Reducing prednisolone

[Mistyscot]

I have been on prednisolone for about 6 weeks and when I try and cut down from 15mg to 12and half I wake up in the middle of the night all sore again

so back up to 15mg and starting to feel a bit better but the last few weeks even with 15 mg never pain free is it ok to up the dose to 17 and half or 20 mg without saying to the doctor as im going on holiday next week and don't wan to be in any pain

thanks Jan

[Celtic PMRGCAuk volunteer]

Jan, very few of us become totally "pain-free" on our steroid starting dose. Only a very few lucky patients have complete resolution in their pain at this stage. We can usually expect around a 70% improvement within a few days, sometimes within hours.

You haven't said how you responded to the 15mg starting dose initially - it could just be that you needed to remain on that dose a little longer before reducing, and reducing by 1mg in the first instance may have proved more successful. Perhaps now that you are back on 15mg you will continue to improve.

Some patients do find they need a slightly higher starting dose to get things under control, for instance a higher dose is often considered necessary for someone who is overweight. But I don't think you should increase your dose without mentioning it to your GP.

I do hope that helps and hope things improve so that you can enjoy your holiday. With the stress of travelling etc involved, it may be wise not to consider any further reductions until you return home.

[Mistyscot in reply to Celtic]

Thanks Celtic

I will stay on 15mg and not put it up to I talk to my GP

when I started on 15mg I felt better for a few weeks but over done it and felt sore again ......... but when im on 15mg i feel pain free most days just when I cut down get so painful

Jans

[Celtic PMRGCAuk volunteer in reply to Mistyscot]

Oh dear, Jan, it sounds like so many of us who have fallen into the trap of overdoing things just 'cos we feel so much better. It's a hard lesson to learn but a very important one - we have to accept that we have a long term inflammatory condition and the steroids are not curing anything, they are just damping down the inflammation that causes the pain. Our muscles become intolerant of exercise and if we overdo things they will rebel. So be kind to yourself and then when you feel back on an even keel again on 15mg, perhaps just try reducing to 14mg in the first instance next time around.

[Rose54]

Hi Jan

As Celtic says you need to give it time and not overdo things.

I was diagnosed in Aug 15 started on 15 in May got down to 10.5 had to go back to 12 and I am struggling to get down to 11.5 .

Pace yourself on holiday try to get a good nights sleep and don't try to do too much

Hope you have a lovely holiday best wishes

Rose

[CJ-pmr15]

Hi

just in case this helps, but I also was not pain free on 15 mg and my GP would not let me increase to 20 mg. However, I noticed that after taking my pred at 7am I did get pain free from late afternoon onwards. I therefore tried splitting the dose. Took 8 mg in the evening about 7pm and 7 mg in the morning. This made a miraculous difference and am pretty much pain free most of the time. I don't have difficulties sleeping (which is why pred is recommended to be taken in the morning), so twice a day works for me. Just a suggestion to try rather than increasing dose.

[Sheribrim]

You have done exactly as I would, increase slowly until you feel pain free but more importantly you should, in my opinion, reduce slowly too. I only go down by 1 mg a month say 15 mg to 14mgand although it takes time it seems to work for me.dont rush it or you are back to square one.

Hope this helps.

[Mistyscot]

Thanks everyone for replying . the next few days will be pretty busy as my daughter prom tomorrow and hairdresser pick her up at 11.30 and Friday dropping my dog of at my son in Kent so a four hour round trip before I go on Holiday Sunday and I will relax on holiday