dose splitting

Hi Flipdover

I had a Dr who spilt my dose when I was first diagonised and I split it right through until I had reduced to about 7.5mg then I took Eileen's advice and went to one dose in the morning.  I did notice that I had to get up at 2am-4am to take it at first and with the experience of hindsight that was when the PMR was still very active in my system. I did get really painful shoulders and knees from stiffness on the one a day am dose however I persisted and managed it with paracetamol.  As time went on and I was about 9 months into PMR I found I could start reducing in 1/2mg stages to 4mg.  I changed the time I was taking it as I was sleeping better at that time however I found I had to stay on 4mg for about 3months and have now reduced 1/2mg in  2 months to 3.5mg without any problems.  Apparently my Dr had different ideas to other Dr's in her practice about splitting but I think it worked for me as the Pred seemed to leave my system in about 12 hours and the pain was then horrible. Of course everyone is different and this is just my experience but from what I have read I'm glad I was splitting the dose when I had the full blown PMR.  Just for encouragement I think It has or is leaving my body now after 15months and all I have to do is get my adrenal glands to do their job so will be trying to reduce every 2 weeks now and will let you know how I am going.   

I find I can't take pred at night at all.  If I'm feeling run down in the morning, I take an extra mg and if I feel really well, I take less - I'm trying to reduce my steroids to come off them altogether.  However, I saw my consultant last week, and he said there was some new research out in Denmark that said that pred helps with the side effects of some DMARDS / chemo, so to take a low dose (ie 3 mg) the morning after that anyway, even when I've weaned off the steroids.

I guess it's different for different people, how it works that is .

I'm on 5 mg at the moment taking 2.5 at 1600 and 2.5 at 0400.It means getting up at a rediculous time and taking a tab (with yoghurt) then going back to sleep for a few more hours, hopefully until after the Pred kicks in. I soon got used to it and it suits me.

Although splitting the dose wasn't something I personally tried whilst on steroids, most people I have come across who have done/are doing so, find that splitting it by taking two-thirds in the morning and one-third in the evening works for them.  

Of course, what works for one may not work for another, but if you have already felt the benefit of splitting it and taking just 1mg in the evening, then it sounds as though splitting the dose could be worth a try for you.

I split my dose a couple of times.   If I took it all in the a.m. (l7mg) up

after a flare due to sciatica, I had this weird dizzy spell during the day.

Doc said it was okay to split the dose.....it stopped the dizzy spell.

 

If 1mg makes a difference why not try 2mg and see if it is better? Anything up to 2/3 in the morning and 1/3 in the evening is often used in the US. Just experiment a bit - but when you change it round try to allow a couple of weeks to get used to what you have done. It may not feel better straight away.

Hi Flipdover, You are the first person to describe EXACTLY how I feel in the mornings  - unmotivated, depressed, negative and cranky - except where you say that after a couple of hours you feel almost manic. After a couple of hours slowly drinking 2 mugs of coffee, I feel just fine. It must be the Pred.  I was putting it down to just getting old !  ( I'm 63). I have been feeling this way for well over a year now (2 years diagnosed with PMR) and am now down to 4.5mg of Pred. So your higher dose may explain the 'almost manic' feeling that I don't have -  at the lower dose. I slept badly and also had the night sweats, but they'll go evetually. I never tried splitting the dose and don't know enought to advise you but there are many wise and wonderful people on this forum as I'm sure you know.  Take care, and thanks, J

I split my dose (now 20 mg) into two 10mg doses. I take one when I wake at 7am and one in the afternoon at about 1:30 pm.  seems to be okay for me. it was at my doc's suggestion. I can't sleep, but then again, I couldn't sleep when I took a single dose at 7 am, so no change there . 

Thanks everyone,

I think I'll try the 2/3 in the morning + 1/3 at night and see how that goes.

I'm so sick of the highs and lows - and so is Mr Flip. Poor man. lol