Accidental missdose

[Lovestosew]

Good morning all, I hope you are all doing well so far today.

I am a 65 year old with Type 2 diabetes & was diagnosed with PMR last March & started on a dose of 15mg Prednisolone. Over the course of the last 12 months I have managed to taper to just 4mg per day with bearable discomfort.

Over the last 7 days I felt so much better, all discomfort had melted away, I felt like a new woman. Bags of energy, I did things I hadn’t done for so long, walks around the town, on my hands and knees cleaning & reaching up to clean to high places. I thought, fantastic, the PMR is gone and I’ll soon taper off pred altogether!

(I hadn’t been sleeping well at all but I put that down to worrying about the world situation and I have also just recently had a Non Hodgkin Lymphoma diagnosis & am waiting surgery.)

However when taking my meds yesterday morning I discovered to my absolute horror that for the last week I had been taking 4x5mg prednisolone each morning so a 20mg dose each day instead of 4x1mg.

I panicked. I took 12mg & later phoned the pharmacist who said to leave it at 12 mg that day & take 11mg today & call the GP on Monday.

So that’s what I’ve done so far. I am terrified that I have messed up my taper, I am scared that the pain will start back in earnest, I am afraid in case I’ve messed up my adrenals.

Has anyone else done anything this daft on their PMR journey? Any advice for me please?

Thank you

[DorsetLady PMRGCAuk volunteer]

No wonder you had a good week!

As you were on 20mg for only a week, you should be okay to drop back down without too much of an issue.

You probably could drop down to 7mg today, unless you’ve already taken the 11mg.

As you mention “bearable discomfort”..I would say you have maybe been pushing the tapering a bit too much. With diabetes that’s understandable, but you need to accommodate both illnesses…and a slower taper will help your adrenals as well…

And don’t worry, a blip like this shouldn’t affect things, but just make sure it doesn’t happen again..,if the boxes of Pred are difficult to distinguish, write the dose on outside with a marker pen.

[Lovestosew in reply to DorsetLady]

Thank you so much for your reply, I feel reassured that I haven’t made a dreadful error and messed things up completely.I have already taken 11mg this morning but will take 7mg tomorrow.

[Koalajane]

Hi, nice to hear from you.Yes, yes many of us have taken the wrong dose by accident and it certainly sounds like your body enjoyed it.

Do not worry and go back to where you were comfortable. You have done extremely well to get to 4mg in a year.

I too am type 2, in remission and on no meds for it and for the last week have been struggling to walk due to sciatica. This has impacted upon my blood sugars but hopefully the sciatica will improve soon and I can go back to my walking which I love

[Lovestosew in reply to Koalajane]

Thank you for replying to me. I am usually so good with my meds, extremely careful. I feel such a fool for slipping! Although I have got down to 4mg in 12 months I haven’t been pain free & comfort since about 7mg. I was so determined to taper to zero pred in 18 months that I just battled on. I’d forgotten how it felt to feel ‘normal’ & the days on 20mg and feeling painfree and so well have been an eye opener!

I do hope your sciatica pain eases soon

[PMRpro Ambassador]

Hope you really enjoyed it!!! You aren't the first and you won't be the last! If you really want to to avoid it happening - put those 5s somewhere not so easy to access!!! And a black marker pen is ideal for writing on the pack! Though like DL - I'm wondering if maybe you really need 5mg (or more) because that diagnosis of NHL will be lurking at the back of your mind and providing a stress factor that might need a bit more pred.

You can take a higher dose - even that high - for up to 7-10 days or so and then drop straight back to your baseline dose without a problem. You will feel that big a drop I suspect just because if the change but it would be OK. As DL says dropping in daily solid steps will probably help.

I DO appreciate the desire to get off pred asap - but PMR DOESN'T just last 18 months for the vast majority of people and as long as the underlying autoimmune disorder is alive, you need pred or the inflammation will build up and cause the symptoms to get as bad as they were at the start. The choice is enough pred or unmanaged PMR - and nothing you can do will speed up the process of not needing pred.

[Lovestosew in reply to PMRpro]

Thank you for replying to me. I will certainly keep my meds separate from now on, I guess I foolishly got complacent. I’ve taken 11mg already today but I think tomorrow I’ll take a big drop to 7mg & then back to where I was at 4mg. Fingers crossed that I don’t feel it too much!

[DorsetLady PMRGCAuk volunteer in reply to Lovestosew]

Personally I would stay at 7mg a bit longer - and maybe 5mg not 4mg - it’s not a race. You’ve already mention discomfort -so ease up! 18 months is very quick to be so low…

[Lovestosew in reply to DorsetLady]

Thank you sweet much for your advice. Ihave stopped panicking, given everything some serious thought & I have decided to take your advice. I will drop to 7mg tomorrow and stay there for a while. Being pain free for the last week has highlighted to me just how uncomfortable I have been feeling these last few months and just how restricted my movement has been.I think in hindsight I’ve had tunnel vision, desperate to get off prednisolone & get back to a more normal life. I will take it slower.

[PMRpro Ambassador in reply to Lovestosew]

Excellent!

[DorsetLady PMRGCAuk volunteer in reply to Lovestosew]

Good! Not nagging, but you do need quality of life..,

[piglette]

At least you took too many it is when you forget to take the pred when it really hurts! You can drop down quickly again, but you want to be in the same position you were when you took the 20mg and felt fantastic, so don’t go back to your original dose but something slightly higher so you can carry on feeling fantastic.

[Lovestosew in reply to piglette]

Thank you, I will take that advice & I’m going to see how I feel at 7mg from tomorrow.

[piglette in reply to Lovestosew]

Good idea. If OK, stay there for a week or so and then you can think of reducing. Don’t reduce if you are getting pain.

[Lovestosew in reply to piglette]

Thank you, I’ll do that.

[Sophiestree in reply to Lovestosew]

Also remember you are about to embark on another journey with the NHL. I think you need to be kind to yourself and stay on 7mg for a while until,everything gets into a more normal routine. You have a lot to deal with right now. You certainly qualify for virtual hugs.

[Lovestosew in reply to Sophiestree]

Oh thank you so much ch, I really appreciate your kind words. My head is all over the place at the moment and the support and reassurance is really helping.

[SheffieldJane]

This suggests to me that you may have gone too low too fast. As DorsetLady has explained the 20 mgs will do you no harm. I did something similar with an accidental extra 5 mgs but rather than having a great day, I became instantly vile tempered. So I think I’d know, my poor husband would.

[Lovestosew in reply to SheffieldJane]

Thank you