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Addison's Disease Message Board


Addison's Disease Board Index


Why do the cortef dosing schedules differ so much depending on the endo? which dosing schedule is best to follow? My son is taking 10mg am 7 1/2 mg noon and 5 mg evening. I'm not sure why his endo said 7 1/2mg instead of 5 for the noon dose. I've read that cortef is an 8 hour drug. Are there any advantages to taking one am and one pm dose with 2/3 of the daily dose taken at the am and 1/3 taken at 5:00 pm? Or is the time day that important?
Most doctors try to mimmick the body's natural release of cortisol or should. If your body functions normally then you would have the most cortisol when you first get up and it will decline as the day goes on. So I guess that is why your doctor is tapering it like that. I started taking Cortef 3 days ago - 10 mg AM, 5 mg w/lunch, and 5 mg w/dinner. However, I haven't been able to go to sleep like I normally do and stay asleep so I am taking my later dose earlier and earlier. Today I am not going to take my evening dose at all to see how that goes.
Some better endos know how a normal body functions and try to mimic it. But then some endummies just say heck, lets just give a once a day long acting steroid not thinking about the consequences or give dosage instructions thinking of convenience, not the body.

There actually is a drug coming out soon - approved in England now I think - that is once a day dosing that will is taken once a day and will mimic the diurnal rhythm so people will have the natural rise and fall that they are supposed to have. It was developed for those that have congenital adrenal hyperplasia and for addison's and will help not keep us so overweight.

If you even look at the lab slip - you see high ranges for morning, and about half that for late afternoon - so dosages should be adjusted accordingly. If you read up - late night or midnight testing shows that normals are really low, hence why when people take doses later in the afternoon, it tends to interfere with sleep.





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