Prednisone stops working at night????

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janettzi
Regular Member


Date Joined Jul 2009
Total Posts : 23
   Posted 7/12/2009 2:28 PM (GMT -6)   
 
 
Hi all,

I mentioned this in another post, but I think it was a little off topic there. I began severely flaring around 6/25 and have been on 60mg prednisone for 6 days now. I guess overall I am much better, during the day I feel reasonably good. The problem is, the pred stops working around midnite and then the frequent, painful and bloody trips begin--up to 15 over a few hours. Things seem settle down again around 7 am. Its such a drastic change in how I feel, I am wondering if this has something to do with the half life of the drug or something. I am also wondering if any of you split the dose up over the day--could it just be a matter of timing that will help maintain the continued relief?  I am soo exhausted from these horrible nites. I know that you have to take the drug as directed, so I didnt want to start experimenting on my own, but was wondering if any of you had experienced this and had found breaking the dose over the course of the day useful.
Thanks!!!

Post Edited (gonnaworkthruthis) : 7/12/2009 6:13:32 PM (GMT-6)


jujub
Forum Moderator


Date Joined Mar 2003
Total Posts : 10407
   Posted 7/12/2009 2:31 PM (GMT -6)   
It's certainly okay to split the dosage. Generally we take pred in the morning because this mimics when the body releases natural cortisol, and it also helps with the insomnia some get from pred. But it's perfectly okay to take 30/30.
Judy
 
Ulcerative colitis forum co-moderator
 
Moderate to severe left-sided UC diagnosed 2001.
Flared for 5 years, finally in remission with Remicade since March 2006.
Avascular necrosis in both shoulders is my "forever" gift from steroids.
Colazal,  Remicade, Nature's Way Primadophilus Reuteri. 
"My life is an ongoing medical adventure"
 


pam222
Veteran Member


Date Joined Jun 2009
Total Posts : 985
   Posted 7/12/2009 3:16 PM (GMT -6)   
I split mine because that's how my GI wanted me to do it because I was always worst at night/early mornings. The energy/staying awake at night is just about the only side effect I don't get from the Pred, so it never bothered me to do it that way. I do get bad night sweats from it, though.
26 year old female
Diagnosed with unspecified UC 11/08 by flex. sig. as I was pregnant at the time and did not want to be put under for a colonoscopy
Breastfeeding my baby boy (born 4/8/09)
10 mg Prednisone AM, 10 mg PM (tapering from 60mg a day)
Started Remicade 6/11/09 (2 infusions so far)
Was on Asacol (2400mg or 3600mg a day) for 6 months with no success


janettzi
Regular Member


Date Joined Jul 2009
Total Posts : 23
   Posted 7/12/2009 10:30 PM (GMT -6)   
Thanks, ladies. Ill give my doc a call tomorrow. Pam, congratulations on your baby boy!


Twirlygirly
New Member


Date Joined Jul 2009
Total Posts : 5
   Posted 7/12/2009 11:53 PM (GMT -6)   
I've had nowhere near the amount of issues you've had in the night; you're very brave. But I have noticed that while I'm on prednisone I am fine during the day and then I have more diarrhea during the night.

glamourgirl
Regular Member


Date Joined Apr 2008
Total Posts : 460
   Posted 7/13/2009 7:05 AM (GMT -6)   
I've gone so far as to split my dose to 4x a day. My doctor thought I was crazy but I really felt like it worked best for me when I kept it even in my system. You should definitely try it, I bet you'll start feeling better at night.
Female, Age 38
Diagnosed w/c.diff 7/02 when pregnant w/1st and only child during 2nd trimester(wasn't on antibiotics)
C.diff flare within weeks of delivering baby 1/03, Diagnosed with UC 2/03
Current Meds:
Lialda, 6MP
Ferrex Forte
Acidophillus, Sacchromyces Boulardii, Oil of Oregano


pam222
Veteran Member


Date Joined Jun 2009
Total Posts : 985
   Posted 7/13/2009 7:44 AM (GMT -6)   
gonnaworkthruthis said...
Thanks, ladies. Ill give my doc a call tomorrow. Pam, congratulations on your baby boy!

thanks :)
26 year old female
Diagnosed with unspecified UC 11/08 by flex. sig. as I was pregnant at the time and did not want to be put under for a colonoscopy
Breastfeeding my baby boy (born 4/8/09)
10 mg Prednisone AM, 10 mg PM (tapering from 60mg a day)
Started Remicade 6/11/09 (2 infusions so far)
Was on Asacol (2400mg or 3600mg a day) for 6 months with no success


fruitgirl
Veteran Member


Date Joined Feb 2009
Total Posts : 7150
   Posted 7/13/2009 9:51 AM (GMT -6)   
My doc had me split my dose. When I was on 40 mg, I took 10 mg 4 times during the day (so breakfast, lunch, dinner, bedtime). When I dropped to 30 mg, I took 10 mg 3 times during the day, and dropped the bedtime dose, and so on and so forth. It seemed to work really well, as I was able to taper off without any problems. However, some people on here thought it was a nutso plan, but whatever!
Status: Remission since late May 2009!
Symptoms began in November 2008, ~4 weeks after giving birth to my son.
Diagnosed with pancolitis on 1/30/09
Currently taking Apriso (4 pills ONCE!! daily), Rowasa twice weekly, Natural Factors Ultimate probiotic 12/12 Formula, and Zoloft (25 mg).


AmyWaffle
Regular Member


Date Joined Jun 2009
Total Posts : 173
   Posted 7/13/2009 10:35 AM (GMT -6)   
My pred usually is prescribed to be split when it is at the 60 dose, 30 7am, 30 5 pm. But I often would still be very bad at night, like you are describing. I have often sat in the bathroom watching the clock, counting the minutes until 7 am so I can take my next dose! It just takes time I guess to heal up. best of luck.
UC since 1996 (age 20)
Mommy of 2 sweet little girls.
My life is one big flare.

Asacol, Azathioprine, Prednisone, Rowasa
First Remicade 6/22/09


janettzi
Regular Member


Date Joined Jul 2009
Total Posts : 23
   Posted 7/13/2009 10:45 AM (GMT -6)   
Thanks, ladies. Yes, I have had two theories-- 1) that the prednisone wears off at nite, hence the question of this post and splitting the dose or 2) the prednisone itself is working on my stomach at nite and causing me problems.

Last nite I decided to keep food in my stomach as much as possible. I kept eating (small amounts) like every two hours. It seemed to be workiing kinda well, and I hadnt made a lot of trips as the nite wore on. I fell asleep, however, around 3:30 am. (after having eaten at 2:15) and then , the fun began again. It was probably 11 trips before 9 am, each one increasingly more nausea, pain, blood. When I got up, my mother gave me a Prilosec (which is what she was told to take with her pred--but he hadnt mentioned it to me). This caused me lots of dry heaves.
Again, things cleared up again around 11 am. Thank God. So its really confusing. My doc told me to take the Prilosec in the a.m. and Zantac before bed. Will try that tonite. If it doesnt work, Im gonna be admitted tomorrow, cause its been a week on pred with these probs.
Unfortunately I took all 60 mg pred at once this a.m., I wish I had read your responses sooner!!!!
Still appreciate your input, though. ;)

Post Edited (gonnaworkthruthis) : 7/13/2009 10:41:29 PM (GMT-6)


Probiotic
Veteran Member


Date Joined Mar 2007
Total Posts : 2832
   Posted 7/13/2009 1:36 PM (GMT -6)   
As far as the body's natural cycle of cortisol production goes, my understanding is that it is lowest around bedtime and it then builds up gradually to a peak at around wakeup time, and then reduces again to the low at bedtime- so it seems to me that many GI's oversimplify this with their advice that  'wakeup is when you need all the cortisone' when in fact you need to start getting it again during the night.  I also suffer badly if I don't split my dose.  If one is wired up to cortisol infusions in a hospital, they do have it coming pretty evenly all day long, in fact.  Prednisone can take a few hours to metabolize fully into cortisone, to boot, further strengthening the idea of a split dose- ideally a booster at bedtime if one were to do twice a day- just my two cents.
Pancolitis >20 years, allergic to all 5ASAs
(To pharma: enough already with the umpteen variants of Asacol!)
Tried everything under the sun (natural and alternative), low carb SCD
Some partial success with TSO but  too expensive to keep up 
Remicade Humira, lots of probiotics, entocort, tapering increasing pred again,
homemade fecal infusions, maybe surgery this year soon
 
 

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