My rheumo told me to take all at once, first thing in the morning. But I have read other advice. My initial medrol pack said to spread the dosage throughout the day.
Please tell me how you take yours and how it works for you.
I have always taken Pred first thing in morning, not sure if I did right thing as it got to mid afternoon before I felt really pain free. I am now on Alternate days 1mg but not totally pain free . Good luck .
Hi I struggle with this myself. If I take it in the morning, it takes 3 hours to be painfree. I am a "morning person", and I like to "get going" fairly bright and early. I do not want to be in pain.......
I prefer to take the whole amount actually in the evening, and I feel fine in the morning. It does happen that by afternoon I have to reach for a couple of Tylenol because the effect of the prednisone has worn off.
Everybody is different....I cannot say that this is the right solution for others.
Sorry to sound cynical, but we are talking about an affliction whose cause is unknown, whose cure is unknown, and for which there are few lifestyle changes that help. On top of that, just about all physicians treat it with the same drug. Thus, the only way they can distinguish themselves, or appear to have something useful to say or do, is to vary the dose. My rheumi, for example, believes that most sufferers are started on much to high a dose, and that after they taper to zero, the symptoms invariably return. He starts at 15 mg at the most, tapers it by 0.5 mg per month until I reach 3 mg or 2 mg without the symptoms returning, and I then stay on that dose for ever. That is his belief. And he says to take the dose once a day, in the morning.
One thing I have learnt in the short term I have been a member of this forum is that as individuals we are all different when it comes to pmr, how it affects us and how we can best manage it to help in our daily lives. Many take it first thing in the morning as instructed, others take it much earlier, others split the dose. I personally find it helps me cope with my day if I take it around 4am as my working day starts around 8am. That may change as I lower the dose, I do not know. I'd say if your current way is working for you.. stick with it, if not experiment a little depending on how you want things to change for you.
I used to take mine at 5am ish, with fruit & yogurt. then i would go back to bed for a hour or two. unlike karen i am retired so did not have any set time to arise again. that worked fine for me. best wishes to one & all.
i have always taken mine around 11.30 am. and was ok untill i got down to 4mg
and then i had a little pain as i got out of bed, and took and took my morning dose again. i must add the pain was bearable. but as i got down to 3mg i would take 1 paracetamol. as i got out of bed. but then down to 2 i started with a flare so went back to 5 mg where i have now been for 2 month
I too am struggling on my alternate days as Rhuemy suggested, the ideal totally pain free dose for me is 2.5 daily but have managed for a few weeks on 1mg Pred.However the tops of legs muscles are very very stiff when getting out of chair and painful so going for blood test to see if my Esr is past 12 and then I will know its a flare.In meantime back to a daily dose.When will we be free I wonder, I am now 30 months with Pmr.
Crikey wish my ear was that low;am delighted that mine is down to 25
I'm new to taking it. My Rheumatologist told me to take 5 mgs 3 times a day unless it gave me insomnia, which it has. So I did my own thing and take 10 mgs in the morning. I'm hoping I can keep it at 10 mgs and nott go up to 15. He said as long as that helped it was fine.
The accepted best practice for taking corticosteroids for PMR and GCA is in a single dose as early as possiblle in the morning. One study has shown that the optimum time to take plain white tablets to avoid morning stiffness is 2am - not entirely practical but I know people who do it.
Remember, Medrol is used for a lot of different things and the normal practice in other illnesses may be to take it in 3 doses spread over the day to achieve and even anti-inflammatory action. In PMR, as in RA, the inflammatory substances are shed in the body in the early morning, about 4.30am (hence the 2am best time) so the greatest amount of work to be done is in the morning. The later you take the steroid the more the inflammation has developed.
There are people for whom the effect doesn't last all day - in some cases they do better by taking about 2/3 of the dose in the morning and the rest in the evening. But as you see from the other posts various people do various things depending on their needs. We on the support groups often tell people to take it as early as they can and settle down for another couple of hours - by which time the pred will be working and you can "get going" as normal.
I used to do alternate day - avoided side effects it seemed and I did well, except I struggled to reduce. But actually, PMR is one of the illnesses where alternate day dosing isn't recommended as it doesn't seem to work very well. The anti-inflammatory effect of pred lasts from 12 to 36 hours depending on the person - if you are a 36 hour person the ADD will work, if you are a 12 hour person it won't - in fact you'll probably be stiff before the end of the day whatever dose you are on.
Of course all physicians treat it with the same drug - prednisolone is the only effective substance that manages the inflammation. It's the ones who insist you can do it with DMARDs who are pushing their luck!
Hi there,
Iam new to PMR however even before seeing the Rumi I knew I needed to split the dose. It just wasn't pulling me through the day. Once I saw her and she told me to split morning/ lunch I was delighted and it made a world of difference for me. My mornings became wonderful however I would get some retuning aches late in the day so on my own I split 3x based on some medical information I read as to the effectiveness of prednisone in our system.
I take 20 mg daily,10mg morning(between 4-6 when I wake up)
5mg lunch
5mg supper
I saw the rumi again this week she wouldoprefer 2x but only when I feel I can.
I know when I start dropping it will then be a portion of the afternoon dose.
as Eileen says everyone is different but I now can walk out of bed in the middle of the night and not crawl.
Yes, it makes a difference to be able to get out of bed and walk instead of crawling. One has to experiment to see which times work.
I have RA and I cannot wait until a determined time to take prednisone when a very painful flare hits. I need to take it right and then and wait 3 hours until it eases and goes away. But this is RA.
I do suffer from PMR in addition and prednisone takes care of both.....so it can be a bit confusing for me to have a pre-determined time of taking it as long as I stay within the 10-15 mg dosage. I am on 12 mg trying to reduce to 10 mg.
On 2x, might taking the second part much later than lunch work better?
If you take one lot in the morning - what time does it start to wear off? If you took the second half about 1 1/2hours before that you might manage with just 2. Just a thought...
What time you take your Pred is up to you and might take a bit of experimenting.
I have tried a few different ways (split up during the day, just before bed, first thing in the AM) and have settled on taking the meds at 3am in the morning. This has allowed me to waken pain free and start doing activities right away. The pain does start to creep in very late in the evening though. Initially I thought that waking up at 3am would comprimise my sleeping, but it has not and I fall back to sleep immediately.
I have had PMR for almost 3 years now and finally down to 8mg. Still having some pain, but it is manageable.
Shawn
As I'm leveling off I can see merging lunch(noon-1:30) and supper to just taking at about p.m.2 to take me through the night.
but I like the fact of reducing 2mg off the dinner one. I can see how that would be easier. We will see. With all the side effect she wants me to stabalize for 3 months from start.