Prednisolone Reduction problems.

[Amstel]

Hi all, another newbie here..!! I got diagnosed with PMR end of July this year and was prescibed 15mg, which like a lot of other people, found it worked miracles almost immediately. I found though that that dose was not lasting 24 hours so doctor agreed to splitting into into twice daily, half and half. This worked well and I followed his directions for gradual reduction, going down to 13mg, then to 10mg as recommended. The pain came back after a couple of days so I went back up to 12mg for a few weeks before reducing to 11mg. Again this worked well until I tried 10mg again on Monday of this week when the shoulder and arm aches returned. I'm still splitting the dose to last 24 hours but I'm concerned that I can't seem to get below 11mg. Am I going to fast with the reductions? Is the pain due to withdrawal or the actual PMR? Any ideas would be greatly appreciated, especially as I'm a drummer who needs functioning arms and legs...!!! Thanks.

[DorsetLady PMRGCAuk volunteer]

Hi Amstel,

You might just find that 11mg is what your body is happy at for the time being. There's nothing to say you cannot stay at that dose for a little longer, say a month and then try again. You may find then, it's okay to drop down, it's not an exact science I'm afraid, can depend of other things as well as PMR - a cold, stress of any kind, cold weather, run up to Christmas, too much vigorous drumming!

All joking apart, your drumming may not be helping. But if you enjoy it, then you'll find a way through.

Next time you try, you could either try a slow reduction plan over a few weeks rather than an "overnight" drop. There are various ones, from one that takes a couple of weeks to a six week one! Or try reducing by just 0.5mg - white uncoated pills can be cut quite easily. Pill cutter about £1 from well known high street chemists.

[Charlie1boy]

Hi Amstel. Yes, I,too found the preds didn't last 24 hours and, like you, split the dose.

Having been diagnosed in Dec 2014, I got down quite quickly to 10mg, but then it took about another year to get to 8mg, most of the time fluctuating between 10 and 8.

There is a school of thought which recommends staying at 10mg for as long as a year. Certainly, there are many people on this forum who find 11/10/9 mg a sticking point to taper. If I had my time again, heaven forbid, I would have stayed at 10mg for much longer (months) before trying to reduce further.

It is, for sure, a condition for which you need to taper down very slowly indeed.

Good luck.

[PMRpro Ambassador]

I think to have got to 11mg since July is - in the great scheme of things - pretty good! However - what about trying splitting 2/3 and 1/3 rather than 1/2 and 1/2? It may be that the half dose isn't quite enough to clear out the morning dose of inflammation so it is starting to build up more.

The slow approach mentioned is here:

healthunlocked.com/pmrgcauk...

It's being used in a clinical study in Leeds - and the feedback from the patients is very positive.

[nuigini in reply to PMRpro]

PMRpro do you have any idea on when the clinical study on the slow approach may be completed and published? Six months, a year? Just a rough guess would do.

[PMRpro Ambassador in reply to nuigini]

No idea - not least because the entire study (there are a load of things being looked at) is being a bit slow with recruitment as one of the non-medic researchers has disappeared to other pastures! (Higher grade, exciting work and more money...)

[nuigini in reply to nuigini]

That's disappointing. All we can do is wait. 😕

[Amstel]

Many thanks for all your replies, they have all certainly given me plenty to think about. I have looked at the slow approach link so I feel I shall be giving this a try starting today. It's comforting to know there are others who are going through this ridiculous condition, and that through forums like this we can all benefit from the support it gives.