Reducing Prednisolone question

[Purplegloss]

I have had PMR since October 2017 now, and gradually reducing fairly successfully. Twice before I had a problem at 3.5mg , and could not get any lower, having a couple of flares. Now I have just got down to 2.75mg by the slow method at the rate of .25mg over a six week period. So it has taken me a long time to get to this point, however the last couple of mornings I have felt quite stiff, and wonder what is going on, so tried the test of taking a couple of Panadol, and the situation is much improved after a couple of hours, so it looks as if it isn't a flare, although I was tempted to take an extra 5mg to sort it out. What do you think the problem is, and should I stay on 2.75mg for a while before reducing further.

[DorsetLady PMRGCAuk volunteer]

If Panadol has helped then maybe not what you think.

You have to appreciate that after a long spell on Pred at higher does, as you get lower the 'normal' aches of pains become noticeable...and [put politely] you are 7 years older..😏

See how things go as they are... it may just be your body 'settling' at 2.75mg.

[SnazzyD]

I’d wait a bit if Panadol works. One just can wake up a bit stiff and not know why. Could be a bit of dehydration from the day before and then a warm night. A bit of a low level virus. I found on these low doses the general withdrawal took a week to appear (apart from the low cortisol thing). Sometimes one has forgotten that one did something a bit extra like doing a chore that has been waiting for so long. Muscles that have been unused in earnest for a while. Even sitting still on a hard chair at some do could do it.

[Viv54 in reply to SnazzyD]

So funny you mention sitting on a hard chair ! A friend rang me a couple of days ago, i was near a dining room chair and just sat on it. To cut a long story short the chat went on far longer than expected . Needless to say my neck and shoulders were so pain full the next morning , i wont do that again !

[PMRpro Ambassador]

I wouldn't taper any further just yet. At this sort of dose there is absolutely no hurry. You can afford to wait and see if it stays like this with a dose of paracetamol (Panadol). Prof Dasgupta told us that he often kept patients on 2 to 3mg longerterm as that reduced the risk of relapses.

[Purplegloss in reply to PMRpro]

Thanks everyone-I will see how it goes. Patience is a virtue!!

[PMRpro Ambassador in reply to Purplegloss]

It is indeed - especially in PMR and GCA!!!

[PMRnewbie2017]

I am exactly the same. I've just started to taper to 2.25mg and saw my new Rheumy this week. I mentioned that i have to take either 1g Paracetamol or 400mg Ibuprofen at bedtime otherwise i waken as stiff as a board. Especially my back and hips. He just shrugged. As I've been feeling really good, and he hasn't pressurised me to reduce more quickly, I thought I'd revisit no pain killers at bedtime. Yet again, i waken with stiffness and had to take something to clear it.Anectdotally, when i was working, i had loads of elderly patients who took 2 Paracetamol at bedtime, to help them sleep??? I think I now know why they did this!

[PMRpro Ambassador in reply to PMRnewbie2017]

I don't need it to sleep - but I have a quite specific low back ache that is much better during the day if I take 500 mg paracetamol early morning. And it is far better with 200mg ibuprofen.

[Purplegloss in reply to PMRpro]

Thanks for all your reply's everyone.