Flare up

[Claremont2023]

Fairly new to PMR. I was on 15 mg but reduced fairly slowly to 12.5 & 10mg (alternate days) & due in weeks time to go to 10mg. Is it possible to get flare ups at this dose? I have a bad headache & my hips & knees are very painful.

[DorsetLady PMRGCAuk volunteer]

You can get a flare at any dose -just means you have gone below the level of Pred your illness actually requires.

And personally don’t think the alternate day tapering does you any favours.

Certainly no further reduction until things sorted. Would suggest you return to 12.5mg (hoping that’s enough to control symptoms) and then request 1mg tablets to get down to10mg -you need them anyway..

Or cut 2.5mg in half to give you 1.25mg -so long as plain white tablets.

Get your headache checked please -could be a sign of GCA

Info link-which gives a better idea of what to expect - think I sent before -but never hurts to re-read -

healthunlocked.com/pmrgcauk...

[Claremont2023 in reply to DorsetLady]

Thanks for the advice. I see the doctor next Tues but I’ll stick to 12.5 till then

[SnazzyD]

I agree with DL that alternate dosing isn’t ideal for most people. If you are finding that the lower dose is too low and your symptoms are coming back, you have no idea if a dose in between would have been enough for you. All you can do is go back up to the higher dose when it is possible that the effective dose is actually somewhere in between. This is why a slower reduction in smaller steps can help stop yo-yoing and potentially more Pred taken long term.

Regards your headache which DL says could be GCA, I would say that a GCA headache doesn’t have to be terrible to be GCA; I’ve had worse migraines. If it is persistent, and you start getting other funny head or eye symptoms, raise the alarm. It is difficult when there are viruses about, not least Covid, but GCA has a different ‘flavour’.

[Claremont2023]

Thank you for the advice. I’ll stick at 12.5 till I see my doctoe.

[PMRpro Ambassador]

And I agree with DL and Snazzy.