Prednisone schedule

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I have recently discovered that splitting my dose (currently 15 mg) and taking half at 7 p.m. and half at 9 a.m. makes a huge difference in my pain levels, both in the evening and upon waking. Yea for me! My primary doctor warns me that taking prednisone in the "afternoon" can suppress adrenal function more than at other times and may make it more difficult to taper. Any thoughts, experience with this? I have been taking prenisone for about 18 months and have never gotten below 12.5 mg. Also, have read many posts on the split dose subject and understand that the results are highly individualized. Thank you.

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5 Replies

  • Posted

    I started at 20 mg in May, have been splitting my does since early July.  It has worked wonderfully for me.  I am now down to 7.5 mg.  I take 5 mg in the a.m. and 2.5 in the evening after dinner.  I will begin working on getting to 5 mg next week.  I will do the taper the way it was recommended on here going six days old dose, one day new dose, and so on until I will be at 5 mg.  I am planning to do it 2.5 a.m. and 2.5 p.m.  I hope it continues to work as well as it has.  I went down my 5 mg at  time until 10, then 2.5 mg at a time.  I think I would prefer the "dead slow" method, but haven't been able to get my rheumatologist to give me a prescription for 1 or 2 mg tabs.  As it is, I split the 5 mg tabs.  It would be hard to split them further.  Well, it has been working for me and I no longer have fatigue and feel quite well.  For me the split dose has been the answer.  I know that some have disagreed with this method.  Good luck to you.  Donna

  • Posted

    There was a study (done in Holland I think) which showed that taking 5mg at night suppressed adrenal function more than taking 15mg in the morning. Ergo: taking pred at night is bad.

    Which is all well and good for people who take pred for a short time for various things like asthma or chest infections. Taking it in the morning means that weaning off it at the end will have fewer problems.

    However, we are on pred for years, not weeks/months, and at a level that is bound to induce adrenal suppression after about 4 or 5 months (probably even sooner). The logic there is then that taking it in a way that provides the best result for the patient makes most sense. Most people who split do about 2/3 in the morning and the rest later in the day - and when suits them best varies. Hav eyou tried different splits and different times?

    How have you tried to reduce below 12.5mg? 

    • Posted

      Thank you, Eileen, for this response and for your commitment to this site and your knowledge. I haven't tried splitting the dosage before, but am going to try 1/3-2/3 instead of 50-50. When I tried to get below 12.5, I was unaware of the dead slow method and followed my doctor's advice to drop 2.5 mg every two weeks. It didn't work! I recently used the method recommended on this site to go from 16 to 15, and was in pain before and after - trying to reduce in order to prepare for surgery. Since splitting the dose, 15 seems quite doable. A little pain, but about half what it was even at 16. I'm having two more tests. It's possible that a uterine infection is the source of the massive inflammation I've had. If that gets dealt with, I hope to be able to reduce - slowly - to the lower levels I see so often reported on this site.

    • Posted

      ",,, followed my doctor's advice to drop 2.5 mg every two weeks. It didn't work!"

      No - it probably didn't!!!!! lol rolleyes Quelle surprise!!!!!!

      That's how you reduce pred in other uses - not in a chronic disease where you have no idea what dose a patient is going to need. 

      You never know - the uterine infection may be part of the PMR symptomatic. PMR is only the outward expression of an underlying disorder - there are several and they may be causing more than just PMR.

      Good luck.

  • Posted

    I have been splitting since within the first 2 weeks of prednisone. I take 10mg in the morning then 5mg at 3pm.

    When i reduce i reduce the morning dose only for now.

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