I began on 15mg per week and got down to 10mg and all was well. I decreased to 9mg and the stiffness came back so I though I would increase to 9.5mg.
This didn't help so I have gone back up to 10mg, thinking that was where I was last well. However the stiffness has not gone away and might be getting worse.
The only thing new thing is that I started taking Binosto for osteoporosis in mid Jan.
Pretty sure I need to increase but not sure by how much. Should I creep up half a milligram or take a larger dose.
I would welcome your advice.
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Lopera
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I would doubt that adding in Binosto would be the cause… sounds as if you have just gone below the dose of Pred you require.
Suggest you treat as a flare- see protocol in the link - and once you have got your PMR back under control drop back to 10mg and stay there for at least a month before you attempt tapering again.
Creeping up rarely works in this scenario- you need a bolder approach. I also think you probably need to stay at 10mg for a bit longer than usual - you have other issues, and you did mention stress in previous post, plus winter often makes tapering difficult.
Would also say, ease up on tapering anyway.. 0.5mg at a time, and if necessarily start using a slower tapering plan.
Thank you DL, I think I just needed the confidence to go up to 15mg which you have given me. I will do this probably for 10 days and then drop down to 10mg. 😘
I went up to 15gm last Tuesday so this is day 5. When I first started on prednisolone back in August, the effect was within hours and this time I was expecting to feel relief by the end of Tuesday but the pain/stiffness has not gone. I'm a bit worried and not sure what to do. Any advice would be welcome.
When you have flared it can take longer to get back under control than initially - sounds bonkers but it seems to be a fact. I’d give it another 5 days [although a flare advice says you can stay 14 days] - if it’s still not better by that time, then you can worry… 😊. Hopefully you won’t need to…
I can empathise with your situation as it feels like a balancing act.... You are aware that the Prednisolone can help you out of the PMR as you have experienced the difference it makes.... balanced with trying not to make the osteoporosis worse...by increasing the tablets. Therefore you are nervous to as it feels like back to square one etc.
This is stressful in itself. We know stress makes all this worse..! I wonder what can help that stress ..
I am on Bonesto and know that I need to be light on myself the day I take it .I warn people I work with, to say I can be a bit weird etc so just ignore me. I try to go slow in the morning as find I need to be near the bathroom anyway, then try and get out for a short quick walk. I know the Osteoporosis benefits from that walk and it seems to make me less anxious.
I have had the recommendation last week for the annual infusion which I think I will go for, then hopefully less to deal with each week but may be a week off feeling off instead a year. Might that suit you better with your other condition?
Thanks TT, it is definitely a dilemma when there is osteoporosis in the background. I would prefer to be on a bone building drug but my GP can only prescribe bisphosphonates. I was referred to the osteoporosis clinic last October but have been told I probably won't get an appointment until September. My main aim at the moment is to avoid another fracture at all costs!
Binosto/alendronic acid CAN cause joint and muscle pain so it isn't out of the question that it is the cause of the stiffness. Often the side effects of various treatments improve as the body gets used to the medications. Hopefully it will.
However, I think overshooting the dose you need is more likely and the first place to look is by treating it as a flare. Just creeping up rarely works unless it is a small difference you need and you catch it very quickly - sometimes you have to springclean before you can go back to daily dusting!
Thank you, yes I have just revisited the leaflet and looked at the side effects. I think because I felt fine the first day I took it, I have not appreciated that it is in my system so I can still experience side effects.
I think the flare protocol is the right thing to do.
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