Flare or relapse at 10

I posted on diabetes and do not know if you will get this Pro so I will do it again reduced to 10 on September 24. My ESR on October 17 was 23 and on October 26 was 31. I know have a headache which I had before but did not recognize it as GCA headache. It is different. I recognize the other symptoms now with my body.Should I go back to 12.5 or higher. I was fine at 12.5 which I stayed on for a month. Then I alternated 12.5 and 10 for 10 days and finally went to 10 on September 24. If you recall I am the person scheduled for eye surgery November 30. That will not happen because I have to be at 10 for surgery. It is however more important to clear the inflammation in my arteries. What a shame things were going so well and I was doing this the slow correct way. Would appreciate your opinion. Thank you. Marilyn

7 Replies

  • Hi Marilyn,

    Sorry to hear about your setback. If you were okay at 12.5mg then you may be alright back at that dose again. Just try and see, you obviously don't want to increase more than necessary. If it doesn't work then you may have to consider a bit higher.

    As you're trying to reduce from 12.5mg to 10mg does than mean you don't have 1mg tablets? I think PMRpro said in a previous post about the 'not more than 10% reduction' . Well you're trying to reduce 20% - that may be too much for you.

    If you can't get get 1mg tablets, then try a slower reduction -

    1st week - 1 day at new dose,

    2nd week - 2 days new dose (not consecutive)

    3rd week - 3 days new dose,

    Increase days on new dose until you reach your goal. That way you you can pick up any problem, and stop or repeat previous week if necessary.

    As you say, shame about your operation, but you need to be right first, good luck.

  • I thought that the 2 1/2 mg would be OK until 10 and then I would go to the 10% but I see that it's not so. Will try your suggestion hope to hear from pro@ soon. Thanks for quick response.

  • This really is something to discuss with your doctors - but if you are getting increased symptoms you must go back up I'm afraid. And the ESR shows there is increasing inflammation.

    If 12.5mg manages the inflammation might the surgeon not consider making an exception? I wonder if having a depot injection might let you get the oral dose down for surgery - or would the surgeon fell that was still too much pred?

  • I have to play this by ear today is an entirely different day my headache is gone but my ears are still ringing again not badly. I might just wait for another blood test. How weird is this last week calcium 8.1 never low before naturally albunim low too as well as potassium. This week everything normal. Did increase potassium by taking two 99 mg tabs. It is strange calcium was nine before then 8.1 then 9 yesterday. Perhaps in seven days or so my sedimentation rate will come down. I think I might want to wait and see how I feel. Eye dr. might do surgery at 12.5. He is a big deal at Bascom Palmer not easy to get to. Rheumatologist didn't think I needed a shot At 10. Let's see what tomorrow brings perhaps I'll get lucky and said rate will stay at 31 or go down. CRP didn't move its normal. But as you always say symptoms Trump blood. Thanks for your response will talk soon. Big picture the picture but now I want to see the write up OK right here with that with the process to me By the what is deposit?

  • You mean "depot"? It is a form of steroid injection that is slow release and works over a few weeks. It is possible to manage PMR with it and I know someone who had GCA symptoms that her injections were raised to cover.

  • Never heard of the drug being used in the US but I can certainly ask. By the way TCZ was approved here last week by the FDA and if I have to go up in the prednisones higher than 12.5 I might consider it if I don't have to pay for it.

  • Was it approved - or given "breakthrough status"? Not quite the same.

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