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Does Prednisone effect increase after 4 or 5 days?
Polymyalgia Rheumatica (PMR) | Last Active: Nov 16, 2023 | Replies (7)Comment receiving replies
The benefits of the meds definitely increased for me over a week or two. I recall complaining to my doctor after the first week that pain had only decreased by about 70%. She said I may have to put up with that.
In the second week after reading here that a split dose can help, I split the dose (then 12.5mg a day) to take 10mg in the morning and 2.5mg in the evening to help with the morning pain. It worked, my morning pain reduced to about 90% pain control on week two, and that has now improved to 95%+.
Doctors who say a split dose is okay also say the majority of the dose should still be taken in the morning with a smaller dose only at night. This has to do with reducing the risk for adrenal insufficiency later on, which can be caused partly by taking too much prednisone in the evening, a time when your body would not normally produce much cortisol.
I've maintained the split dose (current dose 7mg a day), and am taking 5mg in the morning and 2mg in the evening with dinner. I wake with no morning pain and only slight wrist/hand ache in the first week of each reduction.
Your pain relief may not come in the first few days, but it will come.
Replies to "The benefits of the meds definitely increased for me over a week or two. I recall..."
Have you tried switching back to taking your entire prednisone dose in the morning?
After I managed to get below 10 mg, I wasn't having that much morning PMR pain anymore. Granted, I was taking the biologic to be able to stay on that low of a prednisone dose. The biologic didn't interfere with my adrenal function like prednisone did.
At 7 mg of prednisone, I was more concerned about adrenal insufficiency based on the information I was getting from someone who had an adrenal crisis. I think taking the entire dose of prednisone in the context of adrenal insufficiency is important.
Your adrenals need to be nudged into producing cortisol again. This happens in the middle of the night when you sleep. Your cortisol level should be lowest in the middle of the night. The normal function of the circadian rhythm is for your cortisol level to gradually increase until you wake up.
If pain wakes you up then that is something else.
It just depends on how much PMR inflammation you have on 7 mg of prednisone. Hopefully your adrenals will sense a lower cortisol level in the middle of the night and produce some cortisol. If your PMR pain is controlled during the night, maybe taking your entire prednisone dose in the morning when you wake up would be better from an adrenal standpoint.
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Thanks for the reply - I will see this through for the next week and hope that the prednisone will increase my painless time. I am hoping to go painless eventually .
Jim - PMR newby