40 vs 40+

From what my Drs have told me the convention is there is bog all benefit from taking more than 40mg pred during an accute attack unless you have a specific absorbtion problem. Yet a non-AUK friend is always given 60 during an accute attack by her GP and she has no problems with steriod levels etc. Why is it some places just say double your pred to 60, 80 and even 100 when there is no evidence to say it is makes things any better any quicker and just compounds the problems and slows the weening off.

Bex

8 Replies

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  • Hi Bex,

    I never now take any more than 40mg of pred.

    Had a few times in the past taken 60mg but made me feel so peeed off that I refuse - didn't make any difference to me anyway. Had IV infusions of hydro which made me bounce off the walls for days.

    I suupose if it has been proven that you need gallons of it because you have a low absorbtion rate it may be OK but does that then increase the side effects.

    Don't really know if there is a proven cut off point!

    Kate

  • Bex thats Robs opionion aswell they never use over 40mgs yet my local always put me upto 60mgs even thouugh i tell em time and time again that theres no evidence to suggest anymore is any better?

    Andrea xx

  • Bex

    In my ten years experience it always seems to start at 40mgs re acute exacerbations.

    40mgs seems to be a minimum starting dose, whatever your weight, severity of symptoms, etc. A family member always starts with 40mg, different hospital, doc and region, and her asthma is compounded by adrenal problems as well.

    But there does seem to be difference re a variation in sliding dose, tapering dose etc re doctor and regional opinion.( Perhaps it all depends on which training course/conference jolly/medical school they -docs- last got updated.)

    Fine tuning only seems to happen when starting long term maintenance dose.

    Mia

  • must depend where you are cause aintree recomend 30mg from asthma nurse tho a and e and on ward use 40mg

  • When I read the title,I though this was an ""age"" battle with us go-getting 40+ ers going toe-to -toe with those whippersnapper 40 year olds!

    -*gets coat*

  • I've been on up to 90mg and i can't see that it's made a difference apart from affecting my thigh muscles so badly i had to use a stick it's taken me a year to recover and reduce. I don't have probs absorbing although it was thought at one point i did. It almost seems to be a sort of panic by the drs to do something not nothing. I saw the GP a couple of weeks ago as i had to have a tooth out and he instantly trebled my pred from 20 to 60mg to cover extraction ( I actually only took 50 as i thought it was a bit extreme)

    I do wonder if there is some guideline written somewhere for people with addisons?? or have been on long term pred that says just triple the dose if they're ill whatever the starting dose?

  • Bex checked with cons in clinic and yes this is his opinion too, although do know one patient on 60mgs day for 6yrs with little weight gain or side effects etc but has been diagnosed with super liver that excreates extra quickly therefore 60mgs to them is like a lot lower to others?

    Andrea xx

  • Bex checked with cons in clinic and yes this is his opinion too, although do know one patient on 60mgs day for 6yrs with little weight gain or side effects etc but has been diagnosed with super liver that excreates extra quickly therefore 60mgs to them is like a lot lower to others?

    Andrea xx

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