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Going from split dose to single

Posted , 13 users are following.

nick67069
nick67069

I have split my dose almost from the beginning of the PMR treatment.  Because of the unusual daily schedule ( work late into the night) I take pred before going to sleep at about 1AM and also when I get up 8-9 AM).  When I was at 5mg last fall I attempted to reduce late night dose and had  problems and had to go back to 5mg. I was taking 3mg in the evening and 2mg in the morning.

I stayed there until May, when I tried another reduction. This time I reduced morning dose and I went from 5 to 4.5 and shortly after to 4mg with no problem. So now that I am starting next reduction from 4 to 3.5.  I still have not touched evening dose, so my morning dose will be cut from 1mg to 0.5mg.  I am thinking that I should just take one cumulative dose of 3.5mg in the evening. I know that this goes against usual recommendation that prednisone should be taken in the morning, but I had much better results with current schedule (late evenings).

What are your thoughts and comments? Has anyone done anything similar?

0 likes, 39 replies

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  • Michdonn
    Michdonn nick67069

    Posted

    Hi nick67069, question are you using DSNS method? I split my dosage also and have been reducing both doses a little. Good luck. 🙂

    • nick67069
      nick67069 Michdonn

      Posted

      yes I do use DSNS... I am an old timer on this forum smile... Will be 2 years in December

       

    • Michdonn
      Michdonn nick67069

      Posted

      nick67069, I would try to reduce both, try alternating days on the reductions. Till you no longer have anything in the morning. That is what I plan on doing with my evening dose. Good luck, think positive, smiling. 🙂

    • EileenH
      EileenH Michdonn

      Posted

      Mich - You are still on a comparatively high dose for PMR - you will find reducing both at the same time much more difficult below 10mg and almost impossible at below 5mg which is where nick is.
  • BettyE
    BettyE nick67069

    Posted

    I did not ever split my dose but was changed from morning to evening because, for some reason, that took care of my super hyperness when I took it in the morning so I don't think that evening dosing is necessarily a no no although it does come as a surprise to some people.

    Perhaps with your schedule it might be what will work for you. As your dose is now low I would think it would not have dire consequences if it was all taken at night.

    • nick67069
      nick67069 BettyE

      Posted

      Thanks! Glad that I am not alone with evening dose.  I see rheumatologists every 3 months to get prescription ( regulation here in Japan that you can't get more then 90 days of supply). He was the one that initially suggested splitting the dose because of my unusual daily schedule.  I will see him again at the end of September, but by that time I will probably already know the answer if eliminating the morning dose is a good idea.

    • BettyE
      BettyE nick67069

      Posted

       The England cricket team are playing a match that begins at 2.00PM and ends at 6.00PM each day instead of the usual 11.00AM to 6.00PM. They have been told to adjust their eating/sleeping times to fit the new schedule.  You are in good company!
    • BettyE
      BettyE

      Posted

       The England cricket team are playing a match that begins at 2.00PM and ends at 6.00PM each day instead of the usual 11.00AM to 6.00PM.  That makes no sense.

      Correction.... that should have read " and ends at 9.00PM"

       

  • kathy61958
    kathy61958 nick67069

    Posted

    Best of luck to you, Nick.  I truly hope your reduction works well. I've never had a split dose. I have trouble sleeping without adding prednisone to the problem. I'm on 30mg right now. 4:00 AM is my time to take it. I'm hoping a very slow reduction will be in my future.??

    • nick67069
      nick67069 kathy61958

      Posted

      HI Kathy ! thanks for comments. I remember your first post and your struggle to reduce from 40mg.   PMR is not easy to deal with. When I started, I was put on 15mg. I remember reading posts on this site about magic bullet of prednisone. It was not like that for me at all. It took almost a week before I could feel the impact. In retrospect I understand that I started at very low dose and it took time to clear inflammation, but at the time I was wondering if my diagnosis was correct and if I had something else.  We are all different but what is common to all is that PMR requires patience. It is a long, long journey, so take your time.
    • shelleysinclair
      shelleysinclair kathy61958

      Posted

      Hi Kathy. Sleep deprivation is tough. I am going thru perimenopause and have hypothyroid. I find that prednisone makes me feel jittery. I have no trouble going to sleep but am awake like clock work from 230 on. When I was diagnosed at 51 last Feb I thought my symptoms were brought on by perimenopause ....apparently not.
  • shelleysinclair
    shelleysinclair nick67069

    Posted

    Doesn't the late dose keep you awake at night?

    • Michdonn
      Michdonn shelleysinclair

      Posted

      Shelleysinclair, I take most of my Pred at breakfast, but 1/4 at bedtime and have no problem sleeping. I just wondered what I going to do as my dosage get smaller. At 17.5 tapering to 15 mg. Still smiling 🙂

    • nick67069
      nick67069 shelleysinclair

      Posted

      Not at all.. I sleep really good. I must say that because of my unusual schedule I sleep only 5-7 hours at night and I take nap in mid afternoon for an hour or so most days.
    • shelleysinclair
      shelleysinclair Michdonn

      Posted

      I like your positive attitude. I woke up this morning thinking I better do more smiling or this is going to get the best of me 😊

    • Michdonn
      Michdonn shelleysinclair

      Posted

      shelleysinclair, I really do believe that a positive attitude is a great help on this PMR journey we are on. We all learn from each other along the way. I just try to keep smiling. 🙂

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