Prednisolone dosage for AS flare-any advice?

[Andstretch]

Hi. I'm in between biologic meds for ankylosing spondylitis - off Cosentyx and starting on lxzicinumab, but a delay has left me really struggling. I have Prednisolone 5mg tablets from my rheumatologist for flares, to be used as and when needed, and they are sadly very much needed now! My problem is that l use the steroids so cautiously that l have forgotten the suggested dosage. I have 2 a day for two weeks then 1 a day for two weeks in my head? Anyone out there who could offer any advice? Have tried unsuccessfully for two days to get through to Rheumatology Department and will of course continue to try for concrete information, but any help/advice would be hugely appreciated! Thanks in advance!!

[Lolabridge]

Sorry I don’t know so you really will have to contact your Rheumy team.

[Andstretch in reply to Lolabridge]

Thanks for taking the time to reply Lolabridge. I think you may be right - another morning of redialing ahoy! Wish me luck!!

[Mmrr]

We are all different with the dosages of meds we need, and I'm not advising you, just saying what I've been told to do.I've upped my daily prednisilone from 6 to 10 mgs a day for one week to deal with a flare, now on 7.5 for a few days before dropping back to my normal daily dose of 6.

[Andstretch in reply to Mmrr]

Thanks for your input Mmrr, much appreciated.

[nomoreheels]

I wonder, if they were first prescribed as & when needed & you have that particular formula in your head is there any chance it was written as so on the Pharmacy direction label on the box? Or, if you have a copy of the report your GP is sent from the time you had the appointment, when the pred was prescribed, it may have been noted there?

As an aside going from 10mg daily to 5mg daily seems fine but then to stop when on 5mg seems abrupt. As an example I am in the process of having had an increase to see if it brings better control but when I start to I've to taper in 1mg reductions.

Failing all that persevere with trying to get hold of your Rheumy team. If you have no response contact the secretary who works for your Rheumy.

[Andstretch in reply to nomoreheels]

Thanks nomoreheels, and what a great username! 😄 Sadly the pharmacy label simply says four tablets daily - l recall my consultant telling me to ignore that, she'd just put that down so l'd receive a good number of tablets. The specialist nurse line is unfortunately not open today, but l shall be on it at 9.30 promt tomorrow and, if necessary, Friday too! I did take a short, two week course of steroids last summer on the specialist nurse's advice,and that was definitely two tablets for two weeks and then one for two weeks, but the rheumatologist 's advice was a month long and a higher starting dose l think 🤔

[Pinegap]

I have psoriatic arthritis and have followed the same biologic pathway. I switched to ixzicinumab 9 months ago. It takes at least 3 to 4 months to kick in but I found it a far more effective treatment.

[Andstretch in reply to Pinegap]

Oh that's good to hear Pinegap. So glad it's working out for you, and l hope to see similar good results from it too.

[Amb1xkr]

Hi I also have ankylosis spondylitis diagnosed a year ago and was on 15 mg steroids for months and had to decrease slowly. I have had short bursts in the past before being diagnosed for a week or two and told no need to taper after those. Hope you can get in touch with Rheumatologist. I’m on Methotrexate and waiting for another drug as now active in spine and pelvis 🙁 feeling depressed.

[Andstretch in reply to Amb1xkr]

Thanks for your input Amb1xkr. So sorry to hear that you're feeling down, it can seem like a long road ahead with a diagnosis of AS, but the treatments are improving all the time and l'm sure they'll find the right one for you - honestly, there is a light at the end of this dreary old tunnel! I was beginning to feel a little defeated myself, but today has been a very good one😁 steroids are beginning to work their 'magic' and l got through to the specialist nurses and the steroid dosage is fine, l'm to continue with my pneumonia, Covid and flu vaccines all booked for next week and my Ixzicinumab prescription is ready for signature so treatment should begin in around three weeks! I wish you luck with all your further treatments, and if you ever have any questions l'd be happy to help if l can.

[Amb1xkr in reply to Andstretch]

Thank you. Glad you got sorted.🙂

[JenHasRA]

Arg. Sorry. Know the feeling. I believe I need to take as much Prednisone as it takes to stop my symptoms. Because symptoms = damage. So during flares I may take 5 in the AM and 5 again during the day if the symptoms are not 90% gone. Typically during a flare it is at night that I notice I am in too much pain to lay on a bed or fall asleep. Hah. If I notice I am taking 10 a day for two days, I take 10 in the morning the next day. Then I go back to 5 in the morning the next day. I have read and believe that it works best in the AM, so that is when I want to take the level I need. I try to get back down to the 5 ASAP. And then off ASAP. Sigh. My last flare up led to a med change so I've been doing 10 a day as I switch meds. Getting back off Prednisone - Ugh. Another discussion. Flare ups. The name of my autobiography.

[Andstretch in reply to JenHasRA]

Thanks for that JenHasRA. I too have the damage that may be being done during a flare firmly in mind when deciding whether to start a course of Prednisolone! No prizes for struggling on, and sometimes a short course is really the only option.