I forgot what you do when you are using the tapering method and have a flare

[bluegirl7]

Hi, I have been tapering from 3 to 2.5 and using THE Method and now as I am going to the part where you are almost all on the new dose I'm flaring. Lots of pain in hips and shoulders suddenly and lower back. I am due for my second vaccine dose next week and wanted to be as low as possible but with stress and so much cold weather and snow pain is back. This is the month when I had my first symptom in 2017 also.

I took 5 today but don't want to go higher. How to eventually decrease as I hope fully feel better? Thank you as always!

[jinasc]

Personally I would have gone up to 10mg and hit it hard and fast, stay there for about 5 days, then drop no more than 1mg every 2 days and see how you go.

Stress and cold ..................

[PMRpro Ambassador]

You only need to add 5mg for a few days - and then drop straight back to the old dose you know was still enough (i.e. 3mg) Thes are low doses, I doubt they will do much against your immune response for the vaccine.

[bluegirl7 in reply to PMRpro]

Thank you. It is such a painful one. Using all my go-toos - Cliptol gel with ibuprofen, lidocaine pain patches and Tylenol (acetaminophen) and my usual epsom salt bath. I was so hopeful of getting off Pred some day. It destroys my stomach and esaphagus and my skin. Thanks again I will cope!!❤️

[PMRpro Ambassador in reply to bluegirl7]

Are you not on stomach protection meds? Always take pred in the middle of a proper meal and many people find plain yoghurt also helps.

[bluegirl7 in reply to PMRpro]

Oh yes. So much stufff!!! Prior to PMR had very bad GERD and a bizarre situation with an amoeba in past years that has caused issues with my esophagus. In September had to have esophagas stretched and polyps removed again because it was closing up and very painful. So we don't have coated Pred in US so take omneprazole am and pm and Fanotidine every evening and watch diet etc. and so many other meds and concoctions. Issues definitely worse these last 2 years on Pred. I cannot do the middle of the night dose because I would have to eat a lot to do it and then sit up etc. which is how I take it in the am and sometimes split with a lunch meal. I work also albeit from home now but am very busy. There are other things the Pred has done to me that are perhaps more serious in the long run. So I would love to see the back of the Pred but not interested in other meds which seem like they would be worse. Anyway what was once my savior is now a bit of a tormenter as others have expressed.Thank you!!!

[PMRpro Ambassador in reply to bluegirl7]

No-one ever suggested methylpred depot injections? That bypasses the stomach pretty effectively

[Sparrowxyz]

My rheumatologist is very strict about how to reduce prednisone levels and for how long . You might consult your doctor.

[HeronNS]

You have some unique issues regarding your esophagus and gut, so I think PMRpro's suggestion about methylprednisone injections is something you should raise with your doctor. Increase your dose as much as you need to handle the flare and stay there long enough so you know it's truly damped down, then step down in stages as jinasc suggested. Five mg increase should be enough although I personally found a slightly higher increase for an unprecendentedly severe flare worked very well. I've been going down again very slowly as a faster drop caused symptoms to flare up again too much. Four days for every .5 taper; have gone from 10 to 7, but it took a few days to realize this is what I had to do or I might have been a bit lower by now. So far three weeks, so not a quick jump back down by any means! But you do what you have to, and controlling inflammation has got to be the focus.