taking Pred in the night advise please

[howtotaperdown]

HI I think I've read all the advice I can find on taking some of the pred dose in the early hours but I wonder if someone would be kind enough to talk through it again

I understand that the inflammation is 'shed' in to the body around 2 am ? so taking uncoated pred just before this time can help, but obviously could affect sleep.. but might let me sleep

tho tapering down to 7mg (again) is sort of ok, I'm obviously flaring and prefer NOT to increase the pred but put up with day pain.. generally relieved by very regular movement.. but the night paid just wakes me which is not healing and means paracetamol or sleeping pill, BUT that extra pred does my head and body in!

I have tried a couple of times to take half the pred after midnight, but combined with the reason I was doing it, it seemed unmanageable.. now I am determined to try this again and wondered if I could get tips, links, opinions etc.?

thanks..

[PMRpro Ambassador]

No - the inflammatory substances are shed about 4am and it takes prednisone 2 hours to reach its peak in the blood, prednisolone an hour so you take your tablets at the appropriate time.

Putting up with the pain rather than taking more pred is NOT an answer as the leftover inflammation will build up like a dripping tap fills a bucket and will eventually overflow - and you could end up back where you started and a much higher dose of pred to sort it out. There is no virtue in not taking enough pred.

That is it worse at night suggests you are at too low a dose AND the antiinflammatory effect of the pred doesn't last the full 24 hours for you, it can be anything from 12 to 36 hours and it really sounds as if you are nearer the 12 hour end of the spectrum.

An alternative to taking pred in the middle of the night is to split the dose: take about 2/3 of the total dose in the morning with breakfast and the other 1/3 later enough in the day to extend the effect until the next morning's dose is due. You may need to experiment a bit to find the ideal spacing. Perhaps start with the 2/3 with breakfast and the rest of the dose with lunch. If that does the trick, great. If it doesn't then take that second dose a bit later each day until you get a good result. This should mean you can sleep well too.

[DorsetLady PMRGCAuk volunteer]

The inflammation is shed around 4am. So taking your Pred at least an hour or so before then [provided plain white tablets] gives it has time to get into your system and therefore tackle the inflammation as it occurs.

The best time to take it, is up to you... if you wake up any when after midnight then take it then...it's what suits you.

Or as suggested by PMRpro - split your dose.

As you are flaring you need to get that under control initially and then change the timing of taking your pred at a later date. , Don't try and do both things at the same time... that will just make it more difficult.

[piglette]

I have learnt from bitter experience NOT to try and tough out the pain. PMR always wins, it will just rise up and bite you.

[LemonZest11]

I'm one of the ones who swears by the evening dose of pred. I used to awaken in pain but PMRpro and DL suggested taking it when I awaken for a pee. That varied a bit, bur so long as it's before 3am, you should be right. Take it with some yoghurt which is easy to get down in the middle of the night, if it's slightly flavoured. But first, sounds like you need to increase your dose. The advice on here has been to go back to where you felt well, + a couple of extra mgs, and when you manage to carefully reduce to your lowest, effective dose, stay there. Don't be brave, it hasn't worked for anyone here. All the best.

[Bcol]

Taking mine around 02:00 with some yoghurt, has not been a problem and worked well for me. However, get the flare under control first, the longer you leave it the more Pred you will end up taking to get it under control again. Then use one of DL's tapering plans to slowly work your way down. 0.5mg every five to six weeks, as a plan to aim at, works well for me.

[howtotaperdown]

thanks to another helpful reply, also I see you must do tai chi! I have been doing tai chi for 15+ years, I do a short form, : mantakchialondon.com/tai-ch... for info & youtube.com/watch?v=mLqLVAG...(Not working as expected?) for complete 10 min video of form, no point in learning 120+ movements if you have no chi in there, especially as choreography was never my thing

I do believe it helps enormously it certainly gets 'chi' & blood & energy to all the bits of my body which are suffering with PMR, but of course I am not 'cured' from this or anything else I do. I am trying to take part of the dose at 2 am now and will perhaps be able to have a dose regime which suits me better

[howtotaperdown]

dont be disappointed, I dont criticise it, it is just a lot to learn (for me), and I do the '13' movement form which is as old as the longer forms, not the 24 step one you mention, which I dont know, and as long as you get some chi going, any form would be good, it is indeed about the inner structure created (essence) and worked on and ....of course you move more than 13 times, and I feel I really get the body using its limbs to their max! tai chi is indeed a moving meditation, a real treasure