How do you know what is the right dose of pred

[pastamaid]

Just started on my journey, 2 weeks in and still bothering people with questions. Sorry.Was talking to sister and she said how do you know if the dose you are on is the right dose for you. I said it's probably trial and error but she said there must be something better than that! Any ideas? I thought it might be tapering until you feel some pain returning and then stopping until it settles. Or is it less basic than that?

[DorsetLady PMRGCAuk volunteer]

If you look at the information post I sent when you first joined you’ll find it contains this -

As I said, people have started at a bigger dose, and therefore the inflammation at that level is well under control, the art then is to reduce SLOWLY (provided you have NO return of symptoms) to find the lowest dose that can keep you pain free, or at least give the same degree of relief as initial dose.

And if you sister is interested maybe let her read it as well… that’s what it’s for…

[pastamaid in reply to DorsetLady]

Thank you

[PMRpro Ambassador]

It is trial and error to some extent - but done in a process called titration. It is used for other medications as well, for blood pressure is perhaps the most familiar. In that case the doctor starts with a relatively low dose and sees what effect it has on the patient's blood pressure. If it doesn't bring it down to a low enough level, they increase the dose. And repeat that until they get the result they want.

In PMR they start with a dose that is likely to be more than enough and see what happens. 15mg is very often enough but sometimes they need 20 or even 25mg. What they look for is an improvement of at least 70% overall quite quickly. Then the patient stays at that dose for a few weeks until the symptoms have improved and are stable, sometimes they monitor the blood markers to be sure they have fallen significantly. And then you start to taper the dose slowly to find the lowest dose that manages the symptoms as well as the starting dose did. When you get to a dose where the symptoms start to reappear you stop reducing the dose and go back to the last dose you were good at. You wait a couple of months and try a tiny reduction again. If it works, good, if it doesn't you wait a bit longer. RInse and repeat.

[pastamaid in reply to PMRpro]

You are a wonder thank you for all your help xx