Change the time I take Pred?

Hello everyone

Grateful for your advice on this please. I want to change the time I take Pred from approx 11am to around 7pm. Do I need to do it gradually, maybe move by a couple of hours a day, or can I just change in one go?

Thanks very much

[Briana1940]

Hi there.I used to take my prednisone at 6.00 AM.I now take it at 10.00 PM.It works better than morning for me.Am on 4 mgs.Good luck.

[Hidden in reply to Briana1940]

thank you, did you make the change in one go?

[PMRpro Ambassador]

11am is very late to take pred - early morning is better. But it also depends on what dose you are on at present and why you want to switch to 7pm which comes with a few downsides.

[Hidden in reply to PMRpro]

Thank you PMRpro. I suffer from side effects and withdrawal symptoms of Pred and think taking it later will help with those.

[DorsetLady PMRGCAuk volunteer in reply to Hidden]

What side effects? -and the best way to help with steroid withdrawal symptoms is to use a slow tapering plan.

As a matter of interest what dose are you on now?

[Hidden in reply to DorsetLady]

Thank you, I have used the slow taper. I am now on 10.5

[DorsetLady PMRGCAuk volunteer in reply to Hidden]

Okay -well try a change in timings - you won’t know until you try.

[Hidden in reply to DorsetLady]

yes that’s what I thought. Can I change in one go do you think ?

[PMRpro Ambassador in reply to Hidden]

You could, or what about taking about half the dose at 11am and the normal dose in the evening the same day? But if you tell us what your adverse effects are maybe we can help?

And later once you get down to about 5mg, taking it at 7pm isn;t really ideal as it won't help adrenal function return.

[Hidden in reply to PMRpro]

You’ll be sorry you asked! Dizzy, shortness of breath,shaky,muscle pain, exhaustion.

[PMRpro Ambassador in reply to Hidden]

Tell us in detail - what makes it worse, when it happens. They are all fairly normal but some could be the PMR.

[Hidden in reply to PMRpro]

After discussion with my rheumy, who is well known to the charity, we decided that possibly more of the problems I am experiencing are from the Pred rather than the disease itself. I have history of being very sensitive to drugs. The reason I am thinking about changing the timing is because at the moment I am feeling ok in the morning until I take them and within half an hour I can hardly function. Sorry if this is probably all a bit too much info.

[PMRpro Ambassador in reply to Hidden]

No, never too much info, saves us a lot of writing about something useless to you. Yes, that is a not uncommon experience, Sometimes taking them before bed allows you to sleep through it. Sometimes splitting the dose helps - never achieve such a high peak. Everyone is different in how they react. SnazzyD had problems with feeling rubbish after taking her pred.

[Hidden in reply to PMRpro]

Thank you so much. That was my thinking, will try it and see how I get on. I really appreciate the help from you all x

[DorsetLady PMRGCAuk volunteer in reply to Hidden]

Yes -probably the easiest way .

Either start tonight if it’s not too late - or perhaps if you leave to another day take a slightly lower dose in morning (say 7mg) and then full dose at 7pm.

Whichever way yo do it -you’ll need to give it a while to settle before you know if it’s better for you,

[Hidden in reply to DorsetLady]

many thanks DorsetLady

[PRL1957]

Sorry to ask this if it has already been covered, but what sort of prednisolone tablets are you on? Are they uncoated or enteric coated (aka. gastro resistant)? The packaging or advice sheet with the tablets should tell you which they are.

If uncoated (more likely, I think) they will take around 1-3 hours to be absorbed, to deliver their maximum drug concentration into your body. So taking them at 7 pm would give you peak concentration just before bed time. Amongst prednisolone's various side effects, that may upset your sleep.

If coated, the tablets will probably take longer to be absorbed, so the peak dose in your body might be a couple of hours later than for uncoated tablets.

[Hidden in reply to PRL1957]

Yes, uncoated tablets will see how things go

[Hidden]

Hello,I changed from the early hours of the morning 1 a.m to 2 a.m to 8 a.m. some time ago as it was better to have them with my breakfast. I did it in one go without any problems. All the best.

[Hidden in reply to Hidden]

Thank you, fingers crossed

[Hidden in reply to Hidden]

Actually 8 a.m is my cut off point, I take them between 6 to 8 a.m. so far so good. 👍

[toniaell]

I changed to evening because of side effects. It was a total game changer. I got a bit of my life back! I think if I remember I split my dose for a couple of days then took the whole dose on the 3rd day. Hope if goes well

[Hidden in reply to toniaell]

Thank you I’m hoping for the same

[Camelian]

I'm thinking of changing mine to night time as I think I too suffer side effects from the predesalone so please do let us know how you get on. I didn't connect how I was feeling to the predesalone till by accident one day I forgot to take them ,I usually take them between 11-12 with my lunch. I didn't realise I'd forgot till about 6pm and the only reason I did was I was thinking I don't feel as bad today🤔 then I realised I hadn't taken my predesalone so I took it then. It could of been a fluke and me just having a good day but I suspect it was the meds. I take GR and usually start to feel off between 4-6 hours after taking them. Best of luck and please do let us know. It's really difficult trying to work out if symptoms are related to to the disease itself or medication side effects- it becomes even more complicated when you have other health problems 🤦

[DorsetLady PMRGCAuk volunteer in reply to Camelian]

It’s probably best to take GR ones at night anyway.

[Camelian in reply to DorsetLady]

Is it DL? I never knew that. Why is it better to take GR at night?

[PMRpro Ambassador in reply to Camelian]

Because of the time it takes to get into the system , about 5 hours, So you can take them immediately before bed and they are working well by the time you get up, fewer morning symptoms and a better morning.

[Camelian in reply to PMRpro]

It's not so much pain I get- what I experience is similar to the symptoms described by ceceliafran . So if it takes that long to get into your system maybe if I took them about 7 ISH I'd sleep through the symptoms and wake up feeling ok? I too am very sensitive to medication and have withdrawal symptoms with every drop even doing a really slow taper at 0.5mg but up to now the symptoms have improved after a week or two.Thanks for the advice.

[PMRpro Ambassador in reply to Camelian]

That might work providing the pred doesn't disturb your sleep earlier in the night which taking it at 7pm could well do.

[DorsetLady PMRGCAuk volunteer in reply to Camelian]

PMRpro replied

[Hidden in reply to Camelian]

Thank you Camelian I am going to split the dose today and see how that goes then change to evening. Will let you know🤞🏻

[Camelian in reply to Hidden]

I'd appreciate that Caceliafran thank you.

[Missus835]

About a month ago I switched from 7 AM to 9:30 PM. I usually go to bed around 10:15. I find that I sleep through the side effects (sweating, shakes, etc.) and wake up around 6:00 AM feeling fairly well. Not so fatigued throughout the day either. The only drawback, if it is one, is that the Pred only lasts 24 hrs. approx. in our system, so it does start to "wear off" slightly before it's time for the dose. I'm at 32 mg. tapering from 60 mg. The time change was an experiment because the and it seems to be working well for me. Everyone is different.

[Marko666 in reply to Missus835]

Hi, I too take mine before bed about 9.00pm as i have work in the mornings and wouldn't be able to move . Does wear off at the end of the day .

[PMRpro Ambassador in reply to Marko666]

Have you tried splitting the dose? Often you can adust the times so you take the bulk in the morning (usually about 2/3) and the rest about an hour before symptoms are expected to return to carry you over to the next main dose.

[Missus835 in reply to PMRpro]

I had thought about the split dose as well. The pain before bedtime is minimal at this point and I go to sleep immediately. Thanks Pro. Keeping it in mind.

[Marko666 in reply to PMRpro]

Hi thanks that is something I should try( splitting the dose) as I keep waking up at night it's been over 2 yrs never really get down from 15mg at 14 now doing a slow taper as rheumatologist always brings me down every 2 weeks and I flare but it's my method from now, just worried as I can't afford to be in pain for 9 hrs at work , hips shoulders,back, but yes I should try the split dosr Thank-you.

[PMRpro Ambassador in reply to Marko666]

Patients who are working, especially full time, almost always need more pred. ANd rushing at tapers almost never work and just extend the time you need higher doses of pred and can even seem to make the PMR last longer. I do wish they would learn from their errors!

[DorsetLady PMRGCAuk volunteer in reply to PMRpro]

I do wish they would learn from their errors

Trouble is they don’t see it as their errors -it’s the patient at faul.

[Spartans1]

I do split my dose…first at about 9 a.m. and second at about 9 p.m. That’s worked great for me after finding that taking all of it in the morning, didn’t get me through the night. I’m lucky to not have any side effects from the prednisone. Currently slow tapering at 7.5

[Evamollie]

hi I accidentally took my prednisone at 18 hours instead of morning 7 msg at time - found it suited me much better. Now down to 3 which I take at about 21 hours. You’ll soon know if it’s a better time.

[Alebeau]

Just wanted to add my input on dosing prednisone.

I learned from this site years ago to split half in the morning and half at night.

Gave me all day and night relief and I have never had a problem since.

Before that the pred was wearing off through the day so that I always woke up feeling achy.

[Pass7]

I split my dose over the day.Works for me.

[Daffodilia]

I think pred should be taken after a meal to protect stomach - when on high dose - 40 mg - I had a large bowl of porridge for breakfast

[ParoaPrimary]

Hello Ceceliafran,

I was diagnosed with PMR 2yrs ago, starting on 15mg of Pred. At first i took it in the morning as advised by the pharmacist.I found in the morning that i was sore and it took quite some time to be able to do much, till the Pred. ' kicked in '.I have only been with this forum for a short time, but 2yrs ago when i was trying to educate myself about this condition i read on the internet where an ' expert ' suggested taking Pred. in the evening, which i started doing.I found when i woke up in the morning that i felt good , could have kidded myself that i didn't have PMR, and really ' ready to tango '. I am now ' chugging along ' on 1mg Pred., a little neck stiffness and some days also some finger stiffness .I would suggest you try taking Pred. at night and see how you go, but also consider the advice of other forum members of many years standing , who know more than me.Best wishes, we are all in this together !

[Hidden in reply to ParoaPrimary]

Thank you ParoaPrimary I am taking Pred later in the day now and, fingers crossed, most days feel much better.

[ParoaPrimary in reply to Hidden]

Glad you are feeling better Ceceliafran, takes a little ' experimenting ' to find what works best.Because this ' gorilla ' is going to be on our backs for an extended period in most cases, effort to find what makes our lives as comfortable as possible, is worth it i think.Many of the other members take Pred. at night or ' split 'as you can see with a good outcome, so hope your ongoing journey from this point is more comfortable than it has been.Also, with the emotional ' ups and downs ' this condition presents us with, i think feeling good when getting out of bed is psychologically ' uplifting ' and enables us to meet the new day with some optimism.We all have a different ' model ' of the human body and thankfully the good advice given here assists in us making the best decision for each of us.Again, my best wishes !

[Hidden in reply to ParoaPrimary]

Thank you, I wish you the best too!

[ParoaPrimary]

Thank you for your kind words.For all of us ,' time 'will sort everything out, we just need to be patient.And we don't have to look far to find somebody worse off than ourselves.