Which of the following describes the typical prednisone dosing pattern for starting therapy?

• A. Take one tablet in the morning and two tablets at night.
• B. Take three tablets in the morning only.
• C. Take two tablets in the morning and one at night.
• D. Take one tablet in the morning.

Answer: (C)

Glucocorticoid dosing follows the body's natural cortisol pattern: higher in the morning and lower later in the day. When starting prednisone, using divided doses helps maximize daytime anti-inflammatory effect while minimizing nighttime disruption and HPA-axis suppression. Taking two tablets in the morning provides the stronger daytime coverage, while a smaller dose at night maintains effect without a large nocturnal peak that could disturb sleep. This pattern balances symptom control with tolerability. Patterns that place all the medication in the morning miss evening coverage, and giving a dose at night can worsen sleep and circadian disruption.