can it be right i am reducing by 5mg of predniso... - PMRGCAuk
can it be right i am reducing by 5mg of prednisolone a day is this right.?
What dosage did you start from and are you sure that those are your precise instructions? It really doesn't sound possible to me. I've reduced from 20mg to 1.5 in 30 months!
Anodomini can you explain to me about reductions please i am so think when it comes to understanding the reduction pattern,I was on 30mg in june and are now on 13mg,s as from last week now to day I have really bad withdrawal symptoms,had to take 14mg,s to day,but i need it explaining to me if you have the time, ritter Anne.
Annodomini did you reduce daily or monthly?wot sort of pattern did you use please,god i feel dreadful to day have been doing quite well, considering the speed i,v come down,hope you have the time to answer many thanks Anne ritter
80mg last wed for a week then this wed 70mg yesterday 60mg today 50mg tom 40mg and so on till stop. going to a neurologist soon. sorry I mean 10mg a day is it a quick fix?
I see your GP thinks you may have GCA and put you on 80mg pred and you are seeing a rheumy in the New Year - I think your GP should have tried to get you seen as an emergency rather than urgently (that means him phoning the hospital and sending you with a referral letter).
The Kirwan group in Bristol starts GCA patients on 60mg daily for 4 weeks on until remission induction (I presume by that it means until all symptoms have gone if it takes longer). They then reduce to 50mg for 4 weeks, 40 mg for 4 weeks, 30mg for 4 weeks, 20mg for 4 weeks and then reduce the same way as they do for PMR so that it takes them 6 months to go from 60mg to 15mg.
How long were you on 80mg and how far are you to go with the 5mg/day reduction? If it is to below 50mg I would ask him for further information. It may be he gave you the very high dose for a very short time to really attack the inflammation and is now aiming for a more usual dose for the longer term.
The Bristol advice is in the following review paper, aimed at GPs:
"Our approach to the diagnosis and treatment of polymyalgia rheumatica and giant cell (temporal) arteritis" by V Quick and JR Kirwan.
If you google that title you will get a link to the paper which is freely available online. YOu could print it off and take it to your doctor. It is fairly easy to read - and you will see they warn about reducing too far and too fast which can result in a return of the symptoms.
Do tell us how you get on.
Dusty, 80mg is a really high starting dose and if you are seeing him in three days then yes, he might well have instructed you to reduce that amount for the three days. I'd say he was being very cautious with you and doesn't want to risk your eyesight, but without a bit more detail it's difficult to judge.
The whole idea behind the Prednisolone reductions is to try and find the lowest dose on which you are comfortable, and he might want to continue this fast reduction for a few more days at this rate. On the very high doses this kind of reduction can be achieved in order to bring you down to a more comfortable dose. The problems might begin if he wants to continue this fast reduction once you are down to more comfortable levels.
I was posting at the same time - no, if that is what he is doing it is far too fast and you are at risk of the symptoms returning. It is a typical GP error to think they use pred in GCA and PMR they way it is used elsewhere and doing a rapid taper. The reduction must be slow and over a much longer period of time.
Back to the doc Dusty, preferably with a copy of that paper I gave in my first post - and if he is difficult, go to another GP if you can and to A&E if that is the last resort. He did well to decide to treat GCA aggressively - but he needs to do it correctly.
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"How Can It Be A PMR FLARE?" 
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