Can you split Prednisone dose for GCA?

My Doctor warned me that taking Calcium supplements alone can be a problem. It isnt well absorbed by the body and can leave deposits in blood vessels and kidneys. Better to get it from your diet. Not as much of a problem if taken in combination with vit D3 and K2, not sure why ?

Hmm. I’m not sure why she’d say no, unless maybe she meant it wasn’t an absolute must? I don’t see how that could be harmful unless you take too much calcium. Vitamin D would be hard to over-do.

My father is taking Fosomax to prevent bone loss and he was already prescribed a multivitamin that includes calcium and vitamin D because he’s mostly on tube feeding.

I’d be interested to see what they say.

I don't have experience with GCA. My Dr. had originally told me to take my dose all at once in the morning. His reason was because it could effect my sleep if I took it at night. The trouble was if I took it all in the morning it would wear off during my sleep and then I be awake, in pain, and had already taken my daily dose. I've since split my dose and take half in the morning and half before bed. It's working very well for me.
I would speak with your Dr and ask why it needs to be taken all at once. I believe that's the general recommendation but every person/situation needs to be evaluated for what works best.

@galyn

Thanks for your response. We have since changed rheumatologists and the new one said to definitely split the dose, even for GCA, because a person shouldn't even be taking 80 mg all at once daily. So we split the dose and his issues resolved. He's tapered down now to 20 mg and is on Actemra which helps in the tapering. So glad you don't have GCA!!

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.

I’m going in tomorrow morning to have a Color Doppler vascular ultrasound of my temples, hopefully in lieu of the usual biopsy needed to officially call whatever has caused an unrelenting headache in both temples for going on three weeks. My bulging temple and forehead veins/arteries and jaw pain enabled me to reach a tentative diagnosis last weekend but a 7 hour visit to ER Sunday night, including bloodwork and a CT scan with contrast yielded a Rx for lidocaine patches and advice to try to relax so my tension headache will subside. I had elevated C-reactive protein and high sedimentation, but the ER dr. consulted a hospital neurologist who said it wasn’t GCA because that never occurs on both sides. Thank goodness my PCP found the markers to be convincing enough to order the vascular ultrasound and an initial Rx of prednisone. This conversation is such an eye opener. I was able to pick up the first week’s supply this afternoon and took one with food tonight, but the pharmacist said to really “start it” at tomorrow’s breakfast. The label only says take 3 (20m) a day, with food, and I have been puzzling tonight trying to see if that could mean all at once. You all are a blessing. Thank you, and good luck to all of this on our journey.

I'm sorry you're experiencing GCA. I was diagnosed with GCA and PMR almost a year ago. I didn't have any headaches, but I did a lot of fatigue in my jaw muscles when I was eating, tenderness around my ears and on my scalp, night sweats, low grade fever, and temporary loss of vision in one eye. I was hospitalized for 3 days to receive an infusion each day of 1000 mg of methylprednisolone. After I got out of the hospital I started on a dose of 60 mg of prednisone once a day. I was on that dose for 6 weeks. I always took the 3 pills together first thing in the morning. The earlier you take the pills the better. The best time is around 4 am, because that's when the inflammatory substances in the body are at the highest point.

You should take the prednisone with food. The prednisone can irritate your stomach. A lot of people, including me, have to take a proton pump inhibitor to control acid and stomach irritation.

You should schedule an appointment with a rheumatologist if possible. The rheumatologist can manage the prescriptions you need for GCA and monitor your progress with blood tests. You could request a prescription for Actemra, which is a biologic drug that allows you to taper off of prednisone faster and avoid some of the issues with long term prednisone use.

You should also see an ophthalmologist regularly to monitor for problems from the GCA and prednisone.

I had a lot of trouble with insomnia when my prednisone dose was above 40 mg a day. It was especially bad at the highest doses, like 60 mg a day. During that time it helped me to take 5 mg of time release Melatonin before bedtime. That helped me to sleep 5 hours night. I felt pretty bad from the insomnia, but it was just something I had to go through to recover from the GCA.

Sorry again for your illness, and good luck!

I'm sorry you're experiencing GCA. I was diagnosed with GCA and PMR almost a year ago. I didn't have any headaches, but I did a lot of fatigue in my jaw muscles when I was eating, tenderness around my ears and on my scalp, night sweats, low grade fever, and temporary loss of vision in one eye. I was hospitalized for 3 days to receive an infusion each day of 1000 mg of methylprednisolone. After I got out of the hospital I started on a dose of 60 mg of prednisone once a day. I was on that dose for 6 weeks. I always took the 3 pills together first thing in the morning. The earlier you take the pills the better. The best time is around 4 am, because that's when the inflammatory substances in the body are at the highest point.

You should take the prednisone with food. The prednisone can irritate your stomach. A lot of people, including me, have to take a proton pump inhibitor to control acid and stomach irritation.

You should schedule an appointment with a rheumatologist if possible. The rheumatologist can manage the prescriptions you need for GCA and monitor your progress with blood tests. You could request a prescription for Actemra, which is a biologic drug that allows you to taper off of prednisone faster and avoid some of the issues with long term prednisone use.

You should also see an ophthalmologist regularly to monitor for problems from the GCA and prednisone.

I had a lot of trouble with insomnia when my prednisone dose was above 40 mg a day. It was especially bad at the highest doses, like 60 mg a day. During that time it helped me to take 5 mg of time release Melatonin before bedtime. That helped me to sleep 5 hours night. I felt pretty bad from the insomnia, but it was just something I had to go through to recover from the GCA.

Sorry again for your illness, and good luck!