Dosage reduction with covid vaccine?

[Lyndaki]

Hi, sorry if this has been asked before but I can’t find any posts on the site. I’m just wondering if there needs to be a change in dosage of Prednisolone before or after having the covid vaccine. I’m expecting to be called for mine in the next couple of weeks & would like to be prepared if that’s the case. Thanks.

[SheffieldJane]

Not as far as I know. I was wondering about the sick day rules if I get the poorly reaction though, see pinned post from Mrs Nails.

[Lyndaki in reply to SheffieldJane]

Sounds sensible

[DorsetLady PMRGCAuk volunteer]

See post below - question has been addressed in replies - healthunlocked.com/pmrgcauk...

[Lyndaki in reply to DorsetLady]

Thank you!

[PMRpro Ambassador]

No - Prof Sarah Mackie said as much in her webinar last night. Reducing your pred before the jab just puts you at risk of a flare which would be even worse and increasing it afterwards might reduce the efficacy of the development of the immune response.

[Lyndaki in reply to PMRpro]

Thank you

[tangocharlie in reply to PMRpro]

I thought I heard her say that, so thanks for confirming. So does she admit/agree that reducing your dose before your body is ready brings on a flare? The dripping tap causing a puddle. That's what seems to have happened to me many times over the years and what I believe happens but other rheumatologists scoff at this idea. I loved it that at one point she also referred to the standard reduction plans and said something like 'if only it worked like that'. or 'if only it was as simple as that'. I will have to listen again, it was very useful. Hopefully 'atypical' or is it 'assertive'? patients like you and I have taught her some things over the years.

[PMRpro Ambassador in reply to tangocharlie]

She said something about tapering very slowly at one point too I think ...

[tangocharlie in reply to PMRpro]

And that the best time to take Pred was 9am in the morning which surprised me

[MrsNails in reply to tangocharlie]

That’s to mimic the body’s normal production of cortisol, it’s at its highest around 9am.....

[tangocharlie in reply to MrsNails]

I see. I thought it might be better to take it closer to when the IL-6 dollop of inflammation hits our bodies around 4am. If I wake up in the night I have been taking my Pred earlier for that reason, and I am then less stiff by the time I get up around 9am.

[MrsNails in reply to tangocharlie]

I think it’s very much a balance of what’s best for you, the lower you get on Pred the better it is to no longer split the dose & to take it as close as possible to 9am - not that it’s going to affect me anytime soon!....

[tangocharlie in reply to MrsNails]

For me, it takes about 5 hours for the steroids to kick in, so again my logic is to take them earlier so I can function earlier. I guess it's a case of what works. I will be delighted if I ever get below 10 again, but not holding my breath. Hey, I should be optimistic, if everything I'm doing to sort out my microbiome I'll be leaping around the Maypole in a few months

[MrsNails in reply to tangocharlie]

Can only keep our fingers crossed 🤞🏻

[PMRpro Ambassador in reply to MrsNails]

Which means that actually you need to take plain pred about 7.30am and enteric coated about 5am but lets not be too picky! They NEVER think about the lag time ...However - what's the point if you can't move all morning?