NHS Adrenal advice

[Rancho]

I’ve received the emergency card and notes from my GP. It advises to double the steroid dose whilst I have an infection which I currently do, sore throat, aches etc but testing negative for COVID 19.

I’m a little worried that moving from my current 5mg daily to 10mg could instigate a flare when I drop it back down to 5mg when the infection passes. I’m also on 15mg of methotrexate weekly. I’ve never increase pred in this situation so inclined to stay put at 5mg as it’s taken an age to get there.

Any thoughts please.

[DorsetLady PMRGCAuk volunteer]

GP is following sick day rules - medicinehealth.leeds.ac.uk/...

This is post from FAQs relating to same -healthunlocked.com/pmrgcauk...

If you only on 10mg for a few days, you should be able to drop back down without issues.

[SnazzyD]

Personally I never just popped up the dose unless I felt I was ‘losing’. If I was holding my own I stuck. The only time I upped for being ill was when I had Covid last year when I was on 1/1.5mg and once I think when I had flu or something a couple of years ago. I’m sure Mrs Nails will be along as the Methotrexate t-shirt wearer (and more), but I think I’d seek advice on whether to stop the Methotrexate, especially if it is a bacterial throat infection.

[MrsNails]

It’s usual to stop your Methotrexate Dose if you are feeling unwell - has GP prescribed you anything for throat infection? If your GP is recommending you follow Sick Day Rules then that is what l would do. Have you had a PCR Test as opposed to a Lateral Flow Test?

Kind Regards

Get Well Soon 💐

MrsN

[PMRpro Ambassador]

You should be fine to increase the dose for up to 10 days and still drop back to the previous dose. It is the same as someone not on pred taking a short course - just the baseline is higher.

As Snazzy mentions, usually one of the things you are told to do when on MTX is to miss that weeks dose if you are ill, and definitely while you are on antibiotics.

[2013mayo]

Hi, Well it’s up to you, I just recently had to increase my dose of pred from 5mg to 10mg as I had just had major surgery and it caused a bit of relapse. I took the extra for 5 days and then dropped back to my normal dose 5mg with no problem. See how you feel and then decide.

Xx

[Exflex]

Earlier this year I had a chest infection needing a 5 day course of antibiotics. My GP told me to increase Prednisolone from 10 to 20mg for the duration. When the 5 days were up I immediately dropped back to 10mg without problem.