should pred last 24 hours?

[Gooner12]

I only started Pred 3 days ago. Day one I was only in a little pain in the evening and on Day two virtually no pain. Day 3 did not seem to work so well and I had pain in my legs all day and got progressively worse as the day wore on. Just had a very uncomfortable night and pain in legs really bad this morning. Also weakness in arms again. Prescribed 15mg. Should this be lasting 24 hours? Does it take time to build in system?

[SnazzyD]

Not everyone gets the lightning bolt removal of pain but more of a slow burner. For some it doesn’t last 24 hours and it may also be the case that 15mg is not enough for you. Some people need more than this and up to 25mg is the starting range.

One question though, what did you do in the day on those 3 days? It is common for the early appearance of comfort to induce a flurry of activity, only for PMR to come back and bite. Also, did you definitely take 15mg, 3x5mg? These pages are full of us saying we have been a numpty at some point for various sillies done with steroid taking. I don’t want to diminish your plight, just getting the basics out of the way!

[DorsetLady PMRGCAuk volunteer]

Ideally, but it doesn’t for everyone - and as you’ve have only just started the Pred, you might find you actually need more than the 15mg prescribed.

Please contact your doctor, and tell them… and maybe ask if you need to go up to 20mg?

[Gooner12 in reply to DorsetLady]

If only it were that easy to speak to your doctor 😳. I have a phone call booked for Thursday so will mention it then. Thanks for your reply.

[DorsetLady PMRGCAuk volunteer in reply to Gooner12]

I know 🤦🏻‍♀️…but they do need to know your situation ..

[Rose54 in reply to Gooner12]

Is your GP using the Whats app

It so complete the application and they get back to you same day

[Gooner12 in reply to Rose54]

Unfortunately not. Submitted request for call.

[PMRpro Ambassador]

Three days is retty soon to expect miracles - even though I responded well to 15mg in under 6 hours. it was another 2 or 3 weeks before the improvement in pain and stiffness peaked. Maybe by Thursday it will have improved - because I suspect you got on and did things BECAUSE you felt better on those first couple of days. Pred isn't a free pass to go straight back to doing all the stuff you normally do.

[Gooner12 in reply to PMRpro]

Thanks that’s really helpful. Trouble is no pain makes you get on a do stuff.

[PMRpro Ambassador in reply to Gooner12]

It does, and the pred is a false friend there - gives you wings! Which is why we warn everyone ...

[piglette]

Is it because you were suddenly feeling much better you started to overdo things?

[Gooner12 in reply to piglette]

No not really. We only went for a walk and did few light chores

[DorsetLady PMRGCAuk volunteer in reply to Gooner12]

We only went for a walk and did few light chores

But early days that may have been enough - or rather too much! 😊

[Racer2024]

You describe exactly what happened to me. I went back to the doctors and she put me up to 20mg.

I also split my dose to take half with breakfast and half with tea/dinner. Works for me.

[Gooner12 in reply to Racer2024]

That sounds like good advice. Did you just do this or did the doctor suggest it. Does it affect you sleeping?

[NewPMR53]

I’m new on it too and 15mg was not enough for me. I’m on day 14 now and on day 9 went up to 20mg which does seem to last nearly 24 hours. 15mg worked but only for 15/16 hours. Good luck this beginning bit is hard judging what you can do without incurring the wrath of your body!

[Gooner12 in reply to NewPMR53]

Thanks. Do you wake up in agony?

[NewPMR53 in reply to Gooner12]

Not agony any longer but always very achy and knowing I NEED my pills NOW! Today is a bad day already as my arms, shoulders and hands are bad but I just keep saying to myself remember 3 weeks ago when you couldn’t actually get down the stairs without help… it’s really tough. This forum is a godsend though and I’ve learnt so much already.

[Gooner12 in reply to NewPMR53]

Interesting you say about hands. My hands have started hurting in last few days. Thanks for your feedback. Hope your day improves

[Flivoless]

I had a similar start to my PMR journey as yours seems to be. I was started on 15mg but it didn't touch the sides, it wasn't until I went up to 25 mg did I get the blessed relief.

[Gooner12]

thank you that’s interesting. Do you mind me asking what you take now and when did you start tapering?

[PMR_sufferer1]

For some people Pred seems to move out of the body faster than others. It may be worth trying a split dose say 10 mg in the morning and 5 mg in the evening before bed obviously both with a little food This may help but is not guaranteed !

At the end of the day your still getting 15 mg a day and if it doesn't help you have the option to up the dose

I am no way an expert on this just suggesting ideas to avoid contemplating upping your dose.

Also as PMR pro says who is more of an expert than I am for sure the pain drops out quickly with Pred and normally within 5 to 24 hrs. I found my first dose like a miracle to my system the pain went within 24 hrs.

Good luck on the journey stay positive.

[AtopicGuy]

Artificial corticosteroids, such as prednisolone, mimic the behaviour of a natural hormone called cortisol in our bodies. Cortisol helps to regulate several processes, including the immune system and the sleep cycle. So levels of it peak in the morning and dip at night. Ideally, we don't want to interfere with this sleep cycle too much, so the recommendation is to take the full dose when we first wake up and let the levels in our blood steadily decline over 24 hours.

The upshot of this is that some worsening of symptoms later in the day is not unusual. And we should expect the full benefit of steroids to take a few weeks to show, as our immune systems gradually responds to the new regime.

[Gooner12 in reply to AtopicGuy]

Thank you. Can I ask does anyone on here take other pain killers and if so what?

[PMRpro Ambassador in reply to Gooner12]

If you want an answer to that from anyone else besides the author of the thread, AtopicGuy, DL or me, upi will need to post a new thread. However - in general no ordinary painkillers work in PMR or GCA.

[DorsetLady PMRGCAuk volunteer in reply to Gooner12]

Not for GCA no. But as I got singles figures of Pred, OA roared back into being.. so did take paracetamol some days for that.