Hydrocortisone Dosing

[Leeleep]

My cortisol test was 3.1 and rheumatologist sent me to endocrinologist to switch my prednisone to hydrocortisone. I was on 5 mgs prednisone and switched to 10 mgs hydrocortisone. I’m actually having more PMR pain on this. Does 5 mgs prednisone equal 5 mgs hydrocortisone? I’m on the 10 mgs hydrocortisone till my next endocrinologist appoint. I will have a cortisol test a week before seeing endocrinologist and was wondering if I get a better lab result, what the next dose and timing for the hydrocortisone should be.

[PMRpro Ambassador]

No - the equivalence is 4-fold: 10mg of prednisolone/prednisone is the same as 40mg hydrocortisone. So if you were good on 5mg pred, you need 20mg hydrocortisone. They have halved your dose. Probably because the endocrinologist has forgtten youa re n pred to MANAGE PMR.

But why on earth not leave you on pred - or are they trying to see if the HC stimulates your adrenals?

[Leeleep in reply to PMRpro]

I’m assuming she wants to stimulate adrenals. However since she only put me on 10 mgs hydrocortisone, she has cut me back and maybe hence all the pain. I’m going to call and speak to her about this. Seems to me I need to be on 20 mgs. Do you agree?

[PMRpro Ambassador in reply to Leeleep]

I would have thought so. There is also the problem that the antiinflammatory effect of HC lasts about half as long as that of pred - so you may find the symptoms returning in about 12 hours.

[Leeleep in reply to PMRpro]

I need 10 mgs hydrocortisone twice a day . Thanks for help. I have a call into them.

[karools16 in reply to Leeleep]

I was on 20mg Hydrocortisone...10 mg am, 5 at lunch, 5 at dinner.The side effects were so horrendous, I stopped and asked to be changed back to Pred. I am on 4mg, with Addison's Disease.

[Leeleep in reply to karools16]

So far I’m ok on hydrocortisone. Sorry to hear about your experience. Hopefully the hydrocortisone will be better for my adrenals.

[PMRpro Ambassador in reply to Leeleep]

When your adrenal glands simply can't work it doesn't make much difference which you take, pred or HC, and if you still have PMR pain, then pred makes more sense really.

[Bj2016]

Thank goodness for PMRpro. Where else could we get this kind of information?

[PMRpro Ambassador in reply to Bj2016]

A pharmacist - although ANY doctor should know it!!!!

[Izzy51]

Hi I am in my Twelfth year of Pmr and Fybro. Dr tried a few years ago to put me on Hydrocortisone instead of prednisolone, it did nothing for me but made me so poorly again I had to go back on pred. I have been up and down on pred so many times but still have trouble coping. I can't see any end to it. So if you have to go back on pred don't worry about it, do what's best for you. Good luck xx