How does the body use prednisone and should the dose be split?

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My Ruhamatoligist has me splitting my dosage between morning and evening. He recommended this procedure because i was ok during the early periods of the day but I started cramping up and having vision problems in the evening (GCA). Since splitting the dose I have seldom had any problems except for 3 or 4 days after I reduce my dose by the standard 10% or having too many carbs.

I assume that during periods of normal activity the adrenal gland substitute provided by prednisone is used by the body at a fairly standard rate; however, during periods of stress I also assume that more of the chemical is used which left me short in the evening. Can any one on this forum explain how this really works?

Eileen, I will discuss your reduction method with my rheumatologist but I would like to know if you split you doses.

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  • Posted

    This is a discription of how long it stays in the body. The question is if PMR-GCA is covered under the comment "some disorders". I will ask my ruhamatoligist two weeks from now.

    Pharmacokinetics

    Prednisone is readily absorbed from the gastrointestinal tract and is then converted to its active metabolite prednisolone, by hydrogenation of the ketone group at position 11, in the liver. The preconversion biological half-life of prednisone is about 60 minutes.

    Prednisolone is excreted in the urine as free and conjugated metabolites together with an appreciable proportion of unchanged prednisolone. Prednisolone has a usual plasma half-life of 2 to 4 hours.

    It is this intermediate duration of action which makes it suitable for the alternate-day administration regimens which have been found to reduce the risk of adrenocortical insufficiency, yet provide adequate corticosteroid coverage in some disorders.

  • Posted

    Prednisone and methylprednisolone (used in the USA and mainland Europe) or prednisolone (in the UK) are the standard treatment for PMR and GCA.

    They are all what are called intermediate acting corticosteroids - hydrocortisone is short acting and would need repeated doses per day, others are longer acting and would overlap.

    I don't quite get what you are after cc - pred of one sort or another is pretty much the only thing used in PMR all over the world. There isn't another option as yet.

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