Advice re Short Term Pred

[Meggsy]

OH has been coughing and wheezing for a few days. GP has prescribed 25mg pred twice a day for three days, then stop. Will it be ok to come off 50mg just like that without any sort of taper?

[SheffieldJane]

They say it is ok within a few days. I think that I would feel the bump though. That is a high dose, but your doctor knows him and his medical history. I hope he gets well soon!

[Meggsy in reply to SheffieldJane]

That’s probably.

[Meggsy]

Thanks Jane. It’s for OH. I problem wouldn’t have questioned it if I didn’t have PMR and on pred myself. 🌻

[Hidden]

Hi Meggsy

It’s the New(ish) Protocol now for Prednisolone for a Chest Infection/Asthma & often come in a Specific Pack.

It didn’t used to be like that, they used to taper but now it’s a five day course & stop.

MrsN

[Meggsy in reply to Hidden]

Thanks Mrs N, I think I just needed reassurance. 🌻

[Hidden in reply to Meggsy]

Long Term & Short Term Pred are very different.

My Mum was a Chronic Asthmatic, her asthma would be described as ‘brittle’ she was on long term maintenance dose Prednisolone but if she had a Chest Infection her GP would always give her Hydrocortisone to take while she had the Chest Infection so she would not be confused about increased doses etc; it worked very well for her.

[SheffieldJane in reply to Hidden]

Gosh, that’s news to me. I have had chest infections but not severely. That will be the criteria.

[Hidden]

My little fella used regularly have short courses of Pred for Asthma, then his Eczema would clear up immediately but then we’d always get a Flare Up a couple of days later!

He’s 37 now & even recently he rang me to say GP had given him antibiotics & a five day course of Pred but just wanted to check with me that it was OK 👌🏻 Bless Him! 💙

[Meggsy in reply to Hidden]

He loves and trusts his mum. I think it doesn’t matter how old they are, when they need you they become your child again. 💕

[Meggsy]

Thank you Susiquew, I did warn him he might find himself awake and staring at the ceiling at 2am. I was when on 25mg.

[Hidden in reply to Meggsy]

Martin, who was a delightful child could walk up walls when on Pred, he also learned how to somersault over the pew in church, multiple times without stoppinh! Very Entertaining! 🤪

But the ‘highest’ l ever saw him was as he arrived in A&E from school, after an allergic reaction, he’d had his Epipen, hydrocortisone & Piriton; He shouted ‘Hi Mum, I need a Wee’ flew off the gurney & disappeared! The Ambulance Staff said they’d had some trouble keeping him down on the way from school! It was the Adrenalin in the Epipen........

[PMRpro Ambassador]

Yes - it is an absolutely normal use of pred - the difference is the baseline!!

[Meggsy in reply to PMRpro]

Thank you PMRpro, I feel much more relaxed about it now.

[Estellemac]

My sister has COPD and does this when she gets a chest infection. Sometimes it’s 30mg for 5 days then stops. It fine for her no problems. I think that why she doesn’t get the long term use and tapering?

[Meggsy]

Yes, I think I have become so tuned in to the slow tapering that the drop from 50 to zero worried me a little.

[jinasc]

The main reason why most GPs are desperate to get us off pred fast is because they are used to short term use only. Anything up to 10 days depending on the dosage. After that timescale, then slow reduction.

[piglette]

No problem. Pred is prescribed for around 200 different things apparently and most of these are short term usage of a week or so. That is why doctors get so muddled with PMR I reckon.

[PMRpro Ambassador in reply to piglette]

I suspect most of the long term uses of pred are done under the care of a specialist - except PMR!!!!

[piglette in reply to PMRpro]

That is true. I am amazed how bad doctors are regarding their drug knowledge though.

[PMRnewbie2017]

Yes it's fine. Best to give the second dose at lunchtime though rather than at 6pm. That's what I was taught.

(Retired MRPharmS)

[Meggsy in reply to PMRnewbie2017]

Thank you 🌻

[PMRpro Ambassador]

The argument is that the vast majority of infections are viral so abx are no use. The trouble is, the secondary infection may be bacterial - but reducing the swelling with the pred is supposed to reduce that risk. I was never convinced about it with my asthmatic daughter - and our German GP tried often enough to get away with not using abx which always resulted in me having to take her daily for a few days and on the 3rd day he always gave in! When a UK doctor refused abx she was off school for nearly 3 weeks recovering from the nearly pneumonia that developed. He didn't refuse again ...

[Thomas45]

Yes. When I have bad asthma I'm put in 40mg a day in one dose and then stop. When I had PMR while I was on a higher dose for asthma I didn't take the PMR dose as well

I have no problems just stopping, and had none when I had PMR and asthma at the same time.

[Meggsy in reply to Thomas45]

Thank you 🌻

[PMRpro Ambassador]

What always worries me is when they say "I can't hear anything" - Beware the silent chest!