Pred reduction question

[David_H]

Hi all, I've been on Pred now for 4 months (started daily dosage 15mg for 5 weeks, 12mg for 3, 10mg for 3 and now on 6th week on 9mg. Since being on the 9mg I have arm, neck and some leg pain most of the day. Although I have the pain it is very manageable but also very annoying and sometimes tiring.

I guess I should have stayed on 10mg for much longer and I could return to this dosage but I've also just started taking Alendronic Acid for Osteoporosis (GP reckons it was just there and not caused by Pred as not been on it long enough) so I'm loathe to up the Pred dosage due to this.

Would it be better to up my Pred dosage or put up with the discomfort to 'save my bones'? Would a 10mg dosage cause much more of a problem for my bones than, say 9mg over a period of time (which by all accounts could be a year or two or more)?

[DorsetLady PMRGCAuk volunteer]

Hi David,

Sure you will get many more responses, but my initial advice would be, if you are getting pain in arm, neck and legs then the dosage you are on is not enough! And if the dosage of Pred is not keeping you pain-free, or almost pain-free, then there's no point being on it because you are getting the side effects but no benefit.

If you are in pain then that indicates that the inflammation is not under control, and left like that it may become a much more serious problem.

Go back up to a level where you were comfortable, and stay there for a while.

If you have read other posts you will be aware that it is not a race to get to zero (no matter what the medical profession says) it's about getting to the lowest dose your body can be pain-free, and that varies from person to person. Not an exact science I fear. Good luck.

[Celtic PMRGCAuk volunteer]

David

The risk of "putting up with the discomfort to save your bones" is that the inflammation could get much worse which could mean increasing back to your starting dose or even higher, eventually leading to a higher cumulative dose. Far better to increase to 10mg as soon as possible and hope that is sufficient to settle your returning symptoms. In the meantime, your bones should be protected by the medication you have been prescribed due to osteoporosis.

Meanwhile, including plenty of oily fish, and calcium from yoghurt, milk, cheese etc, plus ensuring you have a daily walk will also help to protect your bones.

[PMRpro Ambassador]

1mg won't save your bones - and it will leave you at risk of other problems if it allows the inflammation to resurface as it does damage too. There is no point at all in taking a pred dose that isn't controlling the inflammation - all you get then is downsides with no benefits to balance them out.

I can only repeat what the other two have said - go back to 10mg.