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Can you split Prednisone dose for GCA?
Polymyalgia Rheumatica (PMR) | Last Active: Jun 21 9:08am | Replies (35)Comment receiving replies
Hi @isabelle7, While you wait for others with experience with Giant Cell Arteritis (GCA), there is another discussion that might be helpful on splitting the prednisone dosage.
--- Divided dose or all at once?: https://connect.mayoclinic.org/discussion/divided-dose-or-all-at-once/
I did find some information from 2020 that discusses the question under topic 5 on page 14.
"This evidence, albeit low quality, raises concerns that alternate-day dosing may be associated with a higher relapse risk. Splitting the dose over the day does not seem to confer benefit and potentially carries risks of disturbance of diurnal rhythms, including sleep [96, 97]. In summary, in GCA there appears to be no reason to alter the standard guidance in other medical conditions to prescribe glucocorticoids as a single daily dose in the morning [12, 91]."
--- British Society for Rheumatology guideline on diagnosis and treatment of giant cell arteritis:
https://pmrgcascotland.com/wp-content/uploads/2022/08/BSR-2020-Recommendations-for-the-management-of-GCA.pdf
Can you ask your local pharmacist about splitting the dose to see if they may have any suggestions?
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Thank you @johnbishop - I appreciate the feedback and will check those links. His doctor has been very adamant that he not split the dose. However, when he had just PMR (just diagnosed with GCA last week following positive temporal arterial biopsy.) It's been a hard road with doctors not believing that he had GCA, even though he had all the listed symptoms other than blindness and he'd had PMR since May 2023. He'd been treated with Prednisone, dosing in the morning and at night per his same doctor that is insisting on one-time per day dosing. I wonder if he should have been on one dose the whole time since he developed PMR. He ended up in the ER for the weekend. They're doing 3 days of methylprednisone IV infusions (1,200 mg each) and after 2 he's pain free and sleeping. He has his last today then goes to 80 mg in the morning. We are praying the severe nighttime headaches don't return. That is what sent him to the ER when the doctor told us not to use any more Tylenol. It's been a ride.