Crohn's Disease Forum » Treatment » Prednisone/Entocort » Split vs single dose per day

10-13-2013, 11:35 AM   #1
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Split vs single dose per day

I work in biotech. When my daughter was first diagnosed and put on prednesone she was taking 60 mg every morning. We noticed that her symptoms got worse late in the day. I asked the gastroenterologist if it wouldn't be better for her to take 30 mg in the morning and 30 mg 12 hours later. He agreed that would be better at maintaining a steady dose level. So we switched to that mode. Her symptoms improved and we began to taper down the dose and eventually go back to once a day. We were down to 10 mg once a day disaster stuck: she got a bad head cold which caused a bad flare up. She has been taking 30 mg twice per day, and eating liquid diet, but symptoms still bad. I am wondering whether taking the pred in a single dose is more effective!
10-15-2013, 05:27 PM   #2
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Not an expert in this area of splitting dosages for the day, but I'm not sure what significant difference it would make overall regarding effectiveness- splitting or non-splitting - if the dosage is still the same either way.

It sounds to me more like her total dosage for the day would need to be re-adjusted or the taper needs to be slower and that the doc needs to start discussing long term maintenance medication if they haven't already.

It's common in some people to try steroids, only for a flare to come back once the taper begins. Usually it is because the dosages need to be readjusted or a slower taper needs to occur...sometimes a few times. Rarely is it that the steroids just don't work at all for some people.

I hope you all can figure something out for your daughter!
Crohn's-Colitis May 2012
Current Meds:
6-MP (100mg) / Asacol (4800mg)
Past Meds:
Prednisone/ Entocort / Flagyl
Current Supplements:
B12 Shot (1cc/mo) / Multivitamin / Vitamin D (1000iu) / Calcium (1200mg) / Omega 3 Fish Oil (4800mg)
Additional Info:
Anemia/Borderline Anemia - whole life
Generalized Anxiety Disorder - 2009 (Cognitive Behavioral Therapy, mindfulness meditation)

Last edited by CrohnsChicago; 10-15-2013 at 05:50 PM.
10-16-2013, 04:45 AM   #3
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How long has she been back on 60mg (in two lots of 30mg) a day for?

Flaring up when down to 10mg is likely just because the dose was low rather than anything to do with splitting it or not splitting it.

Going back up to 60mg should help, but although prednisone works quickly it's not always that quick, so if she's just gone back to this dose it might just be taking a while to see the benefits.

If you still don't see improvement you'll probably need to ask the doctor why it's not working as it's unlikely that splitting the dose would be the reason.

(This is based on what my doctor told me when we discussed dosing - I'm assuming it's true for others taking pred, but of course can't guarantee that it is.)
10-16-2013, 09:05 AM   #4
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I agree with the others, my son was on Pred and we played around with the dosing schedule to combat insomnia. I can't say that the pred ever held my sons symptoms at bay, no matter the dose or the dosing schedule. His GI felt C got all the nasty side effects without any of the benefits pred usually provides.

Now although, the pred didn't alleviate his symptoms I like to think it kept things from progressing while waiting on Remicade approval. The first dose of Remicade rectified all my son's symptoms and we started tapering that day.

It may just be the dose being back at 60mg hasn't had enough time to tackle the flare. Was she given antibiotics when she was sick? Has she been checked for C-diff? Because I don't think C-diff would respond. I hope you have some answers soon.
Mom to
C age 19
dx March 2012 CD

CURRENT MEDS: MTX injections, Stelara

Dx May 2014: JSpA
8/2014 ileocecectomy
9/2017 G tube

PAST MEDS: remicade, oral mtx, humira

Last edited by Clash; 10-16-2013 at 03:42 PM.
10-16-2013, 11:09 AM   #5
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Clash, her stool just came back positive for C-Diff! Now she has a new health challenge. She is being given Vancomycin in the hospital, she says it is making her gut have more pain. She is only on IV fluids but I think she needs to be given a probiotic my mouth. If the antibiotics don't work I'll do some research on the poop pill.
10-16-2013, 03:44 PM   #6
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Ohhh soo sorry to hear she has C-diff. When I typed the previous message I was thinking I hope I don't jinx it by bringing up C-diff.

I hope she responds to the vancomycin quickly! Sending Hugs and Support your way!

Crohn's Disease Forum » Treatment » Prednisone/Entocort » Split vs single dose per day
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