Update on pred interaction with Diltiazem.

[Karenjaninaz]

Video. Pulmonary Dr. Visit this morning. I thought it was only the prescribed steroid inhaler he prescribed that was giving me chipmunk face but it is also my steroid taper as well. The diltiazem enhances steroid accumulation and action when taken together. So we stopped the inhalers and prescribed a weaker one if I needed it at lower doses.

Another shocker: I totally forgot my pred yesterday morning! And never felt it until this morning.

I stopped waking up ar night to take it and - so not used to the morning routine

Now I’m wonder if I can lower the taper more quickly since whatever pred I take is still hanging around and enhanced. Just tapering to almost to 7mg.

I will be on diltiazem permanently; no alternative, such as beta blocker because of mild asthma.

[PMRpro Ambassador]

Well you could go faster - providing the effect remains constant. Trouble is, you don't really know how much extra effect there is do you? And he's reduced the overall dose.

[SnazzyD]

I wouldn’t get too excited because you have no idea about exactly what is going on regards the resulting effective dose. Anyway, how fast is faster? Getting that right is probably a minefield and I suspect it wouldn’t save you much in the grand scheme of things.

[Karenjaninaz in reply to SnazzyD]

You are right; I just have to go by how I feel; if I feel “great” not there yet.

I wonder how many prednisone complaints are really an interaction with another drug. I found this out on my own research. Wouldn’t have thought of it if I wasn’t medically trained .

[PMRpro Ambassador in reply to Karenjaninaz]

I suspect quite a few - I think pred gets blamed for a lot that is really the underlying disease. That was my experience at least - I had 5 years of PMR with no pred to assess that. And some things now are due to other things.