Reduced dosage.

[alansouthworth42]

I have suffered from PMR for more eight years and have been taking prednisolone for that length of time, after managing the pain with 5mg per day for some time, my GP suggested I should reduce the dosage slowly, I am now down to 2mg and the pain in my neck, shoulders, wrists and hips as returned. Should I revert to the 5mg per day?

[123-go]

Yes, you should. You don't want the inflammation to build up with the associated pain increasing. How slow was your taper from 5mg?

[alansouthworth42 in reply to 123-go]

I tapered off by 1mg per week as suggested by GP.

[123-go in reply to alansouthworth42]

That kind of taper was too fast to manage the inflammation. I can understand your wish to reduce but if doing so results in return of pain you will be yo-yoing between doses without achieving the desired effect.

I've just seen DorsetLady's reply to you. Wise advice there.

[DorsetLady PMRGCAuk volunteer in reply to alansouthworth42]

Much too quick....1mg a month, or better still 0,5mg per month.

[piglette in reply to alansouthworth42]

How on earth did you manage to reduce that quickly? I would be lying on my back with my legs in the air at that rate!

[YuliK in reply to piglette]

Piglette oh Dear, 😱Not very lady like. 😂

[piglette in reply to YuliK]

Like a dying earwig!

[Thelmarina in reply to piglette]

😂😂😂

[DorsetLady PMRGCAuk volunteer]

How did you reduce from 5mg to 2mg?

If it was slow enough for you to remember at what dose things started to go wrong, then maybe try that dose initially, or just above and see if things settle.

If it only started at 2mg, then a couple of options -

try 3mg for a week - that may may do it, or

Up to 5mg for 5-7 days and then drop back down to 3mg,

Whatever works, I would stay at new dose for a few weeks, maybe a couple of months - then reduce by 0,5mg a time and maybe use a slow taper such as this - healthunlocked.com/pmrgcauk...

But to be honest any dose below 5mg is doing more good than harm, and you may be one of those people that will always need a very low maintenance dose - so don’t get stressed or pushed into something that’s not achievable.

[alansouthworth42 in reply to DorsetLady]

I understand that I shall always need a low maintenance dose, I am just trying to keep it as low as necessary.

[DorsetLady PMRGCAuk volunteer in reply to alansouthworth42]

That’s understandable, but 2mg is obviously too low - sometimes wish doctor’s would let you do the deciding.

[PMRpro Ambassador]

I would, before you get into real trouble - it is a low dose, less than the body makes in the form of cortisol per day for the body to function. Most experts in PMR stop worrying once you are below 8mg and are often happy at 5mg for a long time. That isn't to say don't try to get lower - but you won't do it like that. It has to be SLOWLY.

And that is possibly also part of your problem - after 8 years on pred there is no way in %^££ you can reduce from 5mg to zero at 1mg per week. 1mg every 2 months MIGHT work but your GP was putting you at high risk of an adrenal crisis by suggesting that you reduce at that sort of rate. You can do it after 8 weeks on pred maybe - but not 8 years.

[daworm in reply to PMRpro]

like PMRpro says, that was way too fast of a taper, I took months to drop from mg to mg after I was under 5mg's and even went 1/2 at a time for weeks...

[pollyg263]

you are thre same as me 8 years, i am now pred free for 9 month and i was up and down from 5 m to 2 m but i persiverd and dared to stick it out and eventualy got down to 1 m then ,5 , now after 9 month i still have a little pain in buttocks and shoulders. the shoulder pain got better with excersize and buttok pain seems to have got better with a little walking. and to help sleep i take 1 paracetamol at night and i am ok with that i hope this helps xxx

[daworm in reply to pollyg263]

thats just about where I'm at...zero'd out a few months ago but still got a few aches and pains which I'm choosing to handle with OTC nsaid's and Tylenol as needed...I also have incorporated CBD at a low dose, seems to help with everything, but just be aware CBD can also interact with certain meds...if they go through the liver, which most do....lots of info out there to help guide..