GCA return?

[gtate1914]

I was dx with GCA and PMR Jan. 2018 and have gotten down to 3.5mg of pred. Today I'm having those ice pick to the brain feelings again like I had when first dx with gca. I'm wondering if I should greatly increase my dose, can't get ahold of my rheumy cause it's labor day weekend. Any suggestions?

[DorsetLady PMRGCAuk volunteer]

This link contains usual advice for dealing with a flare-

healthunlocked.com/pmrgcauk...

A few days at the increased dose whilst you wait to get advice would be a good idea, you can easily drop back down if Rheumy doesn’t agree,

[PMRpro Ambassador]

Just enough higher pred to get you to an appointment won;t derail the wagon - you can take more for a week and drop back to the previous dose, as DL's link explains.

[gtate1914 in reply to PMRpro]

thanks for your reply.

I've been at 3.5mg for a month, no problems in tapering down by .25 very slowly. I'm wondering if I would need to Greatly increase my dosage, i.e., 50 mg, which I am loath to do, then drop back to 3.5mg after a few days. Or perhaps would a dexamethasone shot would tide me over until I can speak to my rheumy.

[PMRpro Ambassador in reply to gtate1914]

You almost NEVER need to go back to 50mg at this stage. Many doctors think you do but experts say that even 20mg will sort most problems, The very high doses at the start are to get very quick control of the inflammation to reduce the risk of loss of vision. 40mg is the starting dose for GCA with no red flages of visual symptoms or jaw claudication.

Start with adding 5mg - if that doesn't make you feel better, add 10mg for a few days.

[gtate1914 in reply to PMRpro]

Thank you so much! I was afraid I'd have to go much higher. I did take 10 mg early this morning and it's not as bad as yesterday.