Pred - best taken Morning or Night ?

Hi Flutterbie57

Have taken mine AM, PM and split half AM and half PM and am still undecided as to what is best. Some on the forum wake themselves up at 2AM so as to take their preds with a sandwich or something similar but as I find it hard to sleep anyway be dammed if I am going to wake myself up. I tend to prefer all in the AM with breakfast so that I don't forget. Not everyone is the same so really its trial and error and down to the individual. Good luck.

If you follow this link http://www.patient.co.uk/forums/discuss/pmr-gca-website-addresses-and-resources-35316 it will take you to the pinned section. 

There are different theories and that what works for one does not always work for another.  But it is worth knowing why we are advised to take it in the morning.  

Extract from BSR Guidelines.

commended Time and Why.

The recommended time for taking steroids is normally as a single dose first thing in the morning as this is the closest mimic of the body's normal production of cortisol. 

 By taking it like this there is the least suppression of the HPA axis which is the posh name for the hypothalamus, pituitary and adrenal glands which produce a whole range of chemicals which together make a lot of the rest of our body operate normally (thyroid etc).  

It has been shown in studies that taking a dose of less than 15 mg* in the morning has no suppressive effect whilst 5mg in the evening does suppress the early morning activation of the HPA axis.  *Guidelines referred to are British Society of Rheumatologists June 2009)

One thing more, golden rule pred for breakfast, calcium for lunch, the two don't like to be taken together

Yes totally agree up to individual.I personally have taken always in am after breakfast.Seems to work ok

Flutterbie, I took my complete steroid dose first thing in the morning with breakfast throughout my years on treatment which was simple and uncomplicated.  The earier the better to be in line with our natural cortisol production that takes place in the very early hours - but a bit too early for me to disturb my sleep!  There are a few people who have problems with being unable to function properly during the day due to the steroids taking many hours to take effect in their bodies to reduce their early morning stiffness.  For them, it can help to split their dose, taking two-thirds in the early morning and the remaining third in the evening, the latter dose supposedly enabling them to get going more easily in the morning.  A personal choice - what suits one may not suit another.

Lodger has explained the time to take pred very well from the BSR guidelines. I suppose the time they take to work may vary a bit on whether you take the coated version which takes longer to be absorbed by the body rather than the uncoated variety. I now have some pred which it says must be taken at 10pm in the evening, which is totally different to when I had the coated ones which I was told to take in the morning.

I started taking my pred at midnight when I go to bed due to the fact that it makes me very light headed. Made me very worried about driving so I switched and I have been fine ever since. Really trust your own body and not the doctors advice. Best to you, Flutterbie57

I take mine in late afternoon my dr never suggested a time of day. I tried taking it at 8 am but It gave me fuzzy brain really bad ruined the day,so I went to 6 pm because any later and sleep problems.I am now  at 4pm trying to slowly move it back to am what a pain! I tried other methods such as taking the dose at 6 and then another at 8 am but that made me feel awful so I am back to my slow plan but I am very sensitive to any change.I started at 10 mg I am now at 9mg but everyone is different and responds as such.I think of this as one long experiment.You will find this site will give you great advice gleaned from a wealth of experience.Good luck

mine told me morning and before three pm. 

A study showed that taking pred in the morning had less effect on the adrenal glands producing its own corticosteroid, cortisol, in the early morning. However, that is not the problem in PMR, you are looking for the best result for the lowest dose to reduce the incidence of side effects.

If taking it at midnight means your side effects are masked by being asleep - that's better than taking it early morning and spending a lot of the morning feeling bleugh. Or whatever time/split works best for you.