Bad day today should I up my Prednisolone

[Wayfair]

Started on 40 mgs of Prednisone last December. My doctor has me reducing every 5 weeks, so I am now on 7 mgs. I have coped quite well, but today have very sore muscles in my arm. Also very painful hips, making it hard to walk or stand from sitting. Should I increase my pred?

[PMRpro Ambassador]

Do you just have PMR? 40mg is a high dose to start in PMR. How big are the reduction steps you are using?

What were you up to the last couple of days? More than usual? Something that might have caused the aches?

[HeronNS]

At your dose level you should ask your doctor to let you taper by .5 mg at a time, and to use the dead slow nearly stop method. Rather than dropping to the new dose overnight it is introduced gradually over roughly the same time as your doctor's version, but less likely to trigger withdrawal symptoms or, worse, flares of the PMR. Also makes it easier to determine what is your own personal lowest best dose which will continue to control the symptoms.

[Hidden]

Hi Wayfair

You’ve come down extremely fast & done well but the standard recommendation is never drop by more than 10% so once you’ve gone from 10mg to 9mg the Taper should be by 0.5mg

My wonderful, deceased previous Consultant always advocated 0.5mg from 10mg as 1mg is too big a percentage the lower you go.

So maybe go back to 8mg & then drop to 7.5mg. You can get 2.5mg Tablets to save messing about cutting 1mg tablets in half.

Good Luck

MrsN 🌷

[OutdoorsyGal]

Please note that you are now at the “physiological level” where your body is sensing it may need to start manufacturing some cortisol after a long vacation, and your adrenal glands may need more time to wake up and smell the coffee.

The back and forth of the DSNS method of tapering might just do the trick, especially at 7mg and below.