How fast can I reduce dose after brief increase?

[Jontie]

This follows on from my posts last week. In short, I was on 2.5mg pred after taking 4 years to reduce from 15mg. Then I had a potential GCA scare and my dose was increased to 60mg for 2 days, then 15mg for 5 days. I'm on day 5 of 15mg today. GCA type symptoms, thankfully, have not returned and Dr was supposed to phone me today to discuss next steps. However, she hasn't rung. I don't want to become reliant on 15mg again which would take me back 4 years. I know you're only supposed to drop by 10% but, as I've only been on 15mg for 5 days, I'm planning to reduce to 7.5mg. Do you think that's advisable? Thanks.

[PMRpro Ambassador]

I would try 10mg first for a couple of days - that is still less than 10 days at above 8mg. The 10% is more for tapering and finding the right dose. But 15 to 7.5mg is a lot I feel.

[Jontie in reply to PMRpro]

Ok. Thanks. I'll take your advice.

[SheffieldJane]

I would be worried that the disappearance of GCA symptoms was due to the Pred. Are you and your doctors absolutely convinced that you do not have GCA?I was diagnosed with GCA and Large Cell Vasculitis on little more than my Rheumatologist ‘s intuition, leading to an Ultrasound Scan, that showed the evidence.I have not experienced typical symptoms since beginning Pred. 40 mgs and now Tocilizumab plus Pred. 10 mgs.

Good luck and obviously stay alert for any return of symptoms.

[Jontie in reply to SheffieldJane]

Well my ultrasound was clear, although I'd been on 60mg for 2 days when I had it. Opthalmology couldn't see anything amiss. That's basically what they're baseing the non GCA diagnosis on. I took 10mg last night and have woken with a very low level headache. I'll keep watch for any further symptoms. Thanks.

[PMRpro Ambassador in reply to Jontie]

If all they looked at was the temporal artery that really only means it isn't there! GCA can affect other arteriies without it being in the part of the temporal artery they can get at. Jane's was found in the brachial artery (under her armpit supplying the arm) - but an eye specialist might not be as aware of LVV (large vessel arteritis).

[Jontie in reply to PMRpro]

They only checked right temporal artery and I've no idea if ophthalmologist (year 2 student!) was aware of LVV. Now I'm in a quandary!

[SheffieldJane in reply to Jontie]

I also had a scan of my Aorta which showed, reassuringly, that it was functioning as it should.

[PMRpro Ambassador in reply to Jontie]

Is that Year 2 of consultant/specialist training? Still not a lot of experience unless they are doing it daily. Keep a close eye on your symptoms. (sorry, not an intended pun ...)