What are the doses?

[Liskeard]

Hi there

So ... I’ve decided I need to start on prednisolone.

It seems there is no option and my quality of life at present is pants!

Just need some clarity on timings of supplements recommended and doses.

Starting dose of prednisolone is 15-25mg?

Calcium supplement (dose?) and Vitamin D (dose?) to be taken at different time of day to steroids (is this right?)

Vitamin K2 Mk7 (dose?) to be taken with calcium to aid absorption?

Have I got this right and is there anything else I need to know prior to talking to the doctor?

I’m taking along a couple of articles and info from this forum to share with him.

Thanks for all the help so far

[RunRabbitRun]

Hope you find relief with prednisolone. Good luck.

He/she will probably want you to take PPI (proton pump inhibitors) stomach protectors lanzoprazole, omeprazole etc.. Difficult one. I was put on them 2 years ago but am now trying to get off them but really struggling with acid, despite only being on 1.5mg pred and tapering the ppi. Wish I had read the side effects of ppi first, would have tried to keep off them. Others have good results using yogurt, kefir and oats to protect stomach instead of ppi.

[Harbel]

I was put on 30 first by my gp but only because I was in so much pain and the prescription from the neurologist had not arrived. It was magic. Pain gone in about 16 hours and restored full movement. When the prescription did arrive it was for 20 and after three days on 30 I went on 20. That was not enough but I found that 25 was just right for me and stayed there for 6 weeks. My ESR has been 106 . I was a man of about 13.5 stone 87kg at the time, so if you are less or female the staring dose could be less. I only take coated pred and 500 calcium and 400 vit D and no stomach protection and have no problem with that.A bone scan is recommended for setting the basis for the future. Best of luck with the journey.

[SnazzyD]

Hello. The real experts will be along soon. Yes that’s ok for dosage range but be aware that some docs have started on too low a dose, the person gets little relief then the doc decides that no relief = no PMR. I know you’ve not started yet, but just put that to the back of your mind.

Calcium and Vit D are needed to keep the bones in good shape and you need it even if you go on bone hardening drugs. Calcium needs to be taken away from the Pred because it can change the acidity of your stomach before it has passed through into the small intestine. Do ask for a Vit D blood test to see what dose you need. Vit K2 you have to buy yourself. My consultants had never heard of it.

For stomach protection, a lot of people here don’t like the PPI’s like Omeprazole for various reasons. Some take it fine. I never got on with it and took another sort Ranitidine which is often seen as old fashioned but works fine. In the end I just took Gaviscon because I got rebound acidity after a week or two. Many take yoghurt with their Pred but I’m dairy free. If you search key words on this site, you’ll find loads of discussions on these topics.

[suzy1959]

Just to repeat what is said above- ask for a Dexascan so that you have a marker for your bone density before Pred. and then subsequent Dexascan results can tell you what effect the Pred. is having on your bones. If the doctor wants to put you on a Biphosphonate like Alendronic Acid, be very cautious and do your research before taking it. A lot of us have decided not to take it, despite a lot of pressure from both GP's and Rheumy's.

[piglette]

You have got it perfectly along with the others.

. Starting dose 15-20mg of pred

. Include vit D and calcium (allow at least two hours between taking it and pred)

. Ask for a Dexascan to check your bone density (depending on results you may be offered bisphosphonates)

. You will need various blood tests CRP and/or ESR for inflammation, glucose, U&E, Full Blood Test, vit D, possibly some others too, as your doctor thinks fit.

. Also you should get your eyes tested regularly.

Take life easy and pamper yourself. Pred should make you feel alive again but remember you still have PMR. Good luck.

[SianFinch]

Hi there

I resisted treatment with pred for a long time because I am diabetic and I knew it would cause havoc with my diabetes control. Having said that, it has given me a new lease of life because I can now do things I couldn't before - like pour a cup of water from a kettle and chop carrots!

I assume you do not have diabetes, so your life will be much simpler.

I started with a dose of 15mg and this kept the PMR under control, aches and pains went away within a couple of days and ESR blood results came down to normal within about 4 weeks.

There are side effects with pred; it's not a medication I would chose to take unless there was no other option - which there isn't.

I take 70mg of Alendronic Acid once a week and also Calcium/Vit D every day.

I was already taking Lansaprozol (PPI - proton pump inhibitor) for another condition but if you aren't then you will probably need to take this - it deals with excess stomach acid. Once a day and the dose will vary depending on your situation - mine is slightly higher because of an existing condition.

You will feel heaps better on the pred, so start it and then try to reduce it over time. My reduction regime hasn't gone very well but we are all different and your's may be fine.

I wouldn't be able to live the life I am living today unless I was taking the pred. That just about sums it up!

Sian