1. < Polymyalgia Rheumatica (PMR)
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Does you doctor recommend splitting?

Posted by chis55 @chis55, Aug 29 10:12pm

I’m curious about the evening dosage, if the doctor says it’s okay.
Mine insists all mg taken in the a.m. because of sleep deprivation .

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chis55 | @chis55 | Sep 10 4:30pm
In reply to @megz "You didn't mention in your original post that you were taking 60mg which is a very..." + (show)
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You didn't mention in your original post that you were taking 60mg which is a very high dose, or how long you have been taking it. Are you being treated for giant cell arteritis rather than PMR which is usually treated with one third or one quarter of that dose?

From what you say, it's the pain that's waking you up possibly as much as the prednisone may be. Does your doctor know you have pain that's causing you sleeplessness? Split dosing is fairly common to control night and morning pain with PMR but I haven't heard of it being needed with GCA at those very high doses.

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60mg was the dosage at onset for both GCA and PMR. With the GCA it was gradually decreased over 9 Mo.
PMR was decreased more rapidly with longer time frames for each time as we got down to 10mg and less.

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Elizabeth R | @elizabethannr | Sep 11 9:09am

Someone on one of these questions posted how to taper down by .5mg prednisone. I would like to see this repeated as I can't find it, an it seemed to me it was 4 weeks of going something like: 9mg./8.5.mg, 8.5 mg/9mg, 8.5.mg, 8.5 mg and so on, changing slightly for about 4 weeks till the person worked down successfully to 8.5 mg. I would like to ask this person to repeat this so I can try it that way. thanks.

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vjm0223 | @vjm0223 | Sep 11 10:20am

Both the pharmacist and my rheumatologist said the same thing.
I however just started on it yesterday but I took it after dinner because I hadn’t eaten much all day. I had no problem sleeping. So I called the pharmacist this morning to ask if I could split between am pm. She said no, am is better because the prednisone will creep up on you the more often you take it and probably will cause sleep deprivation.

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megz | @megz | Sep 11 7:40pm
In reply to @elizabethannr "Someone on one of these questions posted how to taper down by .5mg prednisone. I would..." + (show)
Profile picture for Elizabeth R @elizabethannr

Someone on one of these questions posted how to taper down by .5mg prednisone. I would like to see this repeated as I can't find it, an it seemed to me it was 4 weeks of going something like: 9mg./8.5.mg, 8.5 mg/9mg, 8.5.mg, 8.5 mg and so on, changing slightly for about 4 weeks till the person worked down successfully to 8.5 mg. I would like to ask this person to repeat this so I can try it that way. thanks.

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Gradual taper for a softer reduction of .5mg every 3.5-4wks, or 1mg every 7-8wks. It worked for me. If you're on 9mg reducing to 8.5mg, for example -

WEEK 1: 8.5mg / 9mg / 9mg / 8.5mg / 9mg / 9mg / 8.5mg
WEEK 2: 9 / 8.5 / 9 / 8.5 / 9 / 8.5 / 9
WEEK 3: 8.5 / 8.5 / 9 / 8.5 / 8.5 / 9 / 8.5
WEEK 4: Stay on 8.5mg to stabilise and monitor for new pain. Then start the next .5mg reduction the same way.

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chis55 | @chis55 | Sep 11 8:21pm
In reply to @megz "Gradual taper for a softer reduction of .5mg every 3.5-4wks, or 1mg every 7-8wks. It worked..." + (show)
Profile picture for megz @megz

Gradual taper for a softer reduction of .5mg every 3.5-4wks, or 1mg every 7-8wks. It worked for me. If you're on 9mg reducing to 8.5mg, for example -

WEEK 1: 8.5mg / 9mg / 9mg / 8.5mg / 9mg / 9mg / 8.5mg
WEEK 2: 9 / 8.5 / 9 / 8.5 / 9 / 8.5 / 9
WEEK 3: 8.5 / 8.5 / 9 / 8.5 / 8.5 / 9 / 8.5
WEEK 4: Stay on 8.5mg to stabilise and monitor for new pain. Then start the next .5mg reduction the same way.

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Thank you so much..

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Elizabeth R | @elizabethannr | Sep 11 9:07pm
In reply to @megz "Gradual taper for a softer reduction of .5mg every 3.5-4wks, or 1mg every 7-8wks. It worked..." + (show)
Profile picture for megz @megz

Gradual taper for a softer reduction of .5mg every 3.5-4wks, or 1mg every 7-8wks. It worked for me. If you're on 9mg reducing to 8.5mg, for example -

WEEK 1: 8.5mg / 9mg / 9mg / 8.5mg / 9mg / 9mg / 8.5mg
WEEK 2: 9 / 8.5 / 9 / 8.5 / 9 / 8.5 / 9
WEEK 3: 8.5 / 8.5 / 9 / 8.5 / 8.5 / 9 / 8.5
WEEK 4: Stay on 8.5mg to stabilise and monitor for new pain. Then start the next .5mg reduction the same way.

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Oh thank you, thank you!

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