Starting dose of Prednisolone

[Cersei2]

Hi - just diagnosed with PMR - Dr has started me on 80mg for a short course -5-7 days -this seems high - am a bit concerned -I’m 57 and healthy !!!!!!

[fmkkm]

Hi,

Just curious, what’s the plan after the 5-7 days?

[Hidden in reply to fmkkm]

Good Question FM

[Cersei2 in reply to fmkkm]

Next Thursday - so not too far away - feeling like a Duracell bunny will make a change from feeling 150 yrs old 😂

[Hidden]

When do you see your GP again & as Forwardmotion asks, does your GP have a plan after that?

[DorsetLady PMRGCAuk volunteer]

At that level, Pred should obliterate all pain, so I am not sure what it will prove. A much lower dose would be more likely to tell you both more.

But provided he intends to stop after this trial it shouldn’t be too drastic, but you will feel like the Duracell bunny for a few day!

[SnazzyD]

If there is no worry about GCA then my guess is that he thinks that it’ll knock the GCA out of the park but whether he thinks that’ll totally do the trick remains to be seen. I haven’t seen any guidelines that suggest this approach. It is way higher than the recommended max of 25mg. I would question them closely as to their long term plan A. What blood tests have you had?

[suzy1959]

Yes, this is a very high dose for PMR- should be 15-25mgs. No wonder you feel so hyper! Some doctors think you can knock it out with a high dose like with an asthma attack. This is not true. The Pred. just suppresses the symptoms, doesn't cure PMR. It will go when it is ready- an average of over 5 years. Some doctors also prescribe a short burst of Pred. as a test of whether this really is PMR- that may be what yours is doing but as DL said the dose is too high to tell them much. May be worth you querying this with your doctor to check what they are thinking and why they have prescribed such a high dose.

[Hidden]

I think when I got my diagnosis I was on 80mg from the first few days. I was bopping around so much I can't remember exactly though

[Hidden in reply to Hidden]

But you have GCA & that needs a much higher starting dose.

Good Luck with you PIP by the way 🍀

[Hidden in reply to Hidden]

Cheers Mrs Nails. I have had a tough one today! I forgot I have both. D

[Hidden in reply to Hidden]

Some days one condition is enough! 😉 How are you feeling in general? Still planning on the trip to Cyprus?

I’m looking at Cruises & dismissing them as l’m ‘Not So Very Sparkling at the Moment’ translated that means l feel fairly awful but try not to give in!

I’m off to Chester tomorrow to meet my friends & l’m taking the train 🚂 bought myself a Senior Railcard 😉 but don’t tell anyone, as l’m obviously far too young! 😂

[Hidden in reply to Hidden]

I’m getting to understand this more now. Our Cyprus holiday is all paid for so it’s on. TUI and the hotel are giving us some much welcome help and that will make things much easier OR awful ... I don’t know how I will be.

We have arranged that I don’t carry a thing or do anything other than a hopeful short walk. Luckily we are insured as you may remember so if I can’t do it I won’t. That’ll be another avenue of pleasure closed down. I’d be happy to just go for a walk without this bloody pain to be honest.

I have a senior rail card and we had planned on day trips to all the little Cornish towns we love but at the moment I am worried about this.

We did the cruise last December and another is most appealing BUT I am afraid I won’t be able to cope. Imagine being in Portugal and being in too much pain or too tired to even think of trying to get ashore?

I really am struggling here.

I went to Chester when I was a kid and remember it as being lovely and that clock being in a photo.

David

[PMRpro Ambassador]

He's crackers. What is his justification for exposing any patient to such a high dose even for a few days? It isn't the way to manage PMR - could possibly be acceptable if he thought you might have GCA. Is there any sign of that?

[Marijo1951]

I'm no expert but this seems rather irresponsible prescribing. I was diagnosed with both GCA and PMR and started on 60 mg, normal with GCA. This was enough to give me two very alarming 'funny turns' in the first couple of weeks, with thundering headache, sky high blood pressure and an inability to string a coherent sentence together. These episodes were transient and the dosage was necessary for me, but I wouldn't have wanted to risk them without an excellent reason.

[SheffieldJane]

I don’t recognise that treatment protocol for PMR. 15-25 mgs daily is more usual, tapering slowly once your symptoms have stabilised. Does your doctor suspect Giant Cell Arthritis (GCA)? That is the only instance that I have heard of 80 mgs being prescribed because of the danger to your eyesight and 60 mgs is more usual.

Such a large dose for such a short time will not help PMR which can last for a few years and only Prednisalone can reduce the inflammation, pain and stiffness. You need a doctor who understands how to treat PMR.