Times to take Pred if you split the dose.

Bones, joints and muscles
1

Hi All,

I am interested to know what times people are taking Pred when splitting the dose. Also have you noticed any changes in sleeping patterns. My sleeping pattern is awful not going to sleep till 3 or 4am waking at 6.30. I take Pred at 1am as I seem to tolerate it better. Not sure what will happen with side effects if I split the dose.

Welcome your suggestions.

Cheers

Kath

2

Hi Kassiebeetle,

I have noticed disturbance in sleeping.  Usually will go a couple of nights waking up about 2:00 am and not able to fall back to sleep.  Thus will end up taking Melitonin the next night to get a full nights rest.  

3

Dear Poupe

Thanks for that. I have heard of melatonin. Will do some research.

Waking up at 2am. What do you to keep yourself amused in the middle of the night?

4

Either pull out a book or turn on TV which is not the best to do.

5

I take my morning dose in the 6-7am range and evenings around 7:30-8:30pm.  

I originally took one dose in the morning but after 2 months and a flareup,  Just taking it all in the morning was never lasting until the next morning.  I'd wake up hurting until the morning dose kicked in.  I'm doing a very slow reduction and currently take 10 mg in the morning and 3 mg evening.  Since splitting the dose I've had much better luck sleeping.  I'm not sure if that's because I take the majority of it in the morning or not.  Just glad I don't wander all night like I used to. 

My sleep schedule still isn't normal but it's certainly much better than it was, which was very similar to yours.  It seems like my sleep times change every 2-3 weeks but think that's more likely because of things I do that unintentionally push my sleeping hours earlier or later.  Currently I usually fall asleep about 10:30pm, wake up about 2am for an hour and then am able to go back to sleep until the alarm wakes me in the 6:30 - 7:00am range for work.

A month or 2 ago I was extremely busy and somehow forgot to take my morning pills PLUS missed the evening dose as well.  I went to bed and never thought of it until about 3:00-4:00am when my body reminded me what PMR originally felt like before taking Prednisone!  

6

Thanks for your reply. It is good to hear that your sleep patterns are better. I am looking forward to hearing what others do.

Cheers

Kath

7

Kassiebeetle, I take first dose after my morning shake and 2nd dose at bedtime. Second dose is 15-20% of morning dose. Currently on 11 mg tapering to 12 mg. Good luck on your journey. Thinking positive and smiling. 🙂

8

I used to take 1/2 very late ( 1-1:30AM) just before going to sleep and second dose after getting up 8-9AM.

Now that I am down to 4mg, I take only one dose late at night.

Experiment with time, what worked for me, doesn't have to be the best solution for you. It depends on your schedule, how long does pred stay in your body, etc...

 

9

I find splitting the dose works really well for me. Approx one third after eating at 7.30pm and two thirds when I wake up in the night between 3-5am after a ramekin of natural yoghurt.   Pred acts as a sleeping pill for me although according to the leaflet, it can cause wakefulness. 

Splitting the dose in the early days helped the pain and got me through the night whereas one dose after breakfast left me in pain from 2am..

However, what works for one won't for another and it's really a matter of trial and error.  Good luck in finding the balance.

10

Thanks Nick

I probably get about 20 hours relief. I have just come back from talking to Pharmacist. I explained to her about side effects and why I take Pred at 1-2 am and I was thinking of splitting the dose, BUT as per usual professionals have very tunnel vision and she advised me to take the whole dose at 8am. Oh Lordy.

11

Thanks Dianna. It is really good that you don't have sleep issues. I shall let everyone know his it goes. Cheers Kath

12

There is a post put up today from Twopies whose doctor had been at a rheumy conference where they were told that it was now good to say twice daily as they had found it worked better!!!!!

https://patient.info/forums/discuss/pmr-prednisone-and-split-dose-624053?utm_source=forum&utm_campaign=discussion-notification&utm_medium=email

The all in one at 8am is for patients on short-term courses of pred - and it probbaly makes their stopping it after up to 6 weeks easier. We are going have adrenal suppression anyway - when and how you take your pred isn't going to make any difference until possibly below about 7mg. Even then, not necessarily.

13

Thanks Eileen. I did read Toupies post. It was very interesting. I have just taken Pred 5mgms at 7.45pm. Will take 2nd dose sometime during the early morning. Will just play it by ear. So we shall see how things go.

How was the holiday in Malta?

14

Very nice - the resort was in a slightly scruffy area a short walk from a rather more main tourist area. Where we were was quiet, 100 yds from the sea where there were a few good restaurants with another excellent one in the other direction. You could walk by the sea all the way round the point almost on the flat for about 3 miles - perfect. The weather was about 19-20C and sunny almost the whole time, couple of wet days. When Malta does a thunderstorm it really does it! But we got home on Tuesday afternoon - and woke to the first snow of the winter down here in the valley on Wednesday. And this morning it was -13C early doors! Brrrr!

Last year on Dec 1st we put the lights on the balcony and then I sat down for a cup of tea out there. Don't somehow think I shall be doing that this year...

15

Must tell you a funny story about friends of mine who went to Malta a couple of months ago. John is a Vietnam Vet who stepped on a mine and lost his leg and arm and part of his other hand. He decided that he wanted to buy a new shoe. Went into a shoe shop tried on a shoe and decided to buy it. The funny side of the story is the shop assistant put the shoes in the box and gave it to John who promptly said I don't want both shoes. She said no he had to take it. Meantime her colleagues were having a good old laugh as was John's wife When the penny finally dropped she accepted the shoe back rather sheepishly.

Take Care and thanks for all your great advice. Kath.

16

I might be having the same problems and just posted about it on my thread about pmr and split dose pred.

17

Well, I am reporting on what happened last night. I am taking 13mgms of Prednisone which I have been taking between 1-2am. I don't tolerate Prednisone very well if I take it in the mornings. So I split the dose last night. Took 5 MGM's at 7.45pm. At 12.30 I felt awful. My eyes felt swollen, I was short of breath and wheezy felt a bit agitated. It is now 6am. I have not had any sleep at all. I decided to take the remaining 8 MGM's at 2.30 am rather than 0800 and have come to the conclusion that I will stay on the single dose. I don't know why this happened. Eileen you might be able to shed some light on this one. It was not nice.

Thanks

Kathy

18

Hi Kath,

I take 15mg of Prednisone split into two doses. The morning dose is 10mg at 8am and the 'night' dose is 5mg and  ranges from 1am to 3am depending when I wake up. I go to sleep at about 11pm and get up anywhere from 4am to 7am (on a good day) after my night dose. My sleep patterns were bad but have improved. I use a sleep/fitness monitor so I do know how well I slept. The split dose seems to work for me. I hope this helps.

Enan

19

Thanks Enan. I posted earlier on today describing what happened last night and the moderator has not allowed my post. Not sure why nothing out of the ordinary.

I did not get one bit of sleep last night. I started the split dose by taking 5 MGM's at 7.45pm by 12.30pm I was feeling terrible. Swollen eyes.Shortness of breath some wheezing, restless legs and agitated. I have been a bit better today but the restless legs have been there all day. I am beginning to wonder if I might be having a more severe reaction to the pred.

I will see GP next week. But at this stage I am not going to attempt to split the dose. Cheers

20

Please ship me some cold weather, I do not know how warm it was today, probably mid 60s worked outside with just a shirt. Still no snow here, maybe a friend and I might go a bit further north to get a few runs in, in a week or so. Too warm and dry here, still waiting for winter. Thinking positive for snow and smiling.🙂