Changing from Hydrocortisone to Prednisolone

[member_47913]

My first post. It is only a year since my Pituitary Mass was removed and so far so good but I have gained 2.5 stone on hydrocortisone. Last week this was changed to Prednisolone and I am so tired all the time with no energy. Hydrocortisone 10-5-5. Prednisolone 4mg in the morning. Is it normal to feel so out of sorts changing tablets? I have talked to the Endocrine Nurse who was very helpful. My hospital does not have an Endocrine Nurse and the GP will give me an appointment in 4 weeks! Would be good to hear other views. Many thanks.

[Mgh]

Sorry, I have no experience of prednisolone but I have a question! Have your other hormone levels been checked? For example, if you are hypothyroid that could lead to tiredness and weight gain. Hopefully, you see a good specialist endocrinologist with an interest in working with you so you can get a better balance of medications to help you achieve an improved outcome. Wishing you well and hope there is someone out there who can share their pred experience.

[member_47913]

Mgh. Many thanks for your reply. Thankfully I find the Endo at The Foundation very helpful but it would be good to find someone who shares these reactions. All my results after a day of taking bloods are within acceptable ranges so no definite problem. I just wish I had an endocrine consultant I could talk to after trying for years to be diagnosed, having the operation and then being left in limbo to find the answers myself. It has been a great help reading other posts and finding I am not alone. 5 years ago I had Lung Cancer and the whole experience was so different with so much support from the Hospital for the whole journey. The Pituitary Foundation has been so helpful with its informative leaflets.

[member_41389]

Hi
Like mgh I've no experience of prednisolone directly. However I've found the CAHisus site helpful (GOSH endocrinologist run) and this in particular https://www.cahisus.co.uk/pdf/CIRCADIAN%20DOSING%20ADDISON'S.pdf.
The key differences between hydrocortisone are the time for the dose to peak and the duration of activity. Hydrocortisone and prednisolone are different beasts and need a bit of work to optimise. With hydrocortisone I've found little and often works better than the standard 10-5-5 and over the years have evolved to 6 doses a day (mainly because I kept waking at 4 am with the shakes) so I don't try and stretch doses beyond about 5hours apart (longest is bedtime to 4am). My endocrinologist accepts my routine with a wry grin but hasn't objected and I found it has the benefit of persuading the hospital to allow me to self-medicate as their drug round can't accommodate the routine!!
All the best
Tim