Advice please

[Gunflash]

I have a problem, could I ask for advice please from those that know far more about this issue than me. Started at 15 mg, reduced to 12.5 after 3 weeks no problem 3 weeks later I reduced to 10mg, that was 10 days ago, since have been getting leg cramps around 5am in bed, switched dose to 7.5am and 2.5 bedtime. Major flare up in limbs last night, got up at 2am and took 12.5. This morning much more relaxed and no pain. How do I get back to full am dose? If I leave it to tomorrow am that will be 30 hours with no pred. So pains will probably be back tonight. Going to go back to 12.5 is this enough? Should I consider 15mg for a week? Thank you, a despondent Gunflash

[SheffieldJane]

What about a bridging dose of 5mgs then return to 12.5mgs next morning? Far better to have a bit too much in a flare than too little. I hope it works.

On long haul flights I have ended up taking a second dose half way through with the time change. I have felt particularly fine and was able just to press on with my normal dose Australia time. If that makes sense

[PMRpro Ambassador]

I'd do what SJ suggests - 5mg before bed, normal dose in the morning.

Have you tried taking some magnesium? If that doesn't help it might be worth asking your GP for some blood checks - all electrolytes can be involved in cramps.

[Gunflash in reply to PMRpro]

Thanks PMRpro, I will go back to a daily magnesium tablet and speak to GP. When I return to 12.5 tomorrow how long do you stay on the previous dose for before trying to reduce to 10 again? 3 weeks?

[PMRpro Ambassador in reply to Gunflash]

Until the symptoms are controlled again - but then go slower.

[Gunflash in reply to PMRpro]

thanks.

[DorsetLady PMRGCAuk volunteer]

You may find that 12,5mg is enough - depends if you’ve caught the flare quickly in time.

A few days should tell. If not, then yes try 15mg for 5 days. Back down to 12.5 or 13mg - then suggest only 1mg a taper.

If you don’t have 1mg tablets - then ask for them - and in meantime you could cut your 2.5mg In half to give 1.25. Only plain white ones can be cut.

[Gunflash in reply to DorsetLady]

Thank you Dorset Lady, I always appreciate your sound advice. Will use the formula above if 12.5 fails.

[Kendrew]

Don't forget that prednisolone itself has lots of side effects....one of them being muscle and joint pain, so it may not be polymyalgia pain. I've been more unwell with side effects of the steroids than the condition itself and I too had cramp in my legs, numbness in toes, restless legs. I'm not saying that's what's happening with you but it might be worth asking your specialist if the pains could be side effects.

[Gunflash in reply to Kendrew]

Yesterday I had my left index finger go completely stiff like a pole. Most odd. I would like to understand what a flare is supposed to feel like, any idea?

[Kendrew in reply to Gunflash]

Other people are possibly better equipped than myself to answer that, but flares are generally a re-emergence of original symptoms. For me, it would be usually pain and varying degrees of stiffness in muscles and joints. I'm not sure about the GCA side of things but I know there are plenty of people who will be able to help you with that one.

[Kendrew]

The stiffness could have been cramp!....a possible side effect of taking steroids.