How much to increase ? - need to control a flare... - PMRGCAuk

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How much to increase ? - need to control a flare up

suzieh profile image
4 Replies

Have been on 5.5 mg since Dec; thought I was just about ok before Xmas but getting more uncomfortable by the day - had such a heavy feeling and all over soreness in limbs and hips. Took 7 mg on Sat and 7mg Sunday which helped. Tried 6.5 today but feel sore. What next? Stick at 7 each day then the slow reduction again?

I understand how to go down slowly but not really how to medicate for a flare up - advice please

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suzieh
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soojay profile image
soojay

Good morning,........road to nowhere! tough it out on Paracetamol or Naproxen[Dr. advice].Medication,I mean,not"tough it out".Takes weeks to adjust to lowering dosage.See previous posts for brill advice and lovely people.Hugs.Soo.God Bless.

optimist-ok profile image
optimist-ok

I don't know if this helps, but when I had a bad flare last August on 5mg a day, I was told to double the dose. I stayed on 10mg for 1 month, now reducing at 1mg a month. On 6mg at the moment. Fingers crossed! My Rheumatologist is happy with progress as it is now. I think my GP realises now that the blood tests aren't the sole thing to go on, it depends how you feel as well.

PMRpro profile image
PMRproAmbassador

The normal recommendation from top people is to go up to 5mg above where you are having trouble for a week or so or until the symptoms are under control again and then you should be able to reduce fairly quickly to the point where you had no problems before.

It shouldn't take weeks to adjust to lowering the dose - if it does it is more likely to be a flare - the most common cause of a flare is reducing too far or too fast. Half a mg is enough to take you from a dose that is controlling the symptoms to one that isn't - and staying on that dose for long enough will let the inflammation creep back up again and it will be even more difficult to control. Pain that starts quickly after a reduction and fades steadily over 2 to 3 weeks is probably steroid withdrawal, if it starts after a short time and gets worse with time it is far more likely to be a flare.

Naproxen is an NSAID (non-steroidal antiinflammatory drug) and should not be used regularly with pred - like most painkillers the odd dose probably won't hurt. I'm surprised at a doctor telling anyone to take one with pred.

suzieh profile image
suzieh

Thank you for all for good advice- really helps

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