Allergic to prednisalone.

[Rubinluc]

Anyone with PMR who was allergic to prednisalone? My sister has a swollen tongue and lips, brain fog, fatigue and has had to stop the steroids after starting them only a couple of weeks ago. Is there any other treatment?

[DorsetLady PMRGCAuk volunteer]

I guess the GP prescribed, and has now stopped the Pred, if your sister is allergic to them [although fatigue, brain fog affects many people on them] then she needs to be referred to a rheumatologist. There are others drugs which may help PMR known as DMARDs [disease modifying anti rheumatic drugs ] which can be prescribed, but not usually by a GP.

See this from versusarthritis site- for a list of possibilities -

versusarthritis.org/about-a...

[Rubinluc in reply to DorsetLady]

Thank you so much. That is so very helpful and explains why the gp said he would refer her to a rheumatologist if the pain came back.

[DorsetLady PMRGCAuk volunteer in reply to Rubinluc]

If she has PMR, and as GP diagnosed it as such, then it most certainly will come back - in fact in a matter of weeks if not days. so she needs to be referred anyway. ..

Please keep us informed.

[PMRpro Ambassador]

Is it PRED she is allergic to or is it an ingredient in those particular tablets - though of course it is difficult to know and it isn't something to mess about with if there is swelling of the tongue and lips. It is very rare - 0.1-0.3% of patients - so she is very unlucky.

At GP level there isn't any other option - as DL says, DMARDs such as methotrexate, leflunomide and hydroxychloroquine have all worked for small numbers of patients but there are no guarantees with them, and there are a couple of biological drugs that work but you can't have them for PMR in the UK. A few other drugs are being looked at for repurposing but very much at the testing stage at present.

[Gala123 in reply to PMRpro]

Methyl prednisolone intramuscular injections can also be an option if she is not allergic. Again, a rheumatologist can make a decision.

[PMRpro Ambassador in reply to Gala123]

Indeed - I had forgotten that might be an option.

[Excelsior80]

A friend of a friend in Finland with pmr couldn't tolerate prednisolone and does something else, going to hospital every few weeks for an injection. Seems to work .... apparently shes fine until just before the next injection.... but I dont know what it was ..... sorry pretty useless! .... I was keeping it in mind, nice to know alternatives do exist if necessay.

[Rubinluc in reply to Excelsior80]

Thank you. It's probably methyl prednisalone, as mentioned by Gala123.It sounds promising.

[PMRpro Ambassador in reply to Excelsior80]

Rubinluc is probably right.