PMR

[Gran6]

Saw my Rheumy on Thursday and he agreed that I do have PMR as well as GCA which I have had for three years and I am now on 15mgs steroids he said I should start taking methotrexate and folic acid once a week and stay on 15 mgs steroids for a month and reduce 5mgs a month until I get to 5mgs ,I ask if I could just reduce the steroids but he said that it would just keep yoyoing without the methotrexate anyone else been told this not sure about the methotrexate a bit worried. Thanks

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Hi gran 6, Mrs n is away for a week and acts as one of our methotrexate gurus. I am sure about your Dr's rationale for not even try to do a standard dsns taper. You must have a while to make your mind up and they can't make you. Perhaps asks for 3 to 6 months to try dsns and see what happens. If you do yoyo then you can reconsider.

Here are a coue of posts from MrsN about being on it. Good luck🍀🌻

healthunlocked.com/pmrgcauk...

healthunlocked.com/pmrgcauk...

[piglette]

Are you saying he wants you to go from 15mg to 5mg in two months or have I misunderstood? If so, I am gobsmacked.

[Yellowbluebell in reply to piglette]

Thats what i am understanding it to be!!

[Gran6 in reply to piglette]

Yes that what he said but been on steroids long enough to know how to reduce, I am not going to take methotrexate at the moment I am going to taper DSNS way but I will speak to my gp Thanks for this I knew you would all have the answer.

[Marijo1951]

I've been taking MTX since December 2017 and, while I think it has helped me to reduce pred without flares, at the same time my rheumy has let me manage my own slow reduction which must have helped too. At present I'm on 7 mg per day and have been for 3 or 4 months. I've agreed with her to reach 6 mg by the time of my next appointment in January. The plan your rheumy has suggested sounds very drastic by comparison.

[Gran6 in reply to Marijo1951]

Thanks

[Yellowbluebell]

Sorry but reducing 5mg a month is ridiculous and tou are going to feel terrible. Can you possibly see your gp anout tapering in the meantime because this rheumy needs to realise it isnt reccomended to taper this quickxx

[Gran6 in reply to Yellowbluebell]

Thanks

[Ronnie101]

I refused methotrexate twice but couldn't get below 11 mgs prednisone despite using a slow method. I've now been taking it for just over 2 months with no problems yet, and I'm down to 10 mgs using a slow method and feel fine.

We're all different, but you won't know if it will help till you try it.

[Gran6 in reply to Ronnie101]

Thanks

[SheffieldJane]

I agree that staying on your modest start dose for a month is a good idea. I think dropping by 5 mgs a month would be disastrous for you. Please creep down slowly from 15 at I mg a month, stopping at the first sign of bother, then at 10 mgs try 0.5 mgs drops using one of the slow tapers in the pinned posts. I would be concerned that GCA might try to reassert itself. Sorry for your double whammy, it’s all too common I’m afraid.

[Gran6 in reply to SheffieldJane]

Thanks

[PMRpro Ambassador]

Load of rubbish - if he reduces the dose 5mg at a time of course he will get his patients into a yoyo state. Poor sods is all I can say!!!

No reduction step in tapering should be more than 10% of the current dose - 5mg at 15mg is 33%, 50% at 10mg. You can drop 5mg at a time to get off pred altogether in a short course. I did it. Once - it allowed a big flare and I never managed to get to such a low dose again.

Why must they create the problems?