Down to 7 mg of pred and having a flare up

[Marek1]

Hi and once again thanks for brilliant forum .

After seeing my rheumy for the first time in March I have been on what I would consider to be a drastic reduction of pred from my high point of 22mg finally to 7mg in the space of 4 months . The initial drops were 5 mg at a time until I hit 10 mg . Then I was told told to drop 1 mg every 2 weeks . I have made that a lot less severe by dropping half a mg every 2 weeks instead .

I have successfully got down to 7 mg and felt really happy to be reducing the pred down to the lowest levels since starting on it .This is due to the constant issue of side effects after 2.5 years on it . I have been on 7mg for 2 weeks now and was due to reduce to 6.5 yesterday . but for the last 4 days I have been experiencing pretty severe PMR symptoms which I assume is a flare . Horrible .

Can I ask please , from my previous reading on here I think the way forward is to boost my uptake by 5 mg for up to a week and then drop down to 8mg and then back to 7mg . Is that about right as a suggested course of action? or is that too big a boost as its almost doubling my dose?

ps . Somehow up to this point I have been managing the PMR symptoms really well throughout the whole reduction .

Thank you in advance

Marek

[DorsetLady PMRGCAuk volunteer]

Your description for dealing with a flare is correct - see link below - but I’d be inclined to return to 8mg and stay there for at least a month before you start reducing again… and not every 2 weeks. Preferably using one of the slower tapers we talk about- will help your adrenals as well as your PMR.

Have to say it’s surprising you haven’t flared before considering the breakneck speed you’ve been doing. 😳

healthunlocked.com/pmrgcauk...

Slower Tapers -

healthunlocked.com/pmrgcauk...

healthunlocked.com/pmrgcauk...

[Marek1 in reply to DorsetLady]

Thanks ,brilliant help as usual x

[PMRpro Ambassador]

Right approach yes - other than aiming to get back to 7mg immediately. That isn't enough, if it were you wouldn't be flaring, and because you are going quite fast, you need to stop at 8mg to be sure that is still enough - it may not be and you have to be sure before going further. Then 1/2mg per month now, not 2 weeks.

[Marek1 in reply to PMRpro]

Massive thank you . Invaluable as usual x

[offprenisone]

i have been on predisone for over 12 yrs...the last 2 yrs I have been tapering down very slowly . my last blood tests showed a high rise ...over 60, my Dr said to go to 5 mg from 2.5 mg for a week...I go for blood work next week...its disappointing but I will keep trying to get down again.