any advice please?

[Dolcelatte]

hello, I had PMR/GCA diagnosed January 2020 . A minor relapse and then a major one in August 2021 where I had to up my dose to 40mg Prednisolone. After that I have been tapering, cautiously until December 2022 where I was on 5.5mg. At Xmas I was hit by flu with high temperature and cough. My legs wouldn’t hold me up. I isolated in my bedroom as I had a full house with children and their families and luckily full fridge and freezer. My husband was a major help as I was stuck in bed for 3 weeks.

i was prescribed amoxicillin which helped. I decided to increase my Prednisolone by 5mg to 10.5 for the last 3 weeks. I need your advice please on what to do next as my flu symptoms have subsided.

Do I drop back to 5.5mg? Incidentally I am expecting to have a knee replacement operation in a month or so.

Thank you

[SnazzyD]

I certainly wouldn’t because for me personally I don’t underestimate my body’s ability to get used to things quite quickly. Therefore, I would want to avoid withdrawal, plus at 3 weeks you are on the edge of adrenal shutdown again. If it were me I would try 0.5mg per week but be very wary of kickback. The trouble is with viral illnesses is that you can feel mildly knocked back for a while which can also feel like adrenal insufficiency. I’m sure you’ll get more advice so sit tight.

[Dolcelatte in reply to SnazzyD]

thank you very much for your feedback

[DorsetLady PMRGCAuk volunteer]

As  SnazzyD says you’ve gone past the usual time when you can drop back down easily after a flare [maximum suggested is 14 days] - so for that reason, and recovery from flu it does need to be slower…

Perhaps 8mg or 7.5mg initially - and see how that goes….after a couple of week at that level you can then re-evaluate the situation.

Come back and let us know - and maybe have a look at this for upcoming replacements- if this is first one -

healthunlocked.com/pmrgcauk....

[Dolcelatte in reply to DorsetLady]

very grateful for advice. I had already read about knee replacement and Judy Dench interview. Very useful.

[PMRpro Ambassador]

When I was first put on pred, it was 2 weeks each of 15/10/5/stop. That was with a baseline of zero so if you take YOUR baseline as 5mg, I would try 7.5mg on the way down - if that worked, then drop to 6mg after a week or so. If the 7.5mg feels or felt too much all at once I'd go via 9mg for a few days,

[Dolcelatte in reply to PMRpro]

thank you so much for your advice. I will start tomorrow on 7.5 and fingers crossed