please can you tell me any experience you have of splitting a pred dose between evening and morning. I know some people have found it beneficial, using enteric coated at night and non enteric coated in the morning, but is there a downside? Any research?I did a search and found an article about PMR taking longer to go with people on a split dose. Unfortunately I can’t find it now, so I’ve no idea how this would be measured. Quite difficult I would imagine.
Many thanks
The timing with enteric and plain pred is not so much splitting the dose as trying to get the pred into the system at similar times. Enteric coated pred can take as much as 5 or 6 hours to get into the system, plain pred is absorbed in an hour.
Splitting the dose would be used to try and extend the antiinflammatory effect to a full 24 hours in a patient who is finding the symptoms are starting to return before the next daily dose is due - this is because the antiinflammatory effect lasts for between 12 and 36 hours depending on the person and if you are towards the lower end the inflammation and symptoms can resurface sooner than you would like.
Many thanks, sorry for delayed reply, not been well.
Don't worry, I don't expect replies unless I ask a specific question. Hope you are better.
Hi. The type of advice you ask for can only be generalised because we all respond in individual ways. You should feel free to experiment the timing and splitting of your pred dose, as well as whether you prefer to eat something with it. Many different approaches are expressed on this site, as I've learnt over the last couple of years.For about a year (dose c. 12- 6mg) I changed from taking my pred dose at about 7:30 after breakfast to taking one before bed at c. 10:30pm ( say 5mg) and another 5mg after breakfast. This seemed fine for me and I believe that I felt better on waking.
Since getting down below 7mg, I've reverted to a post-breakfast dosing regime again as I believe that this might help adrenal adjustment to further tapering.
So far, so good for me. Now down to 3mg pred daily after 2 years 4 months.
Steady as she goes 😉 OP
Many thanks, sorry for delayed reply, but been well.
should’ve been not been well!
Sorry to hear that. I hope that you are happy with the advice you've received here and feel better soon. OP
I have split my dose several periods on my journey. When my symptoms started returning before bedtime. I would do 2/3 in the morning and 1/3 at night for a few weeks. Then when I would taper, I would taper from the evening dose until I was back to mornings only. It helped me get over a couple of taper humps.
Many thanks, great idea! sorry for delayed reply, but been well.
that should’ve been not been well!
I had PMR for just shy of 9 years. I split my dose within the first few months and continued that throughout my journey. I found late afternoon my pains would return so at 3pm I would take the other 1/2.
It worked for me but as I person mentioned everyone is different.
Many thanks, sorry for delayed reply, not been well.
I had been doing split dosing with 2.5mg coated at bedtime and the remainder with breakfast. I saw a Rheumy privately last July and he firmly said to take all pred in the morning as this aligns with the timing of the body's natural production of Cortisol,
Silly comment. If you take e/c pred at 8am it doesn't get into your system for another 4 to 5 hours, at lunchtime! Hardly what the body does naturally. Taking e/c before bed, delivers it into the system in the early morning just as nature intended, to get you ready for the day.
Don't tell him, what the eyes don't see, the heart don't grieve over.
Enteric coated Prednisolone 
Switching from partial enteric coated
Thought you might like to read my Rheumys comments in letter to GP about enteric coated Prednisolone.
Dosage of Lansoprazole
Enteric coated Prednisolone 
