Tapering : I’ve had PMR for nearly 5 years and... - PMRGCAuk

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Tapering

Magictherabbit profile image
10 Replies

I’ve had PMR for nearly 5 years and currently on 4 mgs of prednisolone. I take it about 4 am when I wake but I’m now waking up in a lot of pain …especially arms and legs .

This week I had some major dental work done … 4 implants which went well but I’m wondering if I should have increased the pred before although I’ve been waking up in pain before I had the implants done. Going to see GP soon but just need some advice as to what I should go up to .

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Magictherabbit profile image
Magictherabbit
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10 Replies
SnazzyD profile image
SnazzyD

Sounds like it wasn’t your implant procedure that caused it as you suggest, since symptoms occurred before. You are seeing the GP but have you read this from the FAQ’s about flares and the approach one can take?

healthunlocked.com/pmrgcauk...

DorsetLady profile image
DorsetLadyPMRGCAuk volunteer

 SnazzyD has kindly given you link to my post about dealing with a flare... hope it helps.

.. and for info you seem to have posted it twice. so perhaps you'd like to delete the other one - to avoid confusion...

healthunlocked.com/pmrgcauk...

PMRpro profile image
PMRproAmbassador

In terms of the implants - yes I think I would have added a bit for the physical strain at a dose where your adrenal function is probably still a bit unreliable. But it concerns me you say you already had the morning pain BEFORE the dental work. That would suggest a flare is also playing a part.

Has anything changed in terms of any ongoing symptoms of the PMR in the last few months?

Magictherabbit profile image
Magictherabbit

Thank you for all your advice…I’m going to increase and hopefully feel better …seeing GP next week although to be fair as you say not many know much about this condition.

Rozzyt profile image
Rozzyt

If you wean yourself till later maybe by an hour each night till u get to say 7am then this dose or ur new dose will last you through the night. I have come down to 3mgs as I have been put on 15mgs Methotrexate and feeling the difference a bit. I find the steriods put too much weight on and you get so far then have flare ups. I have been on steriods for 2 years and intend finishing them very soon. It takes 3 to 6 months for Methotrexate to suppress the immune system. Its working so far. Hopefully get relief soon.

PMRpro profile image
PMRproAmbassador in reply toRozzyt

Don't get too excited - MTX only works that well for a small proportion of PMR patients, whatever your doctor may have said or claimed. It doesn't work at all for some, and others are only able to reduce their pred dose by a few mg.

Magictherabbit profile image
Magictherabbit

I used to take my pred with my breakfast at around 7.30 and I don’t remember waking up at about 4am and feeling this bad . I thought taking it earlier would make me feel better when I got up .

PMRpro profile image
PMRproAmbassador in reply toMagictherabbit

By taking it later, the antiinflammatory effect could last through until the next morning. In some people the antiinflammatory effect doesn't last a full 24 hours. The new batch of inflammatory substances is shed in the body at about 4am, if the pred effect is still there at 4am you won't feel as much as if you had taken yesterdays dose at 6am and it had worn off by 4am. Do you see what I mean?

Magictherabbit profile image
Magictherabbit

I think I see what you mean …If I take it about 6-7 am it may last right through till the next morning and I won’t wake up in the early hours feeling as I do at the moment. Thanks PMR pro

Rozzyt profile image
Rozzyt in reply toMagictherabbit

I take mine at 7.30 after food as prescribed to do from my doc. Keeps everything at bay. Mxt working for me so far.

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