Does Timing of Prednisone Matter?

[Donna5658]

I started taking 15mg of Prednisone for PMR over 14 months ago. My tapering had been fairly successful until I reached 4.5mg. This coincided with a 2 week period of increased (mostly good) stress after which I slowly started having significant pain in my neck and shoulders and very minor pain in my thighs. It was like my original pain but not as severe.

I have always taken my prednisone around noon in order to separate it from my thyroid medicine, which I take before breakfast. Now I’m wondering if by delaying when I take my prednisone allows more inflammation to get a toehold? Would it be better to try to take it earlier?

Thanks!

[Bcol]

Morning Donna, the inflammation that causes the problems starts to get into your system around 04:00-04:30 so an ideal time to take your Pred is around 02:00 ish which means it is in your system and ready to deal with inflammation before it starts to be a problem. A number of us take it around then with some Greek yogurt. I usually have a banana as well, others hard some hard cheese. I will be taking mine shortly.

[piglette]

You could try increasing by 5mg for a week and see how it goes and then dropping back again say to 5.5mg and then back to 4.5mg if things have improved.

[DorsetLady PMRGCAuk volunteer in reply to piglette]

The increase of Pred has been addressed in another thread… 😊

[Sophiestree]

PMRPro replied to someone recently about thyroid meds (I have been taking them for over 40 years) and it seems it is better to take them at night which would eliminate this problem. I plan to start this next week as I had already sorted meds for this week. My only concern will be the fact I'll forget!! But definitely worth a try. That way you can take your pred earlier.

[PMRpro Ambassador]

Certainly taking it earlier will improve symptom control if the antiinflammatory effect of your pred isn't lasting the full 24 hours. An alternative is to split the dose to extend the effect to over 24 hours so the morning batch of inflammatory substances has less effect. Not taking pred until lunchtime potentially means it is working great at 2am but has worn off somewhat by 5am and then the inflammatory substances have free reign for several hours by the time the pred is into your system.

[Gimme]

It certainly seems to make a difference for me. I take it as early as possible. I usually wake about 4.30 am, due to my over active digestive system, so I take it then. I have wondered it is the inflammation to wakes up my IBS in the night. For me, taking it early seems to give me good control throughout the day.

[rlstonejr]

you may have reached your tapering limit. Took me 3 yrs to go from 20 mg to 8 mg. Another 3 yrs to get to 5 mg. Been on prednisone for 9 years - currently at 6 mg.