Advice for a minor flare below 10mg

[papadapadoo]

Having had a previous flare that dropped me back quite a bit, I tapered slowly down, and was very comfortable for a month at 9mg. But when I tried to go to 8, all was well for three days, and then the next day some pain and stiffness returned--not so much as in the previous flare, but I wanted to head it off. So for three days I have been taking 12 mg and today I feel as good as ever I have. In the FAQ from DL there are two bits of advice that I need to reconcile. First, " it’s recommended to add 5mg to the dose you last felt alright - stay there for 7-14 days and then drop back down to just above the dose you flared ." That makes sense, but after only three days I feel no more PMR symptoms, so does this apply?--"get symptoms under control - then drop back to 10mg .....and continue tapering schedule."

The essence of my question is: when there are no apparent symptoms, are the symptoms actually under control? Is there any way to tell? Should I continue the elevated dose for a week, or can I go back now to the dose that was comfortable (9mg for me) and stay there for a few weeks?

I especially appreciate this forum in that I'll bet very few doctors could give me a clear answer and I'm sure several here can!

[PMRpro Ambassador]

If you catch it really quickly it will clear out the inflammation really quickly. I would try dropping back but NOT to the 8mg where you flared and DON'T continue tapering. Your body is telling you you have arrived at the lowest effective dose which is what you are looking for. It doesn't mean you won't get lower - just not yet.

[DorsetLady PMRGCAuk volunteer]

Personally I would give it more than 3 days on higher dose…so take the lowest figure in the advice of 7-14 days.

You may feel good after 3 days, but there was a recent post where someone had reduced too quickly and ended up having another flare…for the sake of a few days I know what I’d do…

As for dropping to 10mg or 9mg -that up to you…you may be fine at 9mg - but you won’t know until you try… and maybe from there trying reducing by 0.5mg a time rather than 1mg.

We can only advise, and that’s based on our personal and other members experiences - but as we also say “your PMR is your PMR , not mine, nor anyone else’s” - and at the end of the day, you have to make the decision.

[Temeraire]

Also when you do taper next time I’d do it gradually and only 0.5mg. Better chance of success

[papadapadoo]

Wow--such quick and helpful answers! What I will do, then, is to do another day at 12 and if I feel as good as today, I'll go back to 9, maybe by 1 mg steps over a week each(?) and hang there at 9 again for another month. I do see that after awhile we realize that there's no hurry and the key is to keep the inflammation under control at whatever dose works. Thanks for such useful advice.

[Heron82 in reply to papadapadoo]

I’m in a similar position as you but was dropping from 9.5 to 9. I stayed at 12 for a week now at 10 for a week. Plan to stay at 10 for another week before dropping to 9.5. Depending on the pains in my shoulders, hands and feet at night.

Good luck

[singingloud]

I’m at the stage of reducing by .5 mg on dead slow taper to 8 mg. I’m keeping a close eye on it because this is where I flared last year and had to start over at 15 last year. So far 8.5 was fine so I’m hoping this next level will be also but I’m being cautious.

My husband will have a knee replacement surgery next Tuesday and I will be the main caregiver so I can’t afford a flare again.

Enjoy the relief from the symptoms and rest at 9mg when you return to it.