Query - what dose for flare

[Abykarma]

Help please! I have been tapering from 7.5mg Pred since January, following Dorset Lady's slow taper plan. This past week I reached 6.25mg every day and yesterday had stiffness in my hands and wrists, neck and across collar bone and shoulders, not as bad as hands. Today I woke with severe pain and stiffness in hands and wrists. Luckily my fingers work to type but I can barely move my wrists/hands it is so painful. This morning I took 8.75mg Pred, but have a feeling this is not going to be enough to alleviate the flare. What dose should I go up to to really smash the inflammation?

I was diagnosed with PMR in March 2022 and the pain was quickly alleviated with 40mg pred, tapering down over weeks and months. Never had any flare while tapering until now.

Your advice would be so appreciated - I really depend on this wonderful forum for information.

[PMRpro Ambassador]

Flare due to overshooting dose instructions: add 5mg to the dose where you flare for up to 7-10 days and drop back to the dose where you were last OK.

How long had you been at 6,5mg? Do you think it was long enough to know that was still enough?

[Abykarma in reply to PMRpro]

Last week I was on 6.5mg for 5 days, 7.5mg the other two. Week before 6.5mg for 4 days, 7.5mg for 3 days, week before 3 days etc etc So this past week was the first one with all 7 days at 6.5mg, but I started on Monday and it's only this weekend that I've flared.

Thanks for your advice re dose - I'll have to go up to 12.25mg as we don't get 1mg pills in SA. Am managing to break the half into a quarter - just.

[DorsetLady PMRGCAuk volunteer in reply to Abykarma]

Lack of choice of tablets does make tapering more difficult .

Once you get things under control and you’re back to lower doses, you can always extend the 5 week taper to 7weeks or even 14 (if necessary). Just look at my original post as and when you get to that stage.

[Abykarma in reply to DorsetLady]

Thanks for your advice Dorset Lady

[DorsetLady PMRGCAuk volunteer]

Usual advice for dealing with a flare is contained in this link - however I do say in the (tapering plan ) notes it’s not set in stone -and if you feel at any time things aren’t “right” you can return to previous week -or even the week before that and repeat necessary stages.

healthunlocked.com/pmrgcauk...

[Abykarma in reply to DorsetLady]

Many thanks Dorset Lady - my hands are so sore that I panicked and forgot about the alphabetical index of topics.