Help and advice on slightly increasing Pred from 2 to 2-1/2 mg

[Jo1947]

Hi have been down to 2 mg of pred for about 3 weeks now and am getting pains in my shoulders every morning even after trying painkillers. I was very well on 2-1/2 and would like to get back there. Should I just start taking the higher dose or is there a better, surer way of doing it,thanks for any advice

[Hidden]

Hi jo1947, it does sound like your body like 2.5mg?! I do the plus 5mg for a few days then back to the dose I was ok at. However I can see plus 5mg would seem a lot at your dose, so perhaps 5mg in total and then 2.5mg after a few days. That's what I have done a couple of times. I then let everything settle for a few weeks. In the grand scheme of taking pred at 2.5mg isn't a big issue....but half a mg makes a big difference doesn't it?!

medpagetoday.org/rheumatolo...

[Jo1947 in reply to Hidden]

Hi Poopadoopy, thanks for your advice. Had real bad pains in my arms during evening and night. I took 5mg at 4.15 am so will try tomorrow at 5mg and then back to 2-1/2 until settled again, will let you know how it goes, thanks

[Hidden in reply to Jo1947]

I hope it works. Sometimes you may need to go to 3mg...but it's not for ever. Yes let us know.

[PMRpro Ambassador]

Have you tried just switching back to 2.5mg? It may work. If not, then try taking 5mg for a couple of days and go back to 2.5mg.

[Jo1947 in reply to PMRpro]

Thanks will try that, I was dreading having to go back up much higher. Will start low and see.

[PMRpro Ambassador in reply to Jo1947]

You should only need the higher dose for a couple of days, if at all. It depends on how much inflammation has built up.

[PamJCam]

Hi, just a thought but could the pains you have be withdrawal symptoms which you can get from steroids? If you look up these symptoms on line they are mainly muscle pain and joint pain.... I’m coming down from 8 to 7 at the moment and I have these symptoms...or could it be the virus...🤔🤔🤔🤔

[PMRpro Ambassador in reply to PamJCam]

Steroid withdrawal pain starts when you lower the dose but then improves with time. It may be similar to the PMR pain but if that flares it gets worse over time.

[Jo1947 in reply to PMRpro]

Thanks PMR pro fairly sure it’s a flare which the 5mg this morning has started to sort out. It shows at this low level how critical .5 mg is to maintaining non flare

[PMRpro Ambassador in reply to Jo1947]

1/2mg can make a difference at practically any level below about 15mg!!!!

[Jo1947 in reply to PMRpro]

So true, when I was at the docs last on 3mg he wanted me to go straight onto 2mg, I told him I’d do 2.5, his comment was, I’m sure you’ll do what you want anyway, too true, I’ll manage an extremely slow reduction to 2mg again when I’m stable again at 2.5

[PMRpro Ambassador in reply to Jo1947]

Top tapering/titration experts in the endocrinology field say no reduction should be more than 10% of the current dose for best results. 3 to 2 in one step is 33% - massive amount relatively speaking.

[Jo1947 in reply to PamJCam]

Pam it’s 3 weeks since I reduced so I think the dose is just .5mg too low for my body. It’s got worse since reduction not better, but thanks for idea. Took 5mg this morning and arms a lot better, will take 4 or 5 mg tomorrow and then go to 2.5 again