Dosage advice with Flares Please

[Mellow-Yellow]

I have had PMR since 2016 and have reduced successfully using your go slow method untill I reached 5mg,where after several attempts I have been stuck stuck for some time. I managed last year to reduce to 4 and a half successfully and then 4 very briefly before flaring.

A couple of months ago I reduced (thrillingly ) to 4 and a half without any problems. Annoyingly I think I’ve overdone it and have started a very painful flare,right buttock down leg with occasional cramping too,rendering me useless.My husband returned home after a hernia repair a couple of weeks ago,so I have been looking after him,plus temporarily taking on a busier work load on our small holding.Nothing huge or heavy..I am 81 but normally cope well.

My daughter next door is usually brilliant at helping out but is herself recovering from illness,although bless her,she is walking dogs for me.

I don’t seem to be very effective at dealing with flares,I increased my dose yesterday morning to 5mg,and the same in the evening with very little effect,a horribly painful night.I’ve gone straight in this morning at 10mg,and am thinking of taking 5mg this evening.Does this sound reasonable to you?

I would so appreciate some advice

with many thanks.

[DorsetLady PMRGCAuk volunteer]

this link contains advice on dealing with a flare - so going up to 10mg would be sensible -and then follow the instructions for length of time and reduction -down to 5mg -not 4mg/4.5mg

healthunlocked.com/pmrgcauk...

[Mellow-Yellow in reply to DorsetLady]

I was considering going higher perhaps a combination of 15mg. 10 mg this morning and a further 5 mg tonight, as 10 mg in a split dose didn’t help me yesterday.However I shall read the advice in the link, and thank you so much for your reply.

[DorsetLady PMRGCAuk volunteer in reply to Mellow-Yellow]

Trouble is the higher you go up , the more you have to come down again -and a single dose rather than a split dose has more oomph -in my opinion. But you also need to give it more time -doesn’t necessarily work within 24 hours.

Good luck anyway

[Mellow-Yellow in reply to DorsetLady]

thank you Dorset Lady..that is a bore isn’t it? .will give this some thought! Hopefully as has been suggested for poss Sciatica I shall take large dose of Ibuprofen at lunch today so 🤞might see improvement! Thank you for persevering with me.😊

[DorsetLady PMRGCAuk volunteer in reply to Mellow-Yellow]

No probs… happy to. 😊

[SheffieldJane]

You have an awful lot on your shoulders right now, this will be working against a successful taper. I’d stop tapering until your life settles down.

Do you mean increase to 15 mgs? If so, this does seem a bit excessive. You need to rest as well, hard as this will be. Is there anyone who could come in to help for a week or so?

You could try the 15 mgs for a week, then drop down to 10 in one go and then do the slow taper. You must, somehow, rest as well. The extra responsibilities are undoing all your good careful work.

[Mellow-Yellow in reply to SheffieldJane]

Thankyou for your reply Sheffield Jane 😊. Yes I did mean 15mg as 10mg yesterday didn’t touch the sides! That seems a good idea trying it for a week..Thankfully My husband is recovering well and has decided to do the chicken duck and sheep check! I can’t actually stagger without a stick inside at the moment and getting out of bed itself is quite an achievement ..so resting it is!

[123-go]

DorsetLady has covered how to deal with a flare-your buttock/leg pain sounds very much like sciatica: have a look at this:

nhs.uk/conditions/sciatica/

You have a lot on your plate right now: hope things ease off soon.

[Mellow-Yellow in reply to 123-go]

You are so kind..thank you.

[PMRpro Ambassador]

What you are describing sound a bit more than "just" a flare - sounds like a bit of sciatica in there too. What I find helps with such acute pain is a flooding dose of 800mg ibuprofen - taken with a meal and some Gaviscon or the like - and a hot water bottle over the painfil area.

[Mellow-Yellow in reply to PMRpro]

Ah thank you for your reply,so much appreciated.Thats interesting..I did have sciatica a few years ago after picking up a friends wheelchair to put in the car....and can’t recall what on earth I took.Gosh it was painful.

I have avoided ibuprofen with steroids so far,but am willing to give it a go,However I don’t have any gaviscon,would taking them with milk be ok after a meal do you think? That’s what I do with Pred.I don’t take omeprazole as first prescribed with Pred as I reacted to it..no side effects with milk!!

[PMRpro Ambassador in reply to Mellow-Yellow]

The occasional dose with food should be fine.

[Mellow-Yellow in reply to PMRpro]

brilliant thank you .will take it after lunch which is clear of Pred!