MtX And pred timing

[Darcy2000]

I am on year 5 of my PMR journey

I know this is a question for my Rheumatologist but until I can get a hold of him thought I would throw it out there .I am on a tapering dose of Pred at 12.5 and once a week I take 20 mgs of Methotrexate. Mornings are brutal but by 10 am I start to feel almost human . Would changing the timing ( I take them in the morning) improve my early mornings? I am a terrible sleeper so taking Pred at night would not be a good idea and MTX is only once a week so I guess I answered my own question 🤷‍♀️😊

Any thoughts on this will be appreciated

[SnazzyD]

So if you are a terrible sleeper, why is taking Pred at night a no go? Or do you mean that if you wake, that’s it, the night is over?

[Smithie49]

Hi Darcy2000. Following suggestions on this forum I now take 5 mg pred when I wake for a pee anytime between 2.00 and 4.00 am. I usually have no problem getting back to sleep. I then take the remaining 2 mg pred around 8.00am. The split dose helps the effect last the entire day . I no longer have a problem with stiffness first thing.

[lsplumb in reply to Smithie49]

Smithie49--do you take your 2-4 a.m. dose without any food? Is so, that doesn't bother your stomach?... Thanks.

[Smithie49 in reply to lsplumb]

I have a small piece of Ryvita before taking the pred and haven't had any stomach problems. I think some people have some yogurt.

[PMRpro Ambassador]

If you really can't cope with the idea of taking your pred at some point in the night when you are awake (as you say you sleep badly anyway) - splitting the dose can improve mornings by extending the duration of the antiinflammatory effect.

You take 2/3 of the dose in the morning at a convenient time with breakfast and the rest of the dose sufficienctly later to extend the symptom relief through until the morning dose is due. Often lunchtime is a good time - can take the pred with food, out of your system by bedtime and mornings are improved but you do have to experiment a bit to find what works best for you.

[Darcy2000 in reply to PMRpro]

thanks will look at that

[Bcol]

I take my full Pred dose around 02:00-03:00 with a small pot of yogurt and often a banana and never had a problem with it getting me through the day.

[Darcy2000 in reply to Bcol]

I am not sure I would get back to sleep but worth a try