How long does Pred work? Can you top up the dose later in the day?

[Motida]

I flagged up that I am now taking 2/3rds of my dose around 2 -3 am and had noticed some very positive benefits in the morning. I take the 1/3rd at breakfast.

I am starting to notice that I am beginning to flag by 3-4 p.m. which did not happen when I took the whole dose at breakfast. Does this mean that Pred starts to wear out because I take it so early?

Is it possible to take the 1/3rd at lunch time or to top up with 0.5mg when the flagging starts? I am on 8 m.g at present. Was down to 7.5 but had a flare up and went back to 9 for 12 days.

My question is because I have no idea how Pred works really. Like everyone I want to get off it as soon as the PMR burns itself out enough. Moon face, weight gain and breathlessness are not jolly.

Thanks in advance

[SnazzyD]

By “flag” do you mean getting tired or getting pain? If you mean tired, it may well be that you are now getting below the level of cortisol needed just to live a day. Normally your adrenal glands do this but they have been overwhelmed by so much steroid of Pred they have shut down. Somewhere under 10mg the Pred dose is no longer quite enough to keep you going on a general level and until your adrenal glands wake up you can feel tired amongst other things. I suggest you look in the FAQ’s for the section on adrenal glands which is essential reading for anyone dipping their toe into sub 10mg. Then come back and ask if you have any questions.

[DorsetLady PMRGCAuk volunteer]

There no problem in taking the smaller dose later in the day - how about 2pm ish - that gives about an hour before you seem to flag.

But, just make sure you haven’t gone below the dose you actually require on a day by day basis.. and as SnazzyD says adrenals may also be a factor…

[PMRpro Ambassador]

I usually say to take the second dose of pred late enough in the day to get the best result for you - it may be at breakfast, lunchtime or even later though the later you take it the more possibility there is that it may keep you awake at night.

And I'm sure you know, cutting your carbs will help you control the weight gain which also often helps the moon face.

[paulus65]

I see you've had some other quite detailed replies but I would advise you to just go ahead and try it. We all seem to react a bit differently to PMR and pred, and as long as you are taking the right dose in 24hours can't think you'll do much harm.