Dexamethasone instead of Prednisone for PMR????

[bluegirl7]

Hi All! Been through some things with esophagus - had dilation and polyps removed. Acid reflux is bad and gastro thinks prednisone has had an impact after 2 years. No enteric pred in US and doc doesn't thiink putting it in a capsule is a good idea. I am down to 3.5 mg - occasional 5 if I flare and quickly down and it has been ok. Now on 20 mg omneprazole am and pm and 40g famotidine in evening. So rheumie moved me to .5mg dexamethasone replacing prednisone. He said it might help my esophagus stomach etc Then we would go back to prednisone when I can get down to 2 - 1 mg.

Has anyone done this or heard of it? I had dexa shots years ago for allergy flares but never this. He said it is a low dose comparable to about 4 mg of prednisone.

As always thank you!

[PMRpro Ambassador]

Very unusual - don't think I have come across anyone actually using it. Is he using it as a daily dose? Although - theoretically it has exactly the same adverse effects including increased gastric acid. Do tell us how you get on.

[bluegirl7 in reply to PMRpro]

Hi, Exactly. This seems so odd to me. Which is why I wanted to know what you all thought. I haven't taken it yet. I am thinking of not doing it. I am going to try taking 3 mg pred instead of 3.5 in 3 single tablets because I think taking 1 mg plus breaking 5 in half might expose me to more of the gastric impact. And keep taking omneprazole etc. I am not sure but am afraid to set myself back with PMR and with my adrenals. Thank you as always!!!

[PMRpro Ambassador in reply to bluegirl7]

My husband struggles with any form of tablet - but broken/cut ones are worse!

[MrsNails]

Dexamethasone works over a longer period than Prednisolone ie a longer ‘half life’ of about 36-72hours, it is given for different conditions rather than PMR l have taken it along side Prednisolone when l was on Chemotherapy, it is not generally used in PMR because the dosage required to taper would be too complex as you can see from your revised dose.

But as PMRpro says do let us know how you get on.

Good Luck

MrsN

emedicine.medscape.com/arti...

[SheffieldJane]

I haven’t heard or read about this treatment regime. For what it’s worth Omeprazole caused more gastric problems for me than it helped. I would want my doctor to talk me through the treatment regime and the rationale for it. Good luck! Keep in touch!

[TheMoaningViolet]

Have they considered Depo-Medrol injections? I believe the standard dose is equivalent to 5mg of Prednisolone. Tangocharlie may be able to give you more information. And PMRpro of course.