Flare up

[Hollieby]

Down to 3mg of prednisalone, having a flare up so have gone back up to 4. I am reading that some people are going up by 5mg. If you are doing this then when your pain is back under control are you jumping straight back down by 5mg or are you transitioning down to your original dose?

[PMRpro Ambassador]

If you add 5mg to the dose where you flared and only need it for up to 7-10 days you can drop straight back to the lower you have chosen without problems. I wouldn't go back to the dose where the flare happened because that was presumably not enough - if you havd been fine at the previous dose for at least a month then that would be the better place to go back to.

This does assume you overshot the dose - if it is an increase in disease activity, it might not work and you might need more.

[ali5son]

I've been trying to tapper to 31/2mg but had to go back up to 4mg. Do nt know if it is considered a flare just a bit sore. Been on pred 3 yrs

[PMRpro Ambassador in reply to ali5son]

Depends on what you define as a flare: a flare is return of symptoms because the dose of pred you are on is not enough to manage the inflammation. That can happen for two reasons:

1. You have reduced your dose of pred too far and it is now not enough and

2. The underlying cause of the PMR/GCA has increased in activity so is making more inflammation and the pred isn't enough for the new extra inflammation

or 3. you have been doing too much and made your muscles sore - more pred won't usually help that.

Either way - the PMR symptoms come back, initially just slightly but increase over time. Let it carry on too long or reduce even further and you will have a flare on your hands. You have to listen to your body and learn to know what it is saying to you!

[ali5son in reply to PMRpro]

Thank you