What time of day do you take your preds
Posted , 13 users are following.
Hello.
Could you pls offer me some advice?
I have been on preds for about 2.5 years reducing from 20 mg with a few flare ups due to reducing too quickly.
I'm now on 8.5mg daily but have been taking the tablets before bedtime so that I can get a good night's sleep and be relatively pain free in the mornings however as I reduce Im feeling pain in the evenings so wondering if it would be better to take the preds in the morning when I get up.
Any thoughts please.
Thank you
0 likes, 44 replies
nick67069 julian99981
Posted
Oregonjohn-UK julian99981
Posted
There are several lines of thought - one dose or split dose - but it does matter that you take at around the same time each day. Pain as the evening goes on is not that uncommon but if it's unbearable - yes split your dose - but it may give you two slightly lesser periods in some level of pain but normally discomfort which most put up with this particularly during reduction times. We are all different!!
Devonmichael julian99981
Posted
EileenH julian99981
Posted
The recommended time to take your preds is all as one dose in the morning and some of the others have mentioned some of the reasoning. However, one of the resons is tha taking them in the morning has been shown to suppress normal adrenal function less than taking them at night. At higher doses that is less important - adrenal function is going to be suppressed anyway with that much pred floating around in your body - but below 10mg there is a fair bit of logic to taking the pred in the morning.
What some people with morning stiffness problems do is take their pred early in the morning, a couple of hours before they want to get up. Pred takes between 40mins and 2 hours to get to a peak in the blood and start to work. A study showed that the optimum time to take ordinary white pred to avoid morning pain pretty much altogether is 2 am - it is at its peak in the blood and tissue in time for the morning shedding of inflammatory cytokines, the substances that cause the trouble, at about 4.30am. I do actually know a few people who set an alarm and do that and I am on a special form of pred that was developed to take at 10pm which then releases at 2am so you don't have to wake up! But taking it as soon as you can after 4.30am seems to work well for a lot of people - and the effect will then last another 4 or 5 hours into the evening than it is for you at present.
nick67069 EileenH
Posted
"However, one of the resons is that taking them in the morning has been shown to suppress normal adrenal function less than taking them at night." I seem to remember that you added at one time that the study which found that taking pred in the evening supresses normal adrenal function was contraversial. Am I immagining that, or you have changed your position on this subject?
EileenH nick67069
Posted
No - I stated the fact of the study. 15mg of pred taken at 8.30am suppressed adrenal function less than 5mg taken at 10 pm. What I also said was it probably doesn't matter too much for us.
If you are on a short course of pred at, say, 10-15mg for a week or two (which is how most pred is used in general practice) then it is far better to take it in the morning than at night and the doctors should advise that. At the end of the short course of pred the patient usually simply stops taking it or spends a week on 5mg less - that is all the tapering they usually require and that is because the moderate dose taken in the morning didn't suppress adrenal function much and production of cortisone continued, albeit at a lower level.
The reason it is not so important for us is that we are on doses of 10-15mg and above for months - long enough for adrenal suppression to occur anyway, what time you take your pred is less significant in that situation and you might as well take it at the time that works best for you. That may even result in you being able to manage on a lower dose and the "total steroid load" over the course of the treatment will be lower - which is a holy grail for many doctors.
nick67069 EileenH
Posted
EileenH nick67069
Posted
I nearly added that - I would think so yes. If you were taking 5mg at night there would be more effect than if you took it in the morning. However - you are only on 2.5mg at night aren't you so there should be some adrenal production in the morning, the rest of the dose is in the morning and at that level shouldn't be doing much.
I don't know, but I would think that you are possibly doing it optimally in every sense in that you are probably encouraging adrenal function to recover but still achieving optimal symptom management for you. The only improvement might be if you can reduce the night time dose rather than the morning one.
nick67069 EileenH
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dea13 EileenH
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Hi EileenH, I am on 35mg at the moment and will be reducing soon, I have my 1st appointment with a Ruemy 9th Nov at last.
Because I'm on the high dose I don't drive... But also because of the breast operation I just had ( went well ) and because most of those appointments are in the mornings, I was having days where I took my preds at different times, sometimes if at home 9am, but if I had an appointment after 1pm or so. I often wondered if that would throw my PMR out of wack so to speak. I am lucky that I do not wake with pain, mine seems to set in later. I have been doing this for about 3 months now since on the high dose for GCA ..... which I have had no other symptoms of since going to the 40mg, down to 35 now. Thanks Dea
EileenH nick67069
Posted
I've suspected that might be the case for some people - interesting.
EileenH dea13
Posted
Changing times as much as that isn't good - and in PMR and with PMR-size doses for some people would really leave them struggling all morning. Some of us need to take it early just to be able to get out of bed! Which is sort of helpful for appointments
As I said earlier though - a great deal will depend on whether you are a 12 or 36 hour person.
Good to hear the op went well - means you can concentrate on the GCA now - and maybe it will help with that stress out of the way. Good to hear the start of the reduction is going well.
dea13 EileenH
Posted
maid_mariane julian99981
Posted
hi Julian
i thought i was the only turtle in reducing among us. it's been over a year for me and I've gone from 20mg to 16mg.
Everyone says take your prednisone in the morning which i do between 5:00am-6:30am however i also split my dose and take 5mg at 3pm to control the afternoon pain.
prednisone is known to screw up your sleep how has yours been over the years?
if you do change your timing tou will have to change slowly.
EileenH maid_mariane
Posted
You CAN just have a single day where you take the extra bit - i.e. you take the old morning dose as usual. Then in the evening you take your new evening dose followed by the new morning dose the next morning - doing that you still have the dose high enough at all times. A few mg extra on one day won't hurt at all.
diana21296 maid_mariane
Posted
I find pred acts as a sleeping pill for me! Take 10mg at 4amish after which I go straight back to sleep and 3.5 at 7pm. Sleep like a log which wasn't the case when I was diagnosed. Back 10 months ago took it at breakfast as instructed but then had to split the dose to cope with bad night pain. Worked like a dream. Night pain went and so did sleeplessness. Sorted.