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.