hydrocortisone or prednisone?

[pmac22]

I am wondering which steroid is better for GCA? I was switched over to hydrocortisone by an endocrinologist to “nudge my adrenal glands into waking up” and also the tests to see if adrenal glands are functioning is better done with being on hydrocortisone. I had test last week and adrenals glands are working.

I am considering switching back to prednisone to continue my tapering. Hydrocortisone seems to upset my stomach more and needs to be taken twice a day. I also feel like I feel more pressure in my temple areas that I did not feel when taking prednisone. I would appreciate hearing anyone else’s experience with this or knowledge. I think PMRpro said that prednisone may be better at GCA inflammation than hydrocortisone. Thank you all for your time.

Peggy

[DorsetLady PMRGCAuk volunteer]

No personal experience, but as Prednisolone/Prednisone is usual type given for GCA and PMR - I think therein lies your answer.

Now you have posted - there are related posts to look at -

[PMRpro Ambassador]

Pred is definitely a better antiinflammatory than hydrocortisone and it isn't unusual for patients to find they tolerate pred better than HC. There is also no reason why pred can't be used. I happened to find this publication just the other day for someone elseL

pubmed.ncbi.nlm.nih.gov/290...

"Prednisolone once daily is more convenient than hydrocortisone thrice daily, and there is no difference in the markers of cardiovascular risk measured. Because prednisolone mimics the circadian rhythm better than other glucocorticoids, it should be considered as an alternative to hydrocortisone for AI."

[pmac22 in reply to PMRpro]

Thank you, I appreciate your help. I have decided to switch back to prednisone. Once a day is so much easier and my stomach feels better too.