Prednisolone

Hi All, having started my steroid program again with a dosage of 20mg a day, I feel so much better. My question is if I have to stay on this dosage for some time or can only maybe taper down to 15mg before pain and fatigue return is this a safe dosage? Does this level cause any other issues if sustained for a long period? I hear of people starting out on much higher doses so just wondered where 15-20mg was on the scale??

[DorsetLady PMRGCAuk volunteer]

Hi

I see 2 months ago you were on 15mg - so what prompted the increase to 20mg?

Was it just for a few days to catch a flare - or have you been on it longer than a week or so.?

If you were having issues at 15mg no point going back to that dose - 17.5mg might be more sensible.

You are not aiming for a specific dose - you are tapering slowly to find the lowest dose that controls your symptoms... whatever that may be.

Is 15-20mg a high dose? Depends- to someone who’s started on 80mg for GCA it is a middling dose to me, to others with PMR it’s high.

But, to be honest you need what you need - otherwise little point being on Pred.

[Hidden in reply to DorsetLady]

I was tapering down from 15 but stiffness, fatigue and pain started to kick in. Got to 10mg.. I have only been really pain free at 20mg so the Rheumatologist suggested restarting the tapering at 20mg and coming down by 1mg a month.. so a slower reduction than previously.

[DorsetLady PMRGCAuk volunteer in reply to Hidden]

As PMRPRO says a more sensible approach from Rheumy - let’s hope it works this time around.

[PMRpro Ambassador]

Your rheumy is doing what should have been done originally - so it is a question of where you get to before it gets uncomfortable. And that changes over time. At the start you are likely to need more than you will a few months down the road - so now, having used 20mg to clear the decks and only going at 1mg at a time you will have a few months before you get to 15mg anyway. Just take it one month at a time - and remember you have a responsibility to do your part to with pacing and resting and not overdoing things.