Forgot to take my pills this morning

More than likely ... the pain/stiffness is the result of missing your dose. I worried about doing that but PMR had a way of reminding me to take my prednisone whenever I forgot.

Sometimes I couldn't remember if I took my daily dose or not. I strongly recommend those weekly medication dosettes. I would lay out all my medications that I planned to take for the whole week on a Sunday. That way my dose would still be in the compartment of the dosette waiting for me to take it if I forgot.

I think a dosette is especially important when you taper Prednisone. People try all kinds of taper strategies by changing their dose every day. That is fine if it works for them but that just confused me. I couldn't remember what dose that I was supposed to take from one day to the next.

My rheumatologist emphasized a "stable dose" instead of a dose that changed every day. My day-to-day pain/stiffness varied slightly when I kept my daily dose the same for an entire week or several weeks. If I had a dramatic increase in pain in one day it was likely that I forgot a dose. If the pain/stiffness increased several days in a row, it was likely a flare since my dose wasn't changing every day.

My individual opinion - yes, it is from the missed meds. I've done this and have noticed a bad night/day that follows.

That's just my experience, my two cents. Take if for what it's worth.

Hope you feel better.

My dilemma about this issue is from a different perspective. Besides the pmr journey, I also have a Meniere's Disease diagnosis. At times, the vertigo, nausea, vomiting have left me unable to take pills. I take the prednisone as soon as I am able to keep some food down. The other pills take more thought as to whether to take them as soon as I am able or just 'miss that dose'.

Thank for everyone's replies. <3

Update: As you've suggeted, I'm pretty sure that All-Over High-Grade Ache with Shoulder Feature (TM) was the PMR resurfacing. It started to go away 2 hours post prednisone and is now gone. I never expected anything like that just because I was six hours late taking my dose. I know the half-life of prednisone is only four hours, but still, zero to 60 in six hours was quite something to experience.

This episode paints in stark relief exactly what the PMR pain is and where it is. As I've reported elsewhere, I have a couple of other leg issues that complicate my mobility. I've never really thought that the PMR affected my Lower Kinetic Chain (as the medical gurus call it) so much. But going on Prednisone and feeling an immense improvement, and now having this self-induced flare have convinced me that from hips to ankles, I've been affected.

I do have a pillbox / med minder, but for some inexplicable reason I had not added the P to my other daily morning pills. I now have done so.

I forgot once a few weeks ago. I take every morning between 9 and 10. And honestly, I didn't feel bad most of the day, until about 7 pm. Then I realized I missed the dose. I held back until the next day. Probably not smart but it seemed ok. I had a bit more restless sleep than usual, and jumped back into it the next day.

That led me to say maybe I can taper. Dropped it only by 1 mg. After a day, the symptoms started coming back. So I went back to where I was (13). And have been there since.

That all was after my second dose of Kevzara, FYI.

Probably a combination of the missed meds and the activity from the day before. Anyone with a phone can set a daily alarm to remember to take meds.

@p0rtia

Some people say a "new batch of inflammation" happens every night. That might be true but the timing coincides with the approximate time when an a.m. dose of Prednisone wears off in the middle of the night because of its half life.

Some people metabolize Prednisone slower than other people. The lucky people who metabolize Prednisone slower might be able to get a full 24 hours of pain relief from a single morning dose of Prednisone but some people don't get 24 hours of pain relief. Prednisone has a rapid onset and short half-life, clearing your system in roughly 16 to 22 hours. Fortunately the rapid onset of prednisone is a quick fix for the problem of increasing inflammation levels whenever it happens.

As you probably have learned the inflammation comes back as soon as prednisone is eliminated from the body. The circadian rhythm is a characteristic of cortisol from the adrenals in the body and not a characteristic of oral Prednisone.