Dose splitting
Posted , 9 users are following.
I've seen a lot of comments the past few days regarding dose splitting as a way to manage PMR pain or pred reactions. So far I haven't felt the need, but I do have a question. Is dose splitting likely to cause any changes in the way the body eventually starts to produce its own cortisol again when reducing pred to low doses? Have any studies been done to show whether the practise is beneficial, neutral,or possibly likely to keep the adrenals supressed longer?
1 like, 8 replies
karen48559 Anhaga
Posted
FlipDover_Aust Anhaga
Posted
I started splitting my dose a while back when I was having trouble getting out of bed in the morning - I'd take a couple of mg in the middle of the night when I got up for a 'wee walk'. I don't feel the need to to it atm, but would if I felt it would be beneficial.
EileenH Anhaga
Posted
However - it all changes when you are taking pred over a longer period. Most patients take a moderate dose for maybe 6 weeks maximum and as a taper - in flares of RA for example, to manage asthma exaccerbations and so on. In those short periods there is less adrenal suppression, especially if you take your dose mid morning as they suggest. When you take it for more than that short time there is an increasing effect on the whole adrenal set-up and you produce less cortisol of your own. Even a few months at a lowish dose is enough to do that - so all of us are affected since we are rarely on pred for that short a time. In that case there is little difference when you take the pred.
Since you are taking it to avoid morning stiffness as well as achieve a good entire day it makes far more sense to take it when it works best for you. If you wait until 9am then you will need until after midday to get going - half the useful day is gone. You wouldn't believe the number of people who have asked the question on the forums - "the pred seems to take a long time to work" and it is solely because they are waiting to take it until mid to late morning when they first have something to eat. Once they try taking it early morning their day changes dramtically.
Anhaga EileenH
Posted
EileenH Anhaga
Posted
maid_mariane Anhaga
Posted
We in Canada do not have a time released prednisone so by splitting in effect maybe the same.
in the past 4 days I have read numerous articles on splitting and prednisone shelf life of 4-6hrs in our system. Other medical articals on splitting for people who feel lethargy, brain fog, low sugar in the afternoon to give them a boost.
I was further interested in a article on reduction of prednisone below 10mg and they recommend splitting to reduce and it's the afternoon dose they drop. Once dropped and stable they split again. You use this theory with the 10% and drop dead could be great. It's something I will be doing.
EileenH maid_mariane
Posted
I have never seen articles about dose splitting of pred for PMR - there are various ways of using pred for different illnesses but the recommendations I have seen in everything I have read with regard to PMR is for a single dose as early as possible - especially once you are at lower doses as taking a single dose in the early morning has less effect on suppression of the adrenal glands than even small doses taken in the evening. Do give me some of your references - if it is links you will have to use pm as they won't be let through easily.
What a shame the others in Canada couldn't see your rheumy - because some people don't have any medical guidance at all when they live in a very rural region.
maid_mariane Anhaga
Posted
Am I wrong isn't mavis UK?