Divided doses

[bowler]

Hi all

I always take my steroids in the morning, however i have read that dividing the dose morning and afternoon is better for tapering, [ but dont take them too late in the afternoon as it can affect the sleep ]

Does anyone divide their dose?

[Celtic PMRGCAuk volunteer]

It is generally recommended that we take our Pred in one complete dose early in the day to be as close as possible to the 4am time when our bodies were making their own supply of natural steroid (cortisol) pre PMR/GCA. However, I have come across a couple of people who split their dose two-thirds in the morning and one-third in the evening. It's a case of finding out what works best for you.

Trials have been carried out on a time release form of Pred which is taken at 10pm and is then released into the body in the early hours of the morning, thereby alleviating the early morning stiffness. I'm unsure without checking whether or not this is widely available yet.

I haven't got any personal experience of dividing my dose, but perhaps someone will join in if they have tried this method.

[Hidden in reply to Celtic]

Interesting, at onset (july)of PMR when I was in a a state not far of Riga Mortis-crawl to the bathroom etc,within 36 hours on pred 20mg was much changed and so it proceeded

for the month.However,due to onset state in mind also I mis heard my GP when advising of

taking the 20mg and for the month took 1 no Pred 5mg tablet 4 times a day.It did me well

I was 'cured'.As to the continuance of the state I am unable to say,as my GP corrected me

then put me on reduction plan 20/15/20................which gave real problems and so it has been so ever since,too fast reduction plans,flu and colds over winter affecting the immune

system.I am now down to 19mg having reduced 1/2mg fortnight but with a recent cold

staying on 19 for an expected month.The warm weather now is going to help

Would be interested Celtic in your comments

[Celtic PMRGCAuk volunteer in reply to Hidden]

Hello scubadiver

That's intriguing to hear that taking 1x 5mg Pred 4 times daily for a month made you feel so well that you felt "cured". That's the first time I've heard of anyone taking Pred that way. With the amount of inflammation in our bodies at diagnosis, then it does make sense to hit it hard with a daily large complete dose.

I can understand that you hit problems when you were advised to try 20/15/20 alternate days. That steepish drop might have worked for some but 20/17.5 might have been better, or even just trying to take 17.5 on one day of the week, two days of the following week, three days of the third week etc can prove successful for some.

It sounds as though you've picked up quite a few 'bugs' over the winter and that always seems to get in the way of successful reductions. As you say, the warmer weather should help to keep infections at bay for a while. Perhaps you could try taking Manuka honey (UMF 10+ or 15+) daily to give your immune system a boost. Expensive, but I can't recommend it enough.

If you haven't had a Vitamin D blood test, then it might be an idea to ask for one. If you are deficient in Vit D, then that can lead to muscle/joint pain and other nasty conditions.

I hope you soon feel better.

[pennyw Administrator PMRGCAuk team member]

I am down to 5mg a day and am sometimes a bit achy especially in shoulders and legs. If tha happens in the night it keeps me awake.I have always taken my pred in the morning with my cereal but for the last couple of weeks I have put up with being stiff for longer in the morning and taken the tablet at about 11am. This seems to keep me feeling less achy through the night and has not kept me from sleeping.

[iforget]

I was told to take the whole dose in one go in the morning after breakfast and so that is what I have been doing...BUT if there was any evidence that supports splitting it to help when reducing then I would certainly be willing to give that a try ... especially if my doc said it was okay to do so.

I really do not feel confident in altering dosage or timings without discussion with my docs