Prednisone dosage split

Posted by bamiller57 @bamiller57, 6 days ago

Something that may help someone but confirm with your physician before implementing. I had a major flare up a few weeks ago. My Rheumatologist started me on a 20 mg Prednisone taper. For several day after about 7:00 pm the symptoms came back with a vengeance and lasted throughout the next morning. I ask my Rheumatologist if I could split the dose, 10 mg upon waking in the morning and 10 mg with dinner and he said although Prednisone is best taken in the morning when your body is naturally producing it to try the split dosage. Since splitting my symptoms have subsided.

Interested in more discussions like this? Go to the Polymyalgia Rheumatica (PMR) Support Group.

megz | @megz | 3 days ago

In reply to @1942marilyne "I wanted to ask anyone taking dexamethasone their experience" + (show)

Maybe @johnbishop or another moderator could start a new discussion for you about dexamethasone.

John, Volunteer Mentor | @johnbishop | 3 days ago

In reply to @megz "Maybe @johnbishop or another moderator could start a new discussion for you about dexamethasone." + (show)

Thanks for the tag @megz. @1942marilyne, I didn't see any discussions on PMR and dexamethasone but there are some member comments in other discussions. Here's a list of the comments by members in the PMR group - https://connect.mayoclinic.org/search/?search=dexamethasone+and+PMR.

There are quite a few discussions on dexamethasone in other groups. Here's a link that lists the different discussions - https://connect.mayoclinic.org/search/discussions/?search=dexamethasone

pu911 | @pu911 | 3 days ago

In reply to @rnm "I'm curious what your initial dosage was and how long it took you to taper down..." + (show)

My initial dose was 20mg starting 12/23, I was down to 10 mg on 6/24. I can't promise you that I was splitting my dose in 1/2 morning and night because I was not recording my dosing. I did starting waking up at 2 or 3 AM feeling wide awake so I tried backing off on my night time dose with limited success. There was a time this Janauary where I did need any pred during day and was only taking it at bedtime. My approach has been to adjust my dose based on how I feel Rheumy's don't like that either. I've been as low as 1 mg/day and felt ok. Right now I have a shoulder that is giving me some issues, might be something other than PMR it's really hard to know. Hope this helps and best of luck!

DadCue | @dadcue | 3 days ago

In reply to @1942marilyne "I wanted to ask anyone taking dexamethasone their experience" + (show)

I believe @tuckerp was taking dexamethasone for PMR. He might share his experience with it. Dexamethasone is stronger than Prednisone and has a longer half life. I know it is used a lot in a hospital setting. Decadron is one of the bland names that I'm familiar with. I have administered it to neurosurgery patients but never used it myself.
https://www.mayoclinic.org/drugs-supplements/dexamethasone-oral-route/description/drg-20075207

megz | @megz | 3 days ago

In reply to @dadcue "I believe @tuckerp was taking dexamethasone for PMR. He might share his experience with it. Dexamethasone..." + (show)

Yes that's right, he was. Was hoping not to fill this thread about splitting prednisone doses with dexamethasone conversations, but it's not my call.

rnm | @rnm | 3 days ago

In reply to @pu911 "My initial dose was 20mg starting 12/23, I was down to 10 mg on 6/24. I..." + (show)

Thank you for the information. Very helpful. Hope you continue to taper successfully and feel well!

hopeinal | @hopeinal | 3 days ago

Splitting my dose works best for me.

blee1937 | @blee1937 | 2 days ago

In reply to @hopeinal "Splitting my dose works best for me." + (show)

My rheumatologist told me to split doses because prednisone only works for 12 hours per dosage in your body. I take one dose very early in the am. and another dosage around 5 pm.

michik | @michik | 1 day ago

In reply to @janetilley "I always took my prednisone dose, whether split or in full, at 3-4 am. This made..." + (show)

@janetilley did taking it that early in the morning, I am assuming without food, not upset your stomach eventually? I have developped so much abdominal discomfort, acid reflux and heart burn, even tough I am on an acid suppressant (PPI) and make sure I take my prednisone with food and a big glass of water.
I tried splitting my dose for a while when I was at 13 mg. I did 11mg with breakfast and 2mg with supper. But my acid reflux seemed to get much worst in the evening. So I am back to full dose in the morning.

janetilley | @janetilley | 3 hours ago

In reply to @michik "@janetilley did taking it that early in the morning, I am assuming without food, not upset..." + (show)

Yes I always take prednisone with food- buried in a spoon of yogurt! It’s the only way for me. I kept it beside my bed. Taking it at breakfast was too late for me- too much pain getting out of bed. I’d rather get the pred working as I slept. It has never disturbed my sleep. Plus I’m up 2-3 times anyway for bathroom. Family trait. I’m at 3 now and ready to taper to 2.5 in two weeks. Evening dose now works best. I found it best to adjust habits as PMR evolved. What works at one stage, may not be best as disease progresses. I learned that tactic early on from this chat room. As I’ve learned so much. Good luck.