Diagnosed PMR May 2019 and started on 15mg Prednisolone which worked a miracle within 10 hours. Have been reducing ever since but last year had some GCA type symptoms so Pred was increased to 40mg whilst waiting to see Rheumatologist and for tests. Ultrasound showed negative and thorough eye exam showed no problem. Decreasing continued again with no problem until December last year when at 8.5mg I began to experience pain in upper arms and thighs again. Spoke to my own Dr and added 5mg for 1 week then back to 10mg for 1 month and decrease 1 mg per month from there. All has been going well except that I decided to decrease by 0.5mg per month. My Dr has always been supportive and happy for me to monitor my own illness although I am now monitored by Rheumatologist (has been phoning 6monthly through pandemic)
At 0.5mg reduction monthly. Am down to 9mg and seem to have some pain increasing again. Decided to go back to 12.5 for a week but this is day 4 and there is no improvement so I’m not sure where to go for here. My Dr is on leave and I dont wish to consult with anyone else in the practice. Do I finish this week at 12.5 or should I add more for the last few days? I really didn’t want to be yo-yo -ing up and down with doses but am at a loss to know how to manage this. I have coped with Prednisolone quite well after adapting my diet so thatI haven’t had a weight increase and side effects are ‘minimal’ so the last thing I want is for the Rheumatologist to add another drug into the mix because of the problem I have getting below8 or 9 mg.
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jaycee444
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Hi, The trouble is once you have a couple of flares quite close together, it seems much more difficult to get a grip of things again.
Usual recommendation is to add 5mg to last dose you were okay at....so from what I’m reading that would be 15mg in this current scenario rather than 12.5mg....and to stay there between 5-10 days.
So maybe another 5-6 days at 15mg. Then, as you seem to be stuttering, rather than drop back down to 10mg in one go, try 2 steps - a week at 12.5 - then 10mg for a month.
From then on, definitely 0.5mg a time, and if not already, a slow taper - here’s a couple to choose from -
Thanks DL. I appreciate your advice. I have already decided I’m not going to be pressurised in to taking another drug. I already have another autoimmune problem - Ulcerative Colitis to contend with so have other long term drugs and their side effects added to the mix.
DL has said everything I would say - except, remember you aren't heading relentlessly for zero, you are looking for the lowest dose that works as well as the starting dose did. You have got stuck at a similar dose twice - usually the sign that you have got to the interim destination. You will get lower - just not yet.
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