timings of dosing when switching to enteric coated pred

[Hidcote]

I have been coping with stomach problems because the pred has been badly irritating my stomach so my doctor has prescribed coated pred. At the moment, I take my pred at about 7.30having taken Esomeprazole and some breakfast. I will need to continue the emprazzole as I have a hiatus hernia. I know it takes longer for coated pred to dissolve further down the digestive system but as I am struggling with repeated flaring and am trying to stabilise on 10mg, I don’t want to rock the boat.

Please could I have some advice on taking the coated pred as I know some people take it when they wake up in the night. But when I was on higher doses I got nightmares.

[Conundrum]

good morning Hidcote

I have GCA/PMR and started on 60mg of Pred. I didn’t want to take a PPI and took tablets with yoghurt. Asked for enteric coated. After reading up on advise on here, I take it between 9 - 10 pm.

Incidentally, I got stuck at 11mg and then at 8 mg kept having flares just had to go really slowly. I am at 2mg now.

Hope it works for you 😊

[PMRpro Ambassador]

Was it plain or coated pred that caused nightmares? If you take coated pred immediately before bed, it will be acting in the morning before you get up as it takes 4 or 5 hours at least to get into the system. If you regularly wake during the night taking it then should also delay it being in your bloodstream for that amount of time and you will go back to sleep. Plain pred is in the system in an hour or so and reaches a high spike and then the level falls, enteric coated pred reaches its peak much more slowly and then falls off in the same way.

[Hidcote in reply to PMRpro]

Thanks PMRpro

It was 15mg of plain pred that caused nightmares. I will try taking coated pred at bedtime about 22.30 and see what happens

[PMRpro Ambassador in reply to Hidcote]

Not surprised! With 10mg coated the peak in the blood should be quite a bit lower but over a longer time and that often lessens side effects.