Alternate day prednisolone.

[Whippet1960]

I have been on Prednisolone since June 2018. I have gradually reduced the dose and got down successfully to 4mg/day. I have reduced further using DSNS but have always relapsed after a couple of weeks. Alternate day prednisolone is used in some situations in Paediatrics. It is thought to reduce adrenal suppression. I was keen to take less steroids so I have reduced my prednisolone by 0.5mg/day on alternate days, reducing every 3 weeks. So 4/3.5 then 4/3.0 and so on to 4mg alternate days and nil on the other days. Obviously this has taken some time.

I have been held the dose steady if I have been doing anything stressful or out of the ordinary.

I have been on 4/0 for a month and all well so far. I will very cautiously reduce the Prednisolone further in a couple of weeks.

[piglette]

It is normally better to take steroids daily with PMR, but you can sometimes get away with it at low doses. If it works for you that is great. A friend with myasthenia gravis takes his steroids every other day and it seems to be recommended for that particular auto immune disease.

[PMRpro Ambassador]

It will work well IF the PMR is in remission and in fact I used ADD early on in PMR, double dose one day, zero the next, and it even worked well then for me but it isn't recommended for PMR and absolutely NOT for GCA. Many people struggle with a single daily dose because their symptoms reappear before the next daily dose is due since the anti-inflammatory effect doesn't last long enough for them. It can be from 12 to 36 hours - if you are at the 12 hour end, the symptoms can be back before evening. If you are at the 36 hour end - great.

I do hope it works well for you - I had next to no adverse effects with it at the start but I had what could have been GCA symptoms and the rheumy here insisted on daily dosing.