Split dose

[Inertia]

Hi,

I first developed PMR in May 2018 and managed successfully to come off Pred in Dec 2020. All well for 2.5 years until a resurgence in symptoms in May 2023. Since then again I have successfully managed down to 4 mg but am finding early mornings difficult. And so I have split the dose to 3 mg in the morning and 1 mg around 10:00. This seems to work well for me but I would be grateful for any observations or comments regarding potential issues or downsides to this strategy especially as I continue to reduce.

[SnazzyD]

Hello there. Shame about the reappearance. What is your trouble in the mornings exactly and do you mean 10am or 10pm for the second dose?

[Inertia in reply to SnazzyD]

10pm. Restricted upper arm movement which wears off later in the morning

[SnazzyD in reply to Inertia]

Have you tried taking the Pred earlier. People find their mornings much better if they take it the early hours or at least a couple of hours before rising. In order to help the adrenal glands recover, dosing at 10pm might not be helping provide the all important low cortisol level needed around midnight to trigger them into action. However, saying all that, if you are getting pain in the mornings, I’m not sure the reduction has been successful. It may be that you need to be on a higher dose. When were you last comfortable?