Staggering Steroids

[Sunshine8888]

Think I read on here that steroids can vary in their effectiveness from 12 to 36 hours. I wondered as my pains tend to return late evening if the steroids for me tend to only to be effective for 12 or so hours. Would the answer be to take my steroids at intervals during the day rather than one go in the morning, currently I’m on 20mgs per day. Is this safe to do? Interested in your thoughts and experiences 🙏

[DorsetLady PMRGCAuk volunteer]

It is safe, but in most cases it is better to take as one dose, more effective. However we do sometimes suggest splitting dose so 2/3rd usual morning time - as early as possible- and 1/3rd later in the day - really depends what time your issues return. Some take at early afternoon, others later in evening.

How long does your morning dose seem to last? If you can pinpoint approx time, then think about taking your second smaller dose about an hour beforehand.

[Charlie1boy]

For me the steroids lasted between twelve and fifteen hours in the early days. I did try splitting the dose on a number of occasions, and sometimes it seemed to work, others not so. Basically, I needed to ensure I was on a high enough dose. Gradually, as I tapered down, the situation improved, and I ended up taking just the one dose each day.

The trouble is that pmr is not consistent in the way it makes itself felt.

Good luck

[PMRpro Ambassador]

You do need to get all the accumulated inflammation cleared out before the single dose works effectively. As DL says it is possible to split the dose and some doctors do suggest it - others don't approve.

I would say exactly the same as DL said so I'll not repeat it.

[AtopicGuy]

The downside of splitting the dose is the possibility of sleep disturbance. The more steroid in the blood at bedtime, the more likely you might suffer insomnia. Hence the recommendation to take it all at breakfast time.

[Sunshine8888 in reply to AtopicGuy]

Good point! Don’t think I could cope with even less sleep 🙏