I’m sure this has been discussed before, but I can’t find it.
I believe Prednisone has a fairly short lifespan in the body - half-life of around 3 to 4 hours.
My question is - if the drug is being absorbed by the system during that period, does drinking large quantities of water, coffee, etc. have any effect on the quantity of pred that is absorbed versus the amount that is “flushed” out ?
I drink a load of coffee and water in the morning and throughout the day (no alcohol ‘cos I take methotrexate !) and living in a warm to hot climate (Southern California), drink water all the time when outside working or walking so as not to dehydrate.
I was told that drinking coffee can affect the adrenal glands and cause steroid induced diabetes, which can be a side effect of pred, I don't know how correct this is. I love coffee but have tried to reduce the amount I drink. I suppose decaffinated is OK, but I am not a fan.
Hi Dave it Mariane in Canada. Don't know if your on our usa/canada forum if not and you want to send me a personal message and I'll tell you how to connect.
I have posted i belive on the usa site quoting an article that stated exactly what you said that prednisone is only in the system about 4 hours. I firmly belive that is why pain comes back later afternoon/evening.
My Rumi has me splitting my dose and until i leveled i split it 3x day to pull me through the night. I know split morning with the majority of the dose with a smaller dose supper and i wake up pain free.
As for coffee i too am a hound and i know it says cut back but would really like to know why. Giving up coffee for me is harder than carbs and booze. Lol
The halflife of pred in the body is 4 hours, yes, but the antiinflammatory effect perists for 12-36 hours, depending on the person. If you are a 12 hours person - which is what is sounds like - then you will have returning stiffness/pain in the late afternoon. I, on the other hand, am obviously nearer a 36 hour person and for quite a time was able to take a double dose of pred on alternate days - a recognised way of reducing pred side-effects but one that doesn't always work in PMR and it is agreed is far too risky for GCA.
The longer you can have in a day without any pred present in the body, the more your own adrenal glands have to do and the less likely it is they will go into hibernation. The side effects, especially the Cushingoid ones, are due to the prescence of excess pred in the body - so 4 hours of exces balanced by 44 hours of none is better is the theory.
However - since the point of pred is to manage the symptoms there isn't a lot of point not managing them as well as it is possible to do is it?
"The interactions of diuretics with other drugs is mainly due to the Na-K dynamics which are altered, not only in the nephron, but also in the body. So, hypokalemia (decreased potassium in the body) due to diuretics causes enhanced toxicity of drugs like digitalis. Or for example, aminoglycoside anibiotics(streptomycin, amikacin) should not be used with diuretics because they potentiate their toxic effects on the kidney.
What it basically means is that diuretics have no effect on drugs being excreted by the kidney, unless that excretion is dependant on Na-K dynamics in the kidney (which is very very rare). Or in other words, the half life of the drug is not affected. The half life of the drug reflects the dosage to be given so that a therapuetic concentration is acheived in the body. And the half life changes only if there is some problem with the kidneys in ulrafiltration - say renal failure, where half life changes and so drug dosages change. Even doses of diuretics change."
I've sent you the link - will keep reading though.
Diuresis is getting rid of WATER - the kidney is quite clever at not getting rid of substances too fast but obviously if you drinks LOADS of water in any form you will then get rid of sodium and potassium and that isn't good. Hence the need for electrolyte supplementation if you sweat/pee a lot.
And it is a fallacy that you can become dehydrated from drinking coffee - you pee the excess fluid out faster but not to excess. Yes, preferably drink water because it has no stimulants or calories but you CAN include the fluids you drink that are in the form of tea and coffee in your daily fluid count.
Not a coffee drinker, except as a rare treat, but drink tea. Did some research and apparently the concerns re coffee do not apply to tea, but in any case I am now making my tea a little bit weaker, i.e. not strong enough to "trot a mouse". One does need some pleasures in life, after all. For a long time I've tried to balance tea drinking with a similar amount of water as I am prone to dehydration headache.
The only problem with tea, which I also drink, is that I am taking vit D and calcium supplements to counteract the steroid side effects and you should not take tea and the supplements at the same time. In fact the vit D is a pain as you cannot take it at the same time as pred either.
I didn't know that. I am going to have to write out a list of everything. I have to take the pred early in the day with food. I can't take my iron in the morning because it shouldn't be taken with calcium and I am supposed to spread my calcium doses out fairly evenly through the day. But now (after all these months) I find I can't take the calcium because I have just had pred. I need to take calcium three times a day, preferably with food and iron (with food) twice a day. I always thought the pred did not interfere with anything and as long as I had some food to protect my stomach it was all okay. Aaaargh!
No, don't think the pred interferes with any thing but the calcium interferes with the pred. I just take calcium/vit D twice a day - as long as you don't take it all in one it should be fine - there is a limit to how much calcium your body can absorb at one time, that's all
Thanks Eileen. I'm on a special calcium supplement now that has to be taken spread out over the course of the day to maximize absorption. At least it isn't the one that had to be taken five times a day which was first suggested! I guess I'll see if I can tolerate a dose before bedtime and take it then instead of at breakfast. Should solve that problem. Honestly, everything is getting so complicated, and what with the walking, and the tai chi and the business of medication and supplements it feels like a fulltime job. Does anything else interfere with the pred? Iron for example? Not supposed to be like this!
Don't think so - not the iron anyway. I know - being ill and arranging meds in the middle of life is not for the faint hearted!
2-3 hours is felt to be enough between pred and calcium-containing supplements if that makes it any simpler? One lady used to set her alarm for 2am to take her pred - it worked better for her like that. Now that would keep your pred away from the calcium...
Goodness knows why you should not have tea with Vit D, it was something to do with the absorption of the vit D. I must admit I sometimes have tea with mine and think sod it!
Oh, Anhaga. It sounds like you need a spread sheet for it all!💊💊 I love your 'mouse ' expression. Haven't heard that one before. We would call it 'builders' tea in this neck of the woods.☕️☕️ Just recently plugged a hole in the outer wall with steel wool to keep the mice at bay!!🐀🐀 Good job I no longer drink tea, though it was always weak tea for me.
What I don’t get is what it is that is acting as the diuretic ? From what I understand a diuretic is any medicine causing increased urination.
So any medicine identified as a diuretic causes the kidney to secrete excess fluid by blocking the re-absorption of either water or electrolytes ?
Does this mean that diuresis is a common side effect of Prednisone ? Not that it is a true diuretic, but many PMR patients do seem to have an increase in urination. I do !
But from what you reference, intake of excess fluids does not seem to have any effect on the half-life of the drug (pred) unless there is a problem with the kidneys in ultrafiltration.
Based on this information, do think that there is any issue taking other drugs such as Valsartan (hydrochlorothiazide) for treating high blood pressure – this is a diuretic.
The ‘world of pills’ is so complicated and it seems that medical professionals don’t go into enough to find out what might be happening or going to happen with this long term pred medication intake.
SO - based on all this - it seems like it doesn't matter how much fluid intake one has, providing the kidneys are functioning correctly, and there shouldn't be any influence on the half-life of the prednisone intake dose - RIGHT !