Reducing from split dose - reduce night or morning?

I did evening…..

Gulp. I might have to face my fear and reduce .5mg from the evening dose this time. It has to go soon anyway. Thanks Tweety.

Here is your scientific answer. Night time might be best. Good luck. You have been at this way to long. :).
"A circadian rhythm is your body's internal 24-hour clock that regulates physical, mental, and behavioral changes, including the sleep-wake cycle, hormone release, and body temperature. This cycle is primarily influenced by light and darkness, which signal the brain's suprachiasmatic nucleus (SCN) to adjust bodily functions."

If you are more inclined to do evenings, then do evening. There is no set answer. Just breatheeeee. You’ve got this!

Thanks for the encouragement from you both. Have changed the weekly meds dispenser to evening reduction. Now I relax and get on with it. 🙂

I've split mine with good results. My rheumy doens't know why and keeps asking my why I don't take it all in one fell swoop in the AM. He seems to think if I take it at night it will interfere with my sleep but I always hit the pillow and am gone.

I don’t think it matters if you can go to sleep and stay asleep without waking up in the middle of the night with pain. I lost half of a night of sleep because of so much pain at 3 a.m.

A single dose all in the morning isn’t supposed to cause as much adrenal suppression . I’m not sure if that is true or not. I took moderately high doses of prednisone for such a long time that my endocrinologist expected my cortisol level to be low after 12 years on prednisone. She expected my adrenal function would be poor no matter if I split my dose or not. She added it would be better when I reached a low dose of prednisone to take it all in the morning. That might help me recover my adrenal function sooner.

Maybe I should try taking it all in the AM for a week and see whether there is any difference. I do wake up at 3 AM but that's just the bathroom trip. My shoulder does hurt in the middle of the night, come to think of it. I have been getting acupuncture for it and it's really helped. I also have my coffemaker set to go off at 4 AM, as I have gotten up early all my life. Then I sit in bed and have a strong mug of coffee along with an extra strength Tylenol and it really helps me get going for the day. Thanks for your share, I appreciate it.

Taking it all in the morning closely mimics your natural hormone release cycle. Many people think they need to even out the dose throughout the day based on the fact that the steroid dose packs have you take it that way. These are the packs that come 6 pills on day 1, 5 pills on day 2, 4 on day three, etc. Taking steroids evenly throughout the day is not mimicking your natural release of steroids. My best, Reader's Digest advise it to take the 1.5 mg in the morning so your body has the best chance of adjusting to a natural rhythm.

I'd agree with you at higher doses. With our body's normal cortisol production being the equivalent of around 5mg prednisone, I assume that at 2mg prednisone with no adrenal insufficiency symptoms like fatigue and lowered blood pressure, my own cortisol production has probably resumed.

Some people have flares even at this late stage so I want to avoid that. I was a bit twitchy about reducing the early evening dose because it has done so well so far at keeping morning pain away. I'm thinking now that that may not matter any more. Currently reducing .5mg from the 1mg early evening dose. Fingers crossed.