Length of predisone effects

[4683Louise]

I have read here the length of time of the effects of a daily dose of predisone is typically 12-36 hours. Should there be a correlation between the length of time one feels the effects (ie- symptoms are controlled) and the amount (or size) of the dose?

I had been on 10 mg for 4 months and generally felt pretty decent- enough that I really didn't track hours of comfort- and was also working full-time.

Now I am on 60 mg and effects last about 16 hours (Also on month-long vacay so lots of rest). It seems to me that the effects of a high dose SHOULD cover 24 hours; because it's not, I am concerned that might mean there is another problem.

(4 weeks ago I was bumped from 10 mg to 60 mg as reaction to ESR and CRP results- I think flare, Dr cautious of GCA; 2 weeks ago blood work came back all in normal range.)

Is aiming for 24 hrs of comfort a reasonable expectation- especially on a high dose- or is the daily rollercoaster of symptoms just the new normal? Grateful for your thoughts.

[PMRpro Ambassador]

Although they are really the same disease but on different placeson the spectrum, the response of PMR and GCA to pred do differ a bit. What comes back in that 8 hours? And have you reported to your rheumy? If you have GCA symptoms- you would hope the dose was high enough to remove all chances of them returning in the 24 hours.

[4683Louise in reply to PMRpro]

I did not know that the 2 conditions respond differently to predisone- that's helpful, thank you. Will research that more.

Returning symptoms in the evening are predominantly redness in face and neck and burning in thigh muscles, some ache in arm muscles. Builds thru the night and the 4 A.M. "rush" leaves me very red and hot.

This started after my last appointment; I return to my Dr in 10 days, will discuss then.

I have not had any of the classic symptoms of GCA (no scalp, jaw, tongue, etc. involvement).

As for the 12-36 hour potential time frame, I can see the likelihood that individual metabolism rates differ from one person to another. Hopefully mine will find the happy medium.

[PMRpro Ambassador in reply to 4683Louise]

That is fairly typical PMR though maybe your rheumy is attributing the thigh and bicep pain to large vessel vasculitis/GCA. Who knows!

[DorsetLady PMRGCAuk volunteer]

Hi,

PMRpro has answered, but I would make a couple comments.

Your increase from 10mg to 60mg was quite spectacular- especially if only based on CRP & ESR readings and no return of significant symptoms (at least that what I get from your post), and was it just one result of your bloods? If so, a bit of a knee jerk reaction from doctor.

Secondly, your bloods should have gone back to “normal” - on that amount of Pred!

Thirdly at that dose I had No symptoms! Plenty of Pred side effects, but no GCA symptoms.

[Jackoh]

I may be reading this wrong but you only mention the word'doctor' and not Consultant or Rheumy. Are you under the care of a Consultant Rheumy or just your GP?

[4683Louise in reply to Jackoh]

I see a rheumatologist. (Sorry I didn't clarify before, new at all this...)

[Jackoh]

No problem I just wondered if you were just being monitored by your own GP.

[mikldiamond]

My recent experience with dosing was I was living with a lot of discomfort about 8 hours per day. I was taking Prednisone at 3am and between 11pm and 7am not moving very well at all. Didn't matter if it was 14mg or 11mg (I was determined to tapper) CRP & ESR elevated. Dr. said Mike this is not working, take your Prednisone back up to 15mg and take 10mg at breakfast 6:30am and 5mg at 5pm. OMG I am a new man. Snowshoed 3 hrs the past two days and feeling no pain. So at this time split dosing is the key for my controlling the symptoms. Wishing you relief too. PS big thanks to the group for helping me get back to not worrying about how low I can go on the Prednisone but to dose with dose needed.