Spliting prednazone dose? | Arthritis Information

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I have been recently diagnosed with a severe case of RA.  I have been on several different levels of Prednazone to control the pain since last summer.  This was used to control the pain as my pcp then the RH doc verified that I was suffering from RA. 

By exprimentation I have found that splitting the pred dosage, (currently at 20 mg per day), into 10 mg. taken at about 4 am and 10 mg. taken at 2pm I am reasonably comfortable all day.

My RA doc started me  off on methatroxate at 10 mg. once a week (along with the folic acid on the other days) three weeks ago.  Keeping me on the 20 mg. of prednazone to control the pain.  However, he ask me to take the prednazone in one dose as he said it was less damaging this way. I tried this for three weeks and was in misery from 6am (when I took the pred) to about 2pm when the pred became effective.  This cycle repeated every day.

I switched back to the split dose 2 days ago and now again have much less pain all day.  I have been unable to find any info about this on the net.  Has anyone else experienced this?

Thankyou.

I found this on Arthritis.ca : "Take exactly the amount prescribed by your doctor. Usually prednisone works best when you take the complete daily dose in the morning, although you can split the dosage if the benefits don't seem to last a full 24 hours. If you find that a half-dose at dinner gives you an unwelcome 'buzz' or causes insomnia, try taking it at lunch time."

Lynk39054.5624652778I don't know what to do my doctor called me friday and told me I have to go off of the predisone because it is raising my bllod sugar. I hope he don't I know that I have relive at least four hours taking 10 nmg at 4 am by 9:00 I can feel it to wear off and I am tebblie pain. I was going to ask him to up it but now I don't know if he will cause he wants me off as soon a spossible I have been on it for 3 months. He try to ween me off 2 weeks ago and I thought i woyuld die from all the pain. I can not take any meds for RA because the 3 they tryed I had really bad side affects. But thats not everyone. Alot of people can take it with out any problems. So I wish you luck I would split it to if I was on 20mg.

Hi Ketch,

There have been times when I have split my prednisone dosage, and it didn't seem to be a problem with my rd.  I'm not sure what was meant by the prednisone beeing more damaging taking it more than once a day...wonder why?  But I do hope that you are feeling beter soon.

I think if you split the dosage it stays at a constant level in your
body. While this might feel good, it makes it harder for your
body to take over hormone production when you come off the
prednisone.

Ketch, my question is why he is keeping you at 20 mg Prednisone and only 10 mg of MTX. The MTX level is usually higher than the Prednisone except right in the beginning when they are trying to control the pain.

I would go back and ask if your MTX can be increased. Then, he should start tapering you from the 20 mg. If you have been on it awhile, you might have to do this as slow as 1 mg a month in order to avoid flares.. If not, he can take you down faster.

For pain control, he should have added something like Mobic or Celebrex which are anti-inflammatories. If those don't work, then other pain killers might be in order.

But staying at 20 mg for any length of time is going to destroy your body, especially your bones. So be sure to ask lots of questions.

Joan, your problem is similar but the reason for getting off prednisone is very important because they do not want you do develop Diabetes. Again, ask about the other meds that I mentioned above. If you cannot take RA meds, and 3 is a small list in this game, then you might want to consider pain management. But you have to ditch the prednisone. RA and Diabetes together are just too dangerous.

You might be able to bargin during the weaning process with testing your blood sugar. It's a terrible dilemna to be in. I really have to get down off mine. I'm at 12 down from 20 and I wish I never had got that high because it is so hard to get off.

Side benefit (beside getting away from this poison) is that you might loss the Pred weight. I've been losing a little since dropping down.

But I understand about the pain. But remember, Prednisone is for inflammation not pain control. If you can switch that thinking, it makes it easier because then you can focus on other medications and therapies that help with the pain.

 I  take   standerdised  tumeric  which  helps  so I    am  able  to  keep  the  prednisone   low  and  the  doc  did not  have  a problem  with me  using  tumeric I  told  him  I  take  it  and  he  said  does  it  help?      and  I  said  yes   so  he  was  like  ok..

 now  granted  when ya  mention  herbs    most  docs  look  at ya  like  huh?    because  they really  do not  know  anything  about    them  besides  the  meds  they write  scripts   for.

I very much want to thank all for the  advise.  I found the Canadian site where they mentioned splitting the prednizone dosage into 2 parts if the effect does not last the full 24 hours.  (This was my problem.)

The RA hit me so hard and so fast the RH doc is scrambling to get the problem under control.  I will see him next weds. and will tactfully discuss with him the many valuable suggestions you all have made.
Thanks

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