GP visit

[Dobermanlover]

Went to see my GP today about Pred reduction and quoted this site saying it is best to take things slowly. He would not give me any 2 1/2 mg tablets, but has left me on 30 mg for a further 2 weeks and then to decrease by 5 mg. Has confused me somewhat, as I would have thought it would be better to lower the dose than stay on it for a further 2 weeks. He was listing all the bad side effects of taking them, oh well I did try! I can't even split them as they are the red coated ones. I just hope my appointment comes through with the rheumy soon, maybe he will be more open to a slower reduction as decreasing by 5 mg was too much.

Thank you again everyone for your helpful comments.

[DorsetLady PMRGCAuk volunteer]

Hi Dobermanlover,

I can understand why GP has left you on 30mg for another couple of weeks, despite him listing the side effects!

When you come to reduce, you could try following plan, first week, five days @ 30mg, two days @ 25mg (not concurrent, say Mon & Thurs), the next week three days @ 30mg, four days @ 25mg, next week one day @ 30mg, six @ 25mg, one @ 30mg. 4th week - 25mg all week!

Hopefully by then you will have seen Rheumy and can discuss 2.5mg tabs. Take care.

[piglette]

I cannot believe that your GP won't give you 2.5mg tablets. He cannot expect you to cut down by 5mg at lower doses, so why not give them now, they are not exactly expensive drugs. In my opinion it is practicing bad medicine. You could try alternate days of 30mg and 25mg of course.

[Celtic PMRGCAuk volunteer]

Unhelpful GP! Some get upset at the feeling that they're being told what to do whereas others are happy to work with you.

However, taking 30mg for another couple of weeks is not a bad idea - I believe you were only on it for 3 weeks initially, whereas 4-6 weeks would be more in line with the recommended time for remaining on the starting dose.

If after the next couple of weeks your symptoms have improved and you feel ready, then I agree with the others about trying alternate days of 30 and 25 in order to achieve a smaller reduction in the absence of 2.5mg pills. Hopefully by that stage you will at least have a date for your rheumy appointment.

[Dobermanlover]

Thank you all for taking the time to reply to my post - I was feeling quite upset last night. Lying in bed last night, I too thought that I could alternate days of 30/25 the first week of reduction and then maybe 30 one day and 25 for 2 days, gradually increasing the 25 days rather than drop completely and fail again. This site really is a great help, can't thank you enough!

[jinasc]

What date where you diagnosed with PMR and started on 30mg?

Need to know what your start date was?

Have you kept a record of your blood tests ie ESR figure and CRP figure?

30mg is a high starter for PMR, is something else going on?

The enteric coated tablets are to protect your stomach - there maybe a good reason for prescribing then at this point in time.

[Dobermanlover in reply to jinasc]

I was diagnosed in late May - initially on 15 mg for 2 weeks,with a 1 day break in the middle (didn't think the diagnosis was right as hadn't responded well enough). Have now been on 30 mg for 4 weeks. Have only had 1 blood test and don't know what the readings were, I wasn't told, but am taking another one next week.

Yes, have to have the enteric coated tablets as had problem with taking anti-inflamataries for arthritic knees

[jinasc]

Got to either of these sites and read up on the guidelines issued by the British Society of Rheumatologists' Diagnosis and Treatment of PMR and Diagnosis and Treatment of GCA.

BSR website

NHS website

Patient.co.uk

PMR GCAuk

PMR GCA Scotland

PMR GCA North East Support.

Knowledge is power.

[Caro12line]

I have 5mg tabs but the pharmacy gave me a "pill cutter" with my last prescription as I am tapering by 2.5. The pill cutter is a green plastic thing with like a razor blade inside. Works very well.

[Dobermanlover]

will the pill cutter cut the red enteric coated ones?

[PMRpro Ambassador in reply to Dobermanlover]

You must not cut the red enteric coated form of pred - it exposes the inside so it is no longer enteric coated. I would suggest seeing another GP in the practice and requesting 2.5mg enteric coated pills, explaining why.

Or you could use this sort of technique

healthunlocked.com/pmrgcauk...

which people who cannot cut their tablets have been able to use to smooth the drop.