Taking Prednisone at evening meal instead of mornings

[Gioielli5]

Having taken Prednisone for 3 months now and tapered from 20mg to 9mg am getting increasingly tired during the day. Does anyone take their medication at their evening meal instead of breakfast? Also take medication for PBC in morning and when taken together they seem to be really making me feel awful all day. Hoping that by splitting the medications I might be able to cope better.

[Zebedee44]

Hi, I always found that taking about a third of my daily dose at bedtime and the rest with breakfast I felt well all day.

But to be honest you have tapered very fast from 20mg down to 9mg and quite possibly gone below the level your body needs to manage the inflammation without really noticing. Inflammation is very tiring to the body.

I did the same in ignorance and following my doctors instructions, but learnt better how to manage PMR through this forum.

[Gioielli5 in reply to Zebedee44]

Thank you will take your advice and also try to get appointment to see dr. (Almost impossible!)

[DorsetLady PMRGCAuk volunteer]

As you have got to 9mg within 3 months I would say maybe your issues are as likely to be due to the fact you have gone too low for your PMR, if that’s the case, then no matter what time you take it, it’s still going to be too low.

You could change the timings, and if the fact that you take both tablets at the same time makes you feel ill, you might feel better… but I wouldn’t guarantee it. Or split Pred doses 2/3rd am; 1/3rd evening as we sometimes suggest.

As you are fairly new -this link may give you a bit more info about PMR -

healthunlocked.com/pmrgcauk...

[Gioielli5 in reply to DorsetLady]

Thank you x

[Gioielli5 in reply to DorsetLady]

Really useful article. Thank you x

[SnazzyD]

Two things might be happening here. 1) You have reduced from your starting dose way faster than is normal and your fatigue may be that your autoimmune activity is causing inflammation that is no longer covered by the dose you’re on. Have you got any PMR symptoms creeping back? 2) When you get somewhere below 10mg your adrenal glands need to start produce your own cortisol. This process can be slow to come back online and fatigue is one of the symptoms. It is worth reading all about this to be prepared. In the FAQ’s

healthunlocked.com/pmrgcauk...

When you get down to under 10mg it is not ideal to take your Pred in the evening because it can slow down the resumption of the natural process.

It could be both things but if I had to put my money on one it would be the first one if your diagnosis is correct.

[PMRpro Ambassador]

I was going to say the same as Snazzy - if you take pred at night at this stage it may make recovering adrenal function harder.

I agree with the others - you may well have overshot the dose you need. To get from 20 to 9mg in 3 months is extremely fast. I would expect you to be no lower than 12,5mg after 3 months having started at 20mg.

[paulst955]

Why have you reduced so fast, who told you top do that? If someone has, told you to do this, do not listen to them again. Getting off pred is a slow process to fast will only cause you pain.

[Gioielli5]

Thanks Paul. On GP instructions!