Given sulfasalazine and told to increase prednisone

[Geordieland]

Good morning ☺️ So after my long awaited follow up appt after my disastrous experience taking Methotrexate , dizziness , feeling nauseous all day and rocketing levels in my liver function , my rheumatologist has prescribed sulfasalazine . I am to increase my 5mgs of Pred to 7 and a half mgs from now for 28 days then reduce down to 5 mgs again and start the SS at 1 tablet for 2 weeks then if bloods are ok increase to 2 tablets a day . I’m concerned that the drop of 2and a half mgs of pred after 28 days is too much ? Am also worried about side effects of SS but with PMR , painful RA and osteoporosis particularly in the head of the femur I need to be taking something 😳 Advice gratefully received x

[PMRpro Ambassador]

I have no experience of sulphsalazine - a rheumy in the UK wanted to start me on it but it requires consultant input and I was about to move here to Italy. He wanted to do it because he didn't think it was PMR - no-one here thinks it isn't PMR.

I suppose you have to try it the way he wants - I would be unhappy about such a large drop but he is probably treating this the way he would manage a flare in RA and assuming the increase in problems is the inflammatory arthritis rather than PMR. If you use one of the slowed tapers, DSNS or DL's alternative, the 2.5mg drop may be tolerable.

[Geordieland in reply to PMRpro]

Thanks - I really do think my RA is by far the main problem so maybe , for once 😂 , I’ll do as I’m told ! Watch this space x