pred dose timing

[Raspberryripple24]

I note that some people are taking their pred around 2am. I did this with split dose when I’d was dosing for PMR. My PMR quickly progressed to GCA and I was advised not to split dose and to take one pred dose in the morning. Because I already have secondary Addisons I am aware of morning dosing. However I still believe the 2am dosing is appropriate to dampen IL-6. May I have input? Was 2am’ish dosing prescribed by rheumy? Thank you!

[SnazzyD]

what dose are you on?

[DorsetLady PMRGCAuk volunteer]

The reason why sometime take Pred at 2am is so it is in system ready to fight the inflammation when it is produced at 4am. The substances (cytokines) are shed at that time -and the sooner the Pred is working on the ones that cause inflammation the better

I had GCA, and certainly it is recommended that it be taken as one dose (especially early days) -but I never saw the need to take my Pred at 2am, nor split it.

Fortunately my dose seem to last the full 24hours, maybe longer, as I didn’t have an issue before I took it around 8am.

[PMRpro Ambassador]

If you split the dose, there is no need for then also including 2am dosing.

The 2am timing was established in a study as the best time to take prednisone for optimal management of morning stiffness and other symptoms in RA and it was pointed out this would apply in PMR and other inflammatory conditions where the cytokines were shed in the early morning.

Another study also established that there was no significant difference in management of inflammation in GCA between single and split dosing although it had been suggested that a single daily dose in the morning would be more effective at combatting the inflammatory effect which only occurs once a day. However, when patient experience breakthrough symptoms before the next daily morning dose is due, it does suggest there is a significant inflammatory effect that you would think poses a risk.

[LemonZest11]

I used to wake up with awful PMR soreness/stiffness and it was suggested on here, by PMRpro I think, that I take it at 2am for the reasons outlined above. Bingo!! It worked. It doesn’t have to be spot on at 2am, but if you are one who awakens for a pee during the night, that will do. Take it with a couple of spoons of yogurt to protect your tummy and straight back to bed. You will wake up feeling “normal”. Worth a try!

[Bcol]

I took my Pred around 02:00 ish from very early on and it certainly worked well for me. Took it with Yogurt, usually Greek, and often a banana. Never had a Rheumy.