador in reply to Andymegv]

That is great! Maybe he'll accept we have an inklong of what it is like and all our suggestions are tried and tested ... Long may that last.

[Andymegv in reply to PMRpro]

Oh, he is listening!!! I am trying to get him to listen to his body more, which generally, is a good thing. I feel for the most part, your body gives you information and lets you know. The hard part is listening and knowing when and if to react to it versus thinking it is just nothing.

[Missus835 in reply to PMRpro]

Isn't it strange how the dose lasts only or exactly 24 hours, as if the pills know (or the body knows). I find that taking the whole dose at bedtime (10ish but I take the pills at 9:30), lasts almost 24 hours, but not quite. The pros outway the cons I guess. Perhaps will experiment with the split dose (unsure at this point). I'm at 36 mg. Had to up it a wee bit as a UTI seems to be lurking and I'm on Ceflex. 1 mg. from 35 to 36 does make a difference.

Finally have a phone appointment with the unreachable star rheumy on May 2nd. I don't know if this is considered to be the "annual" or a follow up to monthly bloodwork. At least I have fresh blood drawn on Apr 28th. I suppose I should be grateful, but there are some issues I really needed her to "look at" in person.

[PMRpro Ambassador in reply to Missus835]

Each type of steroid has a different duration of action, hydrocortisone is short, just a few hours, pred is medium acting, 12-36 hours depending in the person, and dexamethasone is over 36 hours. It is all to do with the halflife, how long it takes to excrete half of the drug from the body. Once a day is convenient for patients and for the majority works well.

[Missus835 in reply to PMRpro]

Thanks for explaining the half life. I wasn't sure how that worked.😀

[artfingers]

I found by trial and error that for me it works to take 2/3 in the morning when I wake up (typically 8am) regular prednisone. Then at 10pm I take Rayos (slow release pred) 1/3 dose and that works well to take me thru to a pain free morning, no stiffness or pain. I have found times can change by an hour or two without any problems. Good luck.

[Andymegv in reply to artfingers]

Thank you artfingers! We are trying this method this week and it seems to be working! YAY!