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@nyxygirl. I did not split my doses. I took the dose for that day the same time I did every day (within minutes). That was successful for me. Also I was not treated by a rheumatologist, my Internist was very familiar with PMR and her approach was different from most of the posts I read on this site. I started with an aggressive dose of prednisone for about 12 days, she smacked PMR in the mouth right off the bat, and I think my taper was successful because of that. 😅 All the best with your journey. Be patient.
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hunib33. I know this is an old thread. I just started coming here a couple weeks ago. I have been off steroids for 2 yrs. But I have had a flare. I was hoping that was behind me. I agree with your approach. Slap this thing aggressively and be done within 10-14 days before you shut down cortisol production. I think I could probably just taper to zero within the 14 days. I am familiar with Dadcue and his similar approach to Uveitis. When you say aggressive what dose did she start you on?
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My ophthalmologist said the same thing about hitting it hard at the start. It was to treat uveitis that was very aggressive during the first couple of flares. One of my first experiences with uveitis was starting with steroid topical eye drops progressing to a low dose of prednisone. Then I worked my way up to 100 mg before uveitis started to respond. Even at 100 mg, uveitis wasn't responding well until I split my dose.
Uveitis can cause vision loss and I was believing my affected eye was a "lost cause" until I split my prednisone dose. I told my ophthalmologist after I tried a split dose. It seemed to work so I wanted his blessing. He said he didn't care what I was doing because he agreed that whatever I was doing was working!
When I had my next flare of uveitis, my ophthalmologist said he wasn't going to mess around with lower doses of prednisone. That was when he said he wanted to hit uveitis hard with 60 mg to start and adjust either up or down as needed. That worked well too as long as I split my dose.
There are some reasons for not splitting your dose. The reasons are related to adrenal suppression. I believe this is pertinent when you reach 10 mg or less. Anything above 10 mg your adrenals will be suppressed no matter what.