Morning misery: Is prednisone effective 24 hrs? PMR and hands

I tried two times on the rec of my doc to take a single daily dose and they were both failures. So I end up with side effects AND PMR symptoms. The split dose has been the only solution for me.

You may want to take a look at the potential downside of split doses versus increasing the single morning dose as regards the possibility of unnecessarily provoking adrenal insufficiency with a split dose. Lots of pros and cons. Good luck !

Taking prednisone in excess of 5 mg per day increases the risk of secondary adrenal insufficiency.
https://www.endocrine-abstracts.org/ea/0037/ea0037ep46
The risk increases in proportion to dose and duration of treatment with prednisone. For people with PMR who are treated with long term prednisone --- adrenal insufficiency is almost a given.
https://www.endocrine-abstracts.org/ea/0056/ea0056p44

Does just putting up with soreness overcome adrenal insufficiency in time ? Ifyou can get by at 2 mg of prednisone should you just stay there until you have no symptoms ? Or just keep reducing dose regardless ?

Timing makes a big difference. You can try this. Works for me.
https://www.hcplive.com/view/nighttime-prednisone-could-address-morning-stiffness-ra

Excellent article. For some reason, a delayed-release formulation of prednisone is very expensive in the United States. I was told my insurance would never pay for it so I only took standard prednisone.

I could never taper off prednisone presumably because of adrenal suppression and low cortisol levels. This article explains this issue well so I highly recommend everyone to read it.

When I was tried on Actemra ... very expensive as well ... I was able to get off prednisone completely. Actemra doesn't interfere with cortisol levels.

I have it in my hands. It started in my arms,shoulders and left knee and hands after a few weeks. It was worse in the left side of my body.

Hi @camie16, Welcome to Connect. Sorry to hear you have PMR pain. How long have you had PMR? Can you share a little more about your diagnosis and treatment?

My hands (especially thumbs and wrists) were painful in the beginning, before diagnosis and prednisone Dec 2019. They are the last remnant of pain and stiffness after 4 years. I’m now on 3.5 mg prednisone. Yesterday, I didn’t take my prednisone until after some blood work in the morning. My hands were much worse, so I’m pretty sure it’s PMR.

When you take your dose at 6:30 pm, does it affect your sleep?