2nd 'rescue' course of prednisolone in 6 months for RA?

[lindyloo2018]

Hiya

my cons has finally said that the 3 week 15mg, 10mg, 5mg) course I did in november was not long enough, I could have told him that- it did not help much. however mtx now raised from 15 to 17.5 and hydroxy 200mg daily restarted 3 months ago. My hands are still bad but there are many things wrong with my hands, mostly inflammed and grossly thickened tendons so trigger fingers, swollen fingers and a thumb tendon that looks broken and/or trapped because I can't straighten my thumb.

anyway ra cons has now prescribed a 4 week course of pred (20mg, 15mg,10mg,5mg) in the hope that it will bring the swelling down in my fingers.

can anyone tell me if it's ok to take another 'rescue' course of prednisolone 6 months after I finished the last course ?

many thanks

[Amnesiac3637]

Hi lindylooo. Not terribly sure why you’re asking that question. If your consultant has prescribed another course of Pred then he/she is the only person you should listen to.

They are the experts, they do this day in, day out with thousands of patients so asking if anyone knows if it’s ok to have another rescue course is trying to get an answer from people who are not rheumatologists and therefore can’t advise you.

Sorry, don’t mean to be obstructive and I can understand your anxiety about your worsening condition but if you’re worried about an aspect of your care you should ask the medic who is caring for you. They have all your medical information and will do the best they can for you in your particular circumstances. I was a senior practice nurse and we never minded anyone asking what, why, when and how…………..hope you get some relief from your pain very soon.

[bpeal1]

Again we can’t give this advice. Assuming the prescribing doctor knew about the previous course they obviously thought it was ok. If they didn’t or if you still have concerns speak to a pharmacist.

[Gilliancheche]

I understand your concerns, I am on my first course of prednisolone and was so scared of even starting. I messaged someone I know who has taken them a few times just for some reassurance. After speaking to her I took the tablets. She advised to take them after breakfast and to avoid caffeine and alcohol while on the course. I'm sure you will be fine but if you need further reassurance your rheumatology team will offer support.

[virtualreality]

Hi   lindyloo2018 , it sounds like you're having a tough time getting the RA under control, sorry to hear how bad the symptoms are at the moment. While as a patient group we can't offer medical opinions on your treatment plan, what I can say is that I've been taking prednisolone for 2.5 years now continuously (and others on here a lot longer), and started at 30mg / day, so the doses you've been prescribed don't sound unusual to me. Is there anything in particular that worries you about taking another course of prednisolone? I know there's a lot of variation in how people are affected by it. Whatever you decide, I really hope you find a longer-term medication regime that controls your RA much better than it is at the moment.

[LillyBeagle]

Hi, I'm having the same at the moment very painful hands, arms and shoulders. Just taken first wk of 20mg, cutting down to 15mg this week. It took about 5days to really alleviate pain but has kicked in. 20mg is a relatively low dose and it is short term. Some people are on 40-60mg.I hope you get some respite soon.

[lindyloo2018 in reply to LillyBeagle]

Hi many thanks, sounds like the same rescue course (20,15,10,5) please could you tell me what other drugs you are taking at the moment ? are you taking sertraline and or hydroxy ?and is the pred working on your hands ? thank you soo much

[LillyBeagle]

I'm on Methotrexate and Tocilizamub biologic injections. I'm in my 9th year of taking the Toci injection and think it's not working like it should so have been having frequent painful flare ups. I had a steroid injection in March but only lasted 3mths. My hospital helpline haven't been at all responsive recently (when Medway Maritime RA Dept have always been very good). Hence GP issuing Preds to help with pain until my 6mthly appt with my specialist nurse next month. Hope you respond to treatment.

[PianoPlayer11]

hi Lindyloo2018. I’m sorry to hear you’re having a tough time. When I was first diagnosed with RA 10 years ago I started on prednisone and methotrexate . I was on prednisone for about 3 weeks until the mtx became affective. Over the years my mtx dose increased until I got to the maximum dose of 25 mgs. It worked well for me (mostly ) until recently when I’ve had to start on biologics. I m still taking 22.5 mgs of mtx. I feel very well with very little pain- so things do get better. Keep yourself informed and don’t be afraid to ask questions , but at the end of the day your medical team are the experts.

[lindyloo2018]

many thanks, which biologics are you taking? hope you are still playing the piano..

[Deeb1764]

I am always on prednisone BUT the ideal is when settled you are not but some of us need it due to medication not quite doing it all. Your consultant won’t be issuing it if they had concerns but worth always discussing with them if it becomes a constant part of medication too.