Prednisolone increase

return of symptoms not as severe as before, I am on 15mg Prednisolone daily do I need to increase my dose please. Your excellent advice is appreciated.

[SnazzyD]

Hello, did you go back up to 15 after the drop to 13 from 15 recently? At what level have you been symptoms free? Was your drop to 13mg in one jump?

[Hidden in reply to SnazzyD]

My drop initially was 1mg then 2mg then back to 15mg but now experiencing symptoms. Have rearranged GP appointment for tomorrow so we will see outcome. Thank you for your help

[SnazzyD in reply to Hidden]

Just for comparison, I did 0.5mg per week at this level down to 10mg but paused for a week or two if at any point I wasn’t sure if my body was happy. I didn’t drop if I was still getting withdrawal symptoms.

[PMRpro Ambassador]

Difficult to say without much more information about your reduction pattern - were you reducing, how much at a time, at what dose were you OK?

[DorsetLady PMRGCAuk volunteer]

How long have you been back on 15mg?

Looking at previous posts would reiterate what we said then - your drop from 15mg to 13mg was too quick/too big a drop, so really you’re back to the beginning.

You need to give the 15mg a chance to work again - maybe at least 2-3 weeks. If it’s not working by then you need to contact GP - and also take a higher dose. Maybe 17.5mg will be enough.

When you do get back on an even keel, then stay there for 4 weeks, and then reduce by 1mg at time.

[Hidden in reply to DorsetLady]

Thank you for advice I am on 15mg but had thought increase might be a way to go. I am seeing my GP on 29th of January so it will be interesting as to what her views are.

[PMRpro Ambassador in reply to Hidden]

And having gone back to 15mg did you then also adapt activities for a while?

It isn't unusual for people to struggle at a dose that was previously enough after they have dropped too far and gone back up. You may need a bit more - it is amazing the difference even 1mg can make - but if you haven't been above 15mg before you ought to speak to the GP first. Once you know your body, your PMR and your response to pred you will know how to adjust your dose best for you.

[Hidden in reply to PMRpro]

Hi again, hope you have a good weekend. Well I have today seen nurse practitioner at our local doctors surgery and after she consulted with a GP would not increase my prednisolone of 15mgs by 1mg or even by 2mg. I am to have a blood test on Monday to establish sodium levels as they are concerned with too low sodium levels. My last blood test on 18th December was 1.34. Shall I increase my preds myself? your advice as always is very much appreciated.

[PMRpro Ambassador in reply to Hidden]

We can't really tell you to go against your GP - however much we think he is wrong!

What blood test is that? Your sodium levels? What a bizarre thing for them to decide to worry about.

[Hidden in reply to PMRpro]

Nurse practitioner also advised that my PRM symptoms whilst on prednisolone will not ever be as severe as they were before I started taking prednisolone as the steroids stop this occurring ! if I am making sense.

[PMRpro Ambassador in reply to Hidden]

Oh YOU are making sense - but she isn't!!!!!! Does she have PMR? How does she think flares happen? Or that it progresses from "just" PMR to the PMR being a symptom of GCA?

[Hidden in reply to PMRpro]

Goodness knows, we shall see what Monday brings, suspect Doctor is still on learning curve with PMR ! I will update then thank you again for your help.

[piglette]

Sounds like you may need to increase, but confirm with your doctor tomorrow.