Thinking of increasing my dose of prednisone

[Reader7]

I'm newly diagnosed with PMR and struggling with reducing prednisone dosage. I started with 30mg at the beginning of June and am now down to 10mg. I'm thinking I need to up my dose due to morning and evening shoulder pain.

[Chrob]

I think 30 to 10 in this short time is far to fast ,check out the reduction plans on here , nothing as speedy as this . I started on 15 eighteen months ago and still reducing slowly . More people will be along later with better knowledge than me but it’s not a race to reduce it’s keeping the inflammation down till it decides to go away .

[Reader7 in reply to Chrob]

Thanks for your input, Chrob. I think you're right about the reduction.

[SheffieldJane]

Hi Reader7 and welcome to the site. Is your pain typically PMR pain and unresponsive to ordinary painkillers. There is no way that you could have injured one shoulder, is there?

What has your PMR journey been so far. For example, duration? What kind of taper have you used?

Sorry for the barrage of questions but the answers will help folk to give their opinions.

[Reader7 in reply to SheffieldJane]

Yes, it's typical PMR pain - shoulders, upper legs, back of neck. No injuries. Unresponsive to painkillers. From the responses, the general consensus is that my dose of prednisone has been lowered too quickly. I appreciate the explanations I've been given for the increase in symptoms. Information to take to my internist. Thanks to all.

[Charlie1boy]

Hi Reader7,

Your post suggests,in my experience of PMR, that you have reduced your prednisolone dose much too quickly.

I started on30mg per day, and it took me 6 months to get to 10mg daily. Three years on I have now got to 4mg.

I know we all have different metabolisms, but for the majority of us PMR will last up to 6years regardless if you may have heard or read otherwise. As you will gather from my experience getting down to 10mg was the easiest part - it gets considerably slower after that.

Having PMR requires spade loads of patience, as well as the need to pace yourself with your daily activities. Lots of rest and tlc is essential.

If I were in your shoes, I would head back to my GP, and discuss a slower tapering programme. There are lots of very sensible suggestions on this site on this subject, so have a look through them.

Good luck

Paddy

[Reader7 in reply to Charlie1boy]

Sounds like good advice. Thanks, Charlie.

[PMRpro Ambassador]

If you have reduced from 30 to 10mg in less than 2 months - no wonder you are struggling! It took me 4 YEARS to get to below 10! Six months is probably more usual and longer for some.

PMR isn't something you take a course of pred tapering with standard drops as you would for a chest infection or a bad asthma attack. You usually start a bit lower than you did (the 2015 Recommendations suggest the lowest effective dose in the range 12-5 - 25mg) and stick at the starting dose for a month or so before tapering SLOWLY! That means 5mg max and preferably 2.5mg at a time at first. Top tapering experts say not more than 10% of the current dose. Many on the forums find 1mg at a time works better and many also use a schedule that spread the transit from every day old dose to every day new lower dose over a few weeks which makes it less of a shock to the system. One of them was approved for use in a study on managing PMR being done in the north of England.

[Reader7]

Thanks so much for your reply...I will talk to my internist on Monday.

[DorsetLady PMRGCAuk volunteer]

Hi,

Two months in your PMR is still very much alive and kicking! As others have said too quick a reduction, and a high starting point - any reason why?

The problem is because you’ve reduced so quickly you’ve gone past the dose you actually need without realising it, so it’s almost a case of starting from the beginning again.

Have a look at this, it might help you understand your illness a little better -

healthunlocked.com/pmrgcauk...

[Reader7]

Thanks!

[piglette]

My gosh I would be in a bad way if I had tried to reduce that fast, although I suppose some people can manage it. The trouble is doctors seem to be hell bent on getting the dose to 10mg max. They seem to forget that the reason for taking it is to actually to help the pain.

[Reader7]

Good point!