Dose pack of methyl prednisone while on 4 mg of prednisone

[Blackcatlover]

Good morning. I am currently on 4mg of prednisone daily and auto injections of Actemra once a month. This is my sixth year trying to keep my PMR under control. Things have been going well for the last four months. Unfortunately I have two herniated disc’s due to a kayak trip. I have seen a neurosurgeon who read my MRIand he has prescribed physical therapy, cortisone injections and a dose pack of methyl prednisone. I am scared to death that what he has prescribed will be bad for my PMR treatments. Will this shot and the dose pack put me at risk for a flare. Thanks in advance for your advice.

[SnazzyD]

Have they explained the mechanism by which the extra steroid is going to help the herniated disk? What is the dosing schedule of the pack?

[Blackcatlover in reply to SnazzyD]

He thinks it will help cut the inflammation. Picking the prescription up today. I know it’s for six days with lowering amounts each day.

[PMRpro Ambassador]

It shouldn't lead to a flare - it is basically the same as you getting the dosepak while not on pred, just your baseline is a bit higher.

But like Snazzy - bit intrigued how they expect it to help.

[Blackcatlover in reply to PMRpro]

Thanks for your reply. My foot and ankle have very little feeling so perhaps he’s hoping the inflammation will go down. It’s the L5 and L1 that are herniated.

[Blackcatlover in reply to PMRpro]

PMRPro, should I be afraid to do this dose pack for six days and should I still take my regular 4mg prednisone each day? I figured out that the first day the methyl prednisolone will equal 30 mg prednisone. That seems so high. I would rather be safe and endure the pain than mess up my PMR journey.

[PMRpro Ambassador in reply to Blackcatlover]

No - take the dosepak AND the 4mg. It's just like taking it for inflammation without being on pred at all but the baseline is slightly higher, 4mg is a low dose. The doctor obviously thinks you need a decent dose to get the extra inflammation undercontrol - after all, if 4mg was enough you wouldn't need it would you? And the idea of the dosepak is that it has a taper built in but you hit the inflammation hard at the start.

[Blackcatlover in reply to PMRpro]

Great reply.as always. You always give me guidance that makes my choices easier. I will start the dose pack tomorrow. So glad you are here for all of us.

[Sharitone]

Is it possible you could have sciatica (because of the herniated discs)?

[Blackcatlover in reply to Sharitone]

He thinks I do have sciatica caused by the herniated discs.

[Seagu11]

Been on Prednisolone for two years from 1 to 60mg now o.k so they must know what they are doing . Do not remember Actemra ? I have a Tuxedo cat I love the bones of him.😋😸

[Blackcatlover in reply to Seagu11]

Thanks for your reply. I just found out methyl prednisolone is a little stronger than regular prednisone but they work the same way. Still not sure if I should start the dose pack and should I also take my regular 4mg dose with it. I’m always so worried about upsetting a regimen that is working for me.

[Blackcatlover in reply to Seagu11]

Love my black cat to pieces too! Fall is here and his favorite toys are dried leaves!❤️🐾🐾😻

[Blackcatlover]

Thanks so much for your very detailed reply. I am currently taking 4mg of prednisone and injecting Actemra monthly. I feel like my PMR is under control and I’m so afraid to upset this journey. Good luck to you with Humira.