When to take prednisolone

[Annodomini]

When I started taking pred almost a year ago, I took it with my evening meal but subsequently read somewhere that it should be taken in the morning. I am sure that I felt livelier and in less pain in the morning when I was taking it in the evening. I wonder if this really makes a difference.

[Polywotsit PMRGCAuk team member]

Hi Anno! Yes, it probably does make a difference, actually. Doctors generally recommend people to take pred in the morning because a) they are fixed on the idea that stiffness and pain are worse in the morning and b) there is some evidence that if taken in the evening, prednisolone can interfere with sleep. This may be because in the hours of darkness our bodies naturally don't manufacture steroids themselves, so having lots of steroids zooming around in the bloodstream might make the body think that it's daytime. However..... researchers have now discovered that in people with PMR, levels of the inflammatory chemicals in the body peak in the small hours. So they are trialling a delayed-release form of prednisolone that people take at bedtime and which releases into the bloodstream when these nasty chemicals are at their highest. Which is rather a longwinded way of saying that, if it doesn't mess up your sleep, taking your steroids at bedtime might not be such a bad idea! (Cue disclaimer... discuss with your doctor first, blah, blah,).

[Annodomini]

Thanks Kate. Nothing much disturbs my sleep. I will ask my GP if she is able to prescribe the slow release version of pred.

[Annodomini in reply to Annodomini]

I have now changed my routine to take the pred with my evening meal and mostly feel less stiff in the morning. As I said, I am one of those lucky people who have a good sleep pattern and this is unaffected.