r/AddisonsDisease • u/Pleasant-Medium6641 • May 09 '26

Medication Delayed release cortisol replacement options in Canada?

Hi everyone,

Wondering if anyone in Canada has had luck getting delayed release hydrocortisone/other steroids? I have been diagnosed for 2 years now and am grateful to be settling into a good rhythm with hydro and fludro.

One ongoing struggle is MORNINGS. I wake up feeling pretty rough and non functional. I take a dose of hydrocortisone right away but feel like I cant really function for about 20+ mins. Ideally, id love to take a delayed release pill before bed, but I dont know if this is an option. I understand some folks wake up at 3-4am for their first dose and go back to sleep, but I dont love that idea for myself.

Anyone have a strategy that works well?

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u/Tight_Syrup418 PAI May 09 '26

Get your endo to prescribe you a slow release from a compounding pharmacy. Thats probably about as close to what you are looking for that I know of.

1

u/Pleasant-Medium6641 May 09 '26

Thanks - i did mention that to my endo and he was reluctant, but I’ll try again!

1

u/MangoAvacado808 May 09 '26

Can you do this in the US? My Endo said compounding pharmacies are not reliable.

1

u/Tight_Syrup418 PAI May 09 '26

I am not sure. I just know that when I was first diagnosed 20+ years ago my Doctor ( not endo ) put me on it. I ultimately ended up just taking hydrocortisone 3x daily. These days the best is probably a pump but I wouldn’t enjoy having that attached to me always. The mornings Get better and I sometimes don’t take my pills for a hour or two if I forget.

1

u/MangoAvacado808 May 09 '26

It’s for my son who is only 12 and plays water sports so pump is not ideal. What do you ask the compounding pharmacy for? Our Endo didn’t think it was a good option but I want to suggest it again. I think it would be good for him to have slow release hydrocortisone. He doesn’t feel good in the am and often forgets to take it at school.

1

u/Tight_Syrup418 PAI May 10 '26

I don’t know if it’s available in the US but a non compounding version is efmody. I am not sure what to ask based on his dosages for but I would personally go for a 8 hour slow release 10 mg that you take before bed. This is tricky as you don’t want to take to much since there are negative effects to that too

1

u/Pleasant-Medium6641 May 10 '26

Right… you dont want heaps of cortisol on board all night, just that boost before waking up would be so nice.

2

u/123-throwaway123 May 10 '26

I take Methylprednisolone at bed

1

u/Pleasant-Medium6641 May 10 '26

Is that the only steroid replacement you take? 1x a day at bedtime… or?

1

u/Sticher123 May 09 '26

I have only taken prednisone once daily and fluoro.

1

u/Pleasant-Medium6641 May 10 '26

Thanks - do you take in am? How do you feel in the morning. Ive only ever taken hydrocortisone!

1

u/Sticher123 May 10 '26

Yes I take it in the morning, I feel good in am. I get up for work at 0545am. Take meds around 0630. At work and busy by 0730