increase not enough?

[Utaker]

i increased my husbands Prednisone to 10mg from 1.5 . Achiness/pain disappeared and most of the exhaustion and tingling in feet has disappeared but he is still a little tired. I’m thinking that I didn’t increase enough. I’m thinking that we didn’t increase enough. I know they said to increase 5mg above where he last felt good, but we weren’t sure when he actually started feeling bad again. I know it was under ten. Is it okay to increase a little more and then taper?

[HeronNS]

How long has he been on the increased dosage? It may take a few days for the full effects to show. An increase from 1.5 to 10 is quite substantial and personally I don't think he should increase more without discussing with doctor, especially if PMR symptoms are under control. There may be more going on than PMR if he has tingling in his feet.

[PMRpro Ambassador]

Have you discussed it with your doctor? Adding 5mg for a week to sort a flare is one thing - going back to 10mg from under 2mg is another. Some of what he is experiencing could be due to poor adrenal function and that is something you have to work your way through - only a low dose of pred encourages it to return and by going so high you are just postponing the evil day.

[Utaker in reply to PMRpro]

he has only been back to 10mg for five days. My doc was ok with that. We are going to start tapering this week. How do you work your way through the poor adrenal function?

[DorsetLady PMRGCAuk volunteer in reply to Utaker]

Slow tapering, small steps , rest when necessary, time -and patience. And maybe a read of this -

healthunlocked.com/pmrgcauk...

[PMRpro Ambassador in reply to Utaker]

Putting up with the fatigue and adusting to compensate

[PMRnewbie2017]

The problem is, a dose of 10mg for 5 days will sort out a lot of things, not just PMR. Going higher still without being sure it is a flare has the potential to put him back to square one.Achiness at 1.5mg isn't unusual in my experience as insufficient cortisol causes muscle aches. Plus, muscle soreness after exercise is more obvious at low doses. At 5mg i could play tennis with no after effects, now at 1.5mg I ache for 2 days after weedng the garden.

[PMRpro Ambassador in reply to PMRnewbie2017]

I wouldn;t say 10mg will sort out a lot of things as well as PMR. There are a lot of things it won't sort - whereas there would be a response to a much higher dose like over 20mg.

[PMRnewbie2017 in reply to PMRpro]

As a stat dose yes i agree but a cumulative dose of 50mg even taking into account metabolim etc is a massive increase from 5x1.5mg the patient would have been taking if they had remained at the former dose. Utaker was enquiring about increasing even further so I wanted to highlight that 10mg is a dose with considerable potency.

[PMRpro Ambassador in reply to PMRnewbie2017]

All context though isn't it? And really, patience is the greatest virtue in PMR!