Flare protocol and how to manage it.I was doing so well on 5mg prednisolone when in the 6th week, a horrid flare hit me affecting my mobility like never before. I added 3mg to make it 8 in total, but that wasn't enough, so upped it by the recommended 5 mg, making the total 10 mg. I stayed with 10mg for my short 5 night holiday so the total is nearing 10 days, mostly effective until today when stiffness is troublesome. May I ask your advice on how long I should stay on 10mg, and can I go back to 6mg, ie above the last effective dose before the flare, or should I make a staged reduction. I feel as though I've lost my way now and would be grateful for any guidance here please.
Kind regards and many thanks.
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waltztherapy
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The normal suggestion is to up by 5mg for a maximum of a couple of weeks then drop back down again in a couple of drops. However if you are still in pain don’t drop back, as the PMR will come back and bite you. You will need a slower taper then though. I wonder what triggered it as flares tend to happen a week or two after reducing.
I’d give the 10mg another 5 days and hope that’s enough to sort things out.. but have to say if it seems less effective now than it did at beginning I do wonder.
Suggest you do as little possible over the next few days to really give the Pred a chance to work.
Hopefully you should be able to drop down to 6mg -but you’ll have to see.
If it doesn’t work out as planned you may need more input…either from us or medics.
Thankyou so much DL. Your advice sounds logical. I did spend my holiday dashing about seeing friends in between dance classes, plus a four hour congested drive home yesterday. Your suggestion of doing as little as possible over the next few days sound wonderful.Bless you for your use words. Xx
I think you have answered your question - even with more pred that is a recipe for feeling as you do. Often it will settle with rest and ordinary painkillers so try that first.
Thankyou PMR. It's so good to have this kind of advice. I am beginning to realise that not pushing oneself even when feeling good, is very important, in addition to giving in to hours of sleep when the brick wall of fatigue strikes. X
When I came down from 20mg to 2mg/day, feeling well at 2mg and therefore instructed to start to take 2-3 days a week 1 mg/day, just at the time I got my first Covid vaccination, I got a terrible flare. My rheumy instructed me to switch again to 8 mg/day, which was effective and then to reduce very very slowly back to 2mg/day. It took me longer than the first time, but better slow than too fast she said. So have a look at your daily intake the first time and do the same reduction or even slower. That is my suggestion. Good luck and hope you feel well again soon.
Aw, thankyou for your kind note GrandmaPirate. It's so helpful to learn of other's experiences with sudden flares at the lower levels. The whole tapering thing is a bit of a minefield it seems.
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