Too much prednisone?

[Trevgrrl]

I know it is bad, but I was so desperate. I've felt pain in the PMR places for a week, and today it was just too much. I'd taken my25 mg in the morning, but about 12, I was still hurting so much in my hips, legs, shoulders, that I took 20 more pred. Now I am sweating and hoping I didn't overdose. Do people over dose on pred? I'm so desperate. I get another Actemra infusion this Thursday and then hopefully regularly to go down on p.

[SnazzyD]

Hello. The sweating will be from the higher dose of Pred. People take much higher daily doses than 45mg for GCA so you’re likely fine, but you already know you shouldn’t whack a load in willy nilly. Did it help your aches and pains?? 45mg in a day is much more than the standard PMR dose. What happened to your GCA worries recently, did they come to anything?

[Hidden]

Hi trevgrrl, sorry to here you are in pain. But I must say your relationship with pred is bumpy to say the least. No, 45 won't hurt you, but you will feel a bit speedy, sweating, no sleep perhaps.

But you a) can't use pred like a painkiller by raising and lowering in big jumps. (b) you are on high doses for PMR after all this time. Last year PMRpro (9mths ago), asked you if your Dr had considered another diagnosis. It is very unusual to be on 20plus so many months down the line.

You have also had times when you forgot to take pred. It's okay, I have taken a double dose once and missed doses about 4 times..over the past 4 years. I realise they are trying a new med but you really need to know what a differential diagnosis might be. Especially when pain returns so badly and you need 20mg more of pred to address it .

As I say no real damage done when you double up one day...but made me 'run' around like an idiot. But please speak to Dr. Feel better soon.

[SheffieldJane]

These symptoms are not right Trevgrrl. You should not be in this kind of pain after 25 mgs if your diagnosis is PMR. It may turn out that you have a different condition altogether. You must seek urgent medical advice. It could even be some sort of Actemra reaction. You won’t come to harm with the amount of Pred you have taken, that is a GCA dose, but you will feel sleepless and wired for a day or two. Please don’t try this again and please contact your doctor/ Rheumatologist for urgent advice, as soon as possible. Let us know what it was. All the best!

[Yellowbluebell]

The thing is no harm will come to you but you cant use pred like paracetamol. It doesnt get rid of pain like that, it works on the inflammation. Hopefully you will feel calmer in the morning but no more "topping up" please.xx YBB

[Trevgrrl]

Thanks for your replies. I am totally flummoxed with what is wrong with me. No, it couldn't be the Actemra, as I only had one dose so far and felt the same before it. I think I felt slightly better after that Actemra dose, so I am hoping it will work for me. Maybe it is psychological my feeling less pain in my hips when I take extra pred? But it does seem to ease that pain.

[Trevgrrl]

As to my eyes, I had an appt this week, but the pandemic interrupted it, so I guess it wasn't as serious as a I felt. My right eye waters a lot and blurry, irritates me some.

[Trevgrrl]

My rheumatolgist doesn't think if is PMR either. The first dr did, and I did improve with pred like a miracle. But after a couple of years and getting down to 13 mg, I got pneumonia and my inflammation went up very high. It remains high if I try to reduce the pred and goes up as I try to go down. I am on oxygen, so my lungs don't seem very strong. Plus I'm obese. And have major depression I take meds for and meet with a psych. I'm a widow living/caring for my 97 year old mama, no children, a brother who helps, and some caretaker people coming in. I'm an artist, a writer, former teach of English, and very sad and shy. That's who I am!

[Trevgrrl]

Another clue perhaps? I have fractures in my ribs that show up in my lung xray.

[scats]

Is there not a doctor or professional you could talk to by phone. I sounds like you have a lot to cope with.

[Yellowbluebell]

You have a lot going on and you do sound like you need to have someone to talk to maybe more regularly than you are seeing your psych. Is your doctor able to arrange some more help. Maybe when you get your next actemra on thursday you could spesk to the dr about how you are feeling. Please let us know how you get on.xx YBB

[PMRpro Ambassador]

I think you need to speak to your rheumatologist if 25mg pred isn't enough - the Actemra sometimes takes a while to kick in so you can reduce the pred dose and if you are having pain 2 weeks before the next infusion is due you need something adjusted. Why are you on the infusion rather than the injections which are what were approved for GCA? You say you are obese so is it weight-related?

Have you ever tried splitting the 25mg dose? It seems that the antiinflammatory effect isn't lasting the full 24 hours and so the new morning dump of inflammatory substances is so much it is taking a long time to resolve.

Where is the "hip" pain? Is it deep in the groin or is it on the outer aspect of your upper leg?

[Trevgrrl in reply to PMRpro]

PMRpro - My doctors are very against me taking 25 or more on the prednisone, and I am trying my hardest to decrease it. The hip pain is just above my hip joints on either side, a fierce burning but freezing up pain in two markable spots not deep in but near the top, the muscle maybe? I also think it might be fibromyalgia, which I have, but who knows what it is. I will ask about the injections. I missed the last infusion because of the pandemic worry, so I think that is why I lost the effect of it. I'm trying to be optimistic about Actemra, so hope it works for me. For me obese means 300 pounds at 5 foot six inches tall. I gained a cool 100something after my husband died and I started prednisone. Before I was quite slim and active, loved tennis and hiking.

[PMRpro Ambassador in reply to Trevgrrl]

I'm sure they are - but that pain sounds as if it could be trochanteric bursitis and that is unlikely to respond to the Actemra, it will to local steroid injections and that may even banish it for good. I do know why they use infusions for us in the USA but the injections would be so much more convenient at present - and yes, going 2 months without the infusions will definitely not have helped.

Have you ever tried cutting carbs with regard to the weight gain? Really does work.