Splitting low doses?
Posted , 10 users are following.
I am on 6MGM pred. I was lowering the evening dose and was taking 5 mgm in the morning and 1MGM at night. I found that I felt really tired in the morning but very peppy evenings. I'm trying now 2.5 evenings the rest of the dose mornings. I seem to feel better most of the day. How low the dose before once a day dosing? It seems, in my case , there is a delay before maximum result. I do put my pred in capsules , weekly, to help keep track of doses (and not drop pills on the floor).
0 likes, 12 replies
nick67069 karenjaninaz
Posted
I can tell you that for me, it is much more efficient if I reduce morning dose and keep late evening dose. When I got down to 4mg or so, I started taking only evening dose. But everyone is different, so best is to try and experiment and see what works for YOU.
diana21296 karenjaninaz
Posted
I used to split my dose with the larger one taken at night after a meal but now I'm on 5.5mg I take the whole dose after the evening meal. If I'm not eating at night I eat a ramekin of plain yoghurt beforehand. I've always taken the larger dose pm as I sleep very well on it. You need to change the splitting gradually so you know that the body accepts the change in routine. Then try the whole dose at night. Experimentation is the name of the game.
EileenH karenjaninaz
Posted
Difficult to say - it's what works for you. I know, really helpful!!!
alebeau karenjaninaz
Posted
This got my attention big time.
I am at the 11.5 marker after one year and am typically taking all of it with breakfast. Every day I suffer morning stiffness and often resort to Tylenol 3 as it is seemed to dull the pain by noon or so. Yesterday I took 6.5 mg in the morning and my whole day was semi stiff but not at a high level. I then took the 5mg at 9 pm.
RESULT
I seemed to sleep way better with less discomfort getting up in the night to urinate and now at 7am I must say I am feeling much less joint and muscle discomfort. I am encouraged by this and will continue this trail method to see if it remains effective over time.
I really want to thank you for your post as I never connected the dots which now seem obvious in terms of pain management.
BTW I am a 71 year old male.and I seriously would like to live a better quality of life while trying to slowly wean off Prednisone - I am trying the DSNS method.
Michdonn alebeau
Posted
Alebeau, I am a 82 year old male who split my dosages. I found with trial and error I did better with about 2/3 in morning, 1/3 at bedtime work for me. We are all different and I think you have to .experiment to see what works for you. Good luck on the rest of your PMR journey. Try to stay active, positive and smile it helps. 🙂
alebeau Michdonn
Posted
Good to know - thank-you
Today was a great day for me pain-wise and I will keep it at 50/50 for now and change to the 65/35 split if I see a degradation.
I wish I had done this long ago - will definitely mention it to the doctor next time.
Will keep active positive and smile often as prescribed:)
nick67069 alebeau
Posted
I have started split dose on advice from my rheumatologist. At the time I was at 12.5mg and due to my schedule ( I was working late) he suggested to take evening dose as late as possible. My bed time is usually about 1AM-2AM and that is the time I take pred. There is a reason for that. Uncoated pills get absorbed by our body in about 2 hours. Cytokines ( the stuff that causes our muscle pain ) is shed by our body about 4-4:30AM. That is the ideal time to have pred in the system. By taking evening does as close to 2AM one is maximizing the efficiency of the pred. I was able to reduce (at the time) from 12.5 to 10mg BECAUSE I split the dose in one step. In my experience, it is much more effective to take dose before sleeping. Now that I am at 2.5-3mg I only take pred late in the evening.
diana21296 alebeau
Posted
Drs don't seem to recommend splitting. I got the advice from this fabulous forum and all my 2am pain disappeared instantly!
EileenH diana21296
Posted
They are taught that it should be taken all at once in the morning - and don't really understand the nature of the beast, It is the same with tapering - one size fits all. And we know it doesn't ...
alebeau diana21296
Posted
I will be strongly recommending the split dose for all my Doctors PMR patients, this is my second day and I feel reborn!!
Cannot believe the doctor does not know this.
EileenH alebeau
Posted
It very much depends on the patient. The antiinflammatory effect of pred lasts from 12 to 36 hours and it is the patients for whom it only lasts less than 24 hours who benefit from split doses. In the early days of pred for my PMR I actually did what is called alternate day dosing which is a recognised technique used in some illnesses to reduce the adverse effects of pred: you take a double dose on alternate days. It worked fine for me and a single daily dose lasts the full 24 hours until the next dose is due. But you are right - if any patient complains symptoms return within 24 hours then split dosing is well worth trying.
In the past it has not been recommended for GCA but in fact a study found it didn't make any difference and the argument has to be that if symptoms have returned - so has the inflammation and a split dose is going to help that.
Michdonn alebeau
Posted
Alebeau, Doctors know what is written in a book back the university. Most are reading the article that are being published. Most if not all of them do not have PMR, so they do not understand the condition, plus most have a GOD complex. That is why it is so important to learn to listen to your body and read the article that are published.
Happy reading and good luck! 🙂