pill splitting

[Storm-boy]

hi everyone. I have noticed some people take Pred in .25mg increments. Is it possible to split a 1mg pred pill into 4. Would make tapering easier for me I think.

[SheffieldJane]

If you have a good sharp pill cutter it maybe possible, I found it a bit hit and miss and often got crumbs.

[Storm-boy in reply to SheffieldJane]

Thank you Sheffield Jane. I’m going to give it a go.

[DorsetLady PMRGCAuk volunteer]

Always worth a try - invest in pill cutter…

[PMRpro Ambassador]

If you are above 2mg and can get plain 2.5mg tablets (they are available both prednisolone in the UK and prednisone in the USA) they are easier to halve with a pill cutter to get 1,25mg

[LucilleG]

I did it before and will do it again when I taper from 5 mg to 4.75 mg starting in August. It was a bit messy and the quarters weren't always even, but as long as you don't lose any of the pill, it works!

[PMRpro Ambassador in reply to LucilleG]

See my reply immediately above,

[LucilleG in reply to PMRpro]

I'm unable to get 2.5 mg pills - only 5 mg and 1 mg.

[PMRpro Ambassador in reply to LucilleG]

Are the 5s easier to quarter maybe?

[LucilleG in reply to PMRpro]

I will do that! I can cut a 5 into quarters (1.25 mg), then I would only need to cut the 1 mg into a half (0.5 mg) and then add three 1 mg = 4.75 mg. Thanks!

[Sharitone]

I cut mine into quarters. If your tablets are flat it is much easier, but when I had convex ones, it was almost impossible to do it anywhere near accurately; the darned things wobble around. I also quartered 2.5mg tablets so was able to taper by 1/8 mg at a time once below 4mg. It worked very well for me.

[PMRpro Ambassador in reply to Sharitone]

Convex tablets can be split in half by putting them on a hard surface and pressing on opposite sides with your thumbs - works but a bit fiddly with tiny tablets.

[LBM1953]

My pill splitter normally shreds not cuts so I have found that doing it with my thumb nail against the base of my other thumb works well.....

[DorsetLady PMRGCAuk volunteer in reply to LBM1953]

You either need a better pill cutter or a better tee shot! 😊

[Exflex]

Yes, I have been splitting 1mg into quarters for some time now. I started when I reached 2mg. Now on 3/4 -> 1/2 on the DL taper plan.

I’ve noticed some ‘brands’ of prednisolone have a weak point half way aiding the cut which I do with my finger nails; some don’t. Either way I cut into quarters using a large nail cutter (designed for toe nails), and if it’s imprecise what I take one day will even out the next day when the additional quarter is due.

[papadapadoo]

After making lots of dust with a conventional pill splitter, I found EqualSplit Pill Splitter from Amazon. It's different and splits firmly and cleanly, though it is expensive and has a learning curve.

[mloyuken]

I had the doctor provide a 2.5 mg and 1.0 mg. Between them I could split and get 0.25 increments. it is a math puzzle, but doable, with only 1 cut of the pill. I used a sharp paring knife. From 5.0 mg and down below to 0.5 mg I could get 0.25 increments, and tapered to completion. Now PMR free for 1 year with the gradual slow reduction.

[BarbB]

Pred has a long half life. It is not necessary to try to split doses in .25 increments because it takes more than a day for your body to eliminate the prior dose. If you want to go from 5 to 4.75 mg just alternate 5 mg and 4.5 mg and it will even out to 4.75.

After I got down to 5 mg I found it more useful to think in terms of total weekly dose rather than daily dose. I started reducing my weekly dose by 1 mg/week - which meant taking 0.5 mg less every 3rd day. I did not start feeling the effect until a day or 2 AFTER my second dose reduction. I stayed at the new lower weekly dose until my withdrawal symptoms eased, which was usually 3-4 weeks. I was VERY sensitive to these dose reductions and it took me two years to get off it completely using this method.

[PMRpro Ambassador in reply to BarbB]

"it takes more than a day for your body to eliminate the prior dose"

Sorry, not so, The elimination half life of prednisone is around 3 to 4 hours. It usually takes around 5.5 x half-life for a drug to be completely eliminated from your system. So for pred it is 16,5 to 22 hours for it to be effectively eliminated.

[Pippah45]

I am doing .25 doses having failed dismally going with halves. The pills can crumble but I find it fairly easy to guess the crumbs. I may get a bit less one day and a bit more then next but that evens out over the days. Last time I did it I didn't stay on the .25 for all that long feeling OK enough to move on to .5. A pill cutter is a must.