Almost 3 months in with 20 mgs methotrexate weekly and tapering Pred currently at 10 mgs . Going Down to 9 mgs august 1st and then 1 mg per month . I have been as low as 3 mgs before but never felt as poorly as I do right now with PMR . The MTX appears to be doing nothing at all and I realize it could take up to 6 -12 weeks
I am going on a 2 week trip to Ireland and I am temped to bump it up to 15 mg for the trip. Of course my Rheumy is on holiday so this will be my decision .
any thoughts ?
Methotrexate works for some people and not others, I hope it works for you. When you say you feel bad, what are your symptoms, is it muscle pain or something else?
MTX works for a small cohort of patients, by no means all. And it can take months to allow reduction of pred, not weeks. Some doctors have very rosy expectations of using it. As I always say - if it was that good they'd use it instead of pred. They don't.
In your place - I would.
Regarding the tapering regime you've mentioned, I would say that as you're on 10mg per day at present, don't reduce by 1mg per month, but by 1/2mg every 6 -8 weeks. If you try to reduce at 1mg per month the chances are that you'll flare and have to go back up again. The watchword is Patience! The slower you go the lower you go. If you try to reduce quickly you'll just end up bouncing back up all the time.
As for Methotrexate, if it's not doing anything for you then stop taking it. It's just adding confusion to your system.
Regarding bumping your Pred up to 15mg per day while on your holiday in Ireland, yes, I would do that as well. We have friends who live in Milltown Malbay on the West coast, and whenever we've been over to visit them I always up my Pred dose for the duration.
Environmental or Psychological aspect of PMR?
PMR sudden horrific pain
PMR
