A quick story and a word of caution to my friends here. I accidently missed my bedtime dose of prednisone and was shocked at the result. Here’s what happened.
I am currently on 19 mg after a long struggle with PMR and a GCA appearance (treated with high dose and now inactive). I’m making efforts to taper down, but that’s another story. At this point, I find it works best to take a split dose daily with 12 mg in the morning with breakfast and 7 mg at bedtime with milk. I carefully pack my pill boxes every Saturday morning to make sure I don’t miss any of my prescriptions, especially my prednisone. Well, a few weeks ago I was packing the boxes and discovered I did not have enough to complete the week. No problem; I called the pharmacy for a refill and my wife picked it up the next day and put the bottle in the cupboard for me.
Unfortunately, I forgot about it, even though I labeled my pill box to remind myself! That Thursday evening, I swallowed the pills in the compartment and went to bed, not knowing I missed 7 mg of my precious pred! I had a terrible night of pain and loss of sleep. But that’s not the shocking part. As I started my morning, working on the computer, I still did not realize what happened and was feeling very tired and seriously depressed. My task at hand before breakfast was to type out a Power of Attorney document for my wife to care for the affairs of a disabled friend. I typed in the lady’s name, but when it came to typing in my wife’s, I could not remember her name! Needless to say, I was a little freaked out! “What is happening to me?” I immediately abandoned my computer work and returned to the kitchen to make breakfast. It was only then I realized what happened. Everything returned to normal a while after my morning dose, but it was quite scary to me that such a thing could happen after missing my evening dose.
In the days that followed, I was reminded of the rather precarious situation I am in being dependent on prednisone. I became concerned that if I should be in an accident and did not receive my prednisone, my adrenal insufficiency could put my life in danger. So, to mitigate this potential, I now wear a medical alert bracelet that, among other conditions, lists “Adrenal Insufficiency” and “Prednisone Dependent.” Anyone in a similar condition may want to consider this as well.
missing dose of prednisone
Missed my dose of prednisone and the midnight dose of antibiotic! 
Tapering below 7 mg and timing of prednisone dose
Splitting Pred Dose Morning/Night
Moving time of Pred dose. 
