Small flare Advice

[fishingnut]

After 4.3 years of PMR, I am currently on 2.5 mg Prednisone, after a flare up at 2 mg a couple months ago. I was just going to continue with 2.5 for a few weeks, but am noticing another small flare. I’m hoping to just ride this out without increasing Prednisone. Does that seem reasonable?

[DorsetLady PMRGCAuk volunteer]

…unlikely to work as you’ve flared a couple of times in as many months, sounds as if you’ve probably reached your lowest dose - for the time being anyway. If you ignore things, it’s likely to escalate…so try 3 or 3.5mg now before that happens.

As such low doses, as many have discovered 0,5mg really does make a huge difference. Get yourself stable and maybe stay at slightly higher dose a little longer than normal…. why spoil things now you’ve got so low…

[fishingnut in reply to DorsetLady]

Thank you…I appreciate the feedback. My GP actually has taken the philosophy of 3 mg for life if necessary. So at least I’m not bucking him, like I had to the rheumy I first went to, who wanted me off Prednisone within a year.

[PMRpro Ambassador]

I don't think there is such a thing as a "small flare" - leave any increase in symptoms due to being at too low a dose long enough and they will mount up to make a bigger flare.

I agree with DL's comment - catch it now and don;t rule out the possibility you need more pred. Or you might end up needing a lot more pred ...

[fishingnut in reply to PMRpro]

Thank you…makes sense. I’m grateful for the prompt reply and expertise you are so willing to share.

[piglette]

If you try and tough it out the PMR will come back and bite you. I would increase by 5mg for say a week to really hit the PMR on the head and then you can drop back again ideally in two steps. Say go to 3mg first for a few days, if all is OK reduce again. It will really pay off.

[fishingnut]

Sounds like a smart plan actually…and less painful. Thank you.

[SheffieldJane]

Half a mg is so amazingly strong. I am on 5.5, a recent drop and felt tired but pain free all day having taking my tablets in the early hours. Around 9 pm I was getting stabbing pains in my head, back pain and leg pain. I took half a mg of uncoated Pred, ( I cannot get coated) I will take 5 mg coated in the early hours. This was sufficient to remove all the pain within the hour. I need to avoid over treating. This is powerful stuff.