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3X dosage error, oh well.

Posted , 10 users are following.

dan38655
dan38655

I was meaning to try a 2mg dose of prednisone this afternoon, down from my recent, daily 3mg. 

Somehow I grabbed the wrong bottle, ended up taking two of the 5mg tabs instead.

So I am expecting great relief, from my mangeable level of symptoms that 3mg/day leaves me with.

I'm sort of kicking myself, but I'm also glad that it wasn't three 5mg tablets!

I will skip tomorrow's dose for sure, and will get in a good weight-lifting workout tonight, even though I did that just yesterday.  I hope that I can sleep normally tonight.

I'm sure that I'm not the only one who has done this(?).

0 likes, 9 replies

9 Replies

  • julian.
    julian. dan38655

    Posted

    I don't think it matters that much really. The half life of pred is a few hours, the therapeutic effects last a bit longer. Hence part of the daily cycle of morning pred relieving the symptoms over a few hours that build up again for the next morning. And why twice a day works better for some - lower peaks and shallower troughs. My guess is any effects will have worn off by tomorrow.
  • nick67069
    nick67069 dan38655

    Posted

    Consider that to be "deep cleaning" biggrin error. And no need to "kill" yourself with additional excercise. Let it work in your advantage and recover better...
  • ptolemy
    ptolemy dan38655

    Posted

    Dan we all have done it, at least it was not the other way round when you forget to take them, you only do that once! I would carry on as normal tomorrow and not skip anything.
  • dan38655
    dan38655

    Posted

    That is great information to know about the half-life in te bloodstream.

    I didn't notice much effect, 10mg is still a relatively low dose, and I slept ok after staying up late.

    I've been able to skip a day when I was at 5mg, but did pay the price during the last hours of the 48-hr period.

    Funny thing was that I noticed my mistake by the appearance of size of the pills, however the sight of the larger tablets somehow didn't register until just after I had swallowed them, then the mental picture of what was just in my hand suddenly had me looking at the label on the bottle.

    I was mostly concerned by having used up, wasted, so much of my stash of prednisone.  I may end up needing one more bottle before pmr is done with me.

    I have to say that it's great to be getting back into lifting weights with my arms, and not just bike riding.  I can get a god range of motion if I keep my routine fast-moving enough to stay thoroughly warmed up, with little recovery time between sets.  I am doing very light stuff, and will have a long way to go to restore close to my former strength, but at this early stage my strength is improving quite a bit each week, with no indications of over-doing it.

  • reggie92967
    reggie92967 dan38655

    Posted

    Dan can I ask how long ago you were DX'd with PMR & what your prednisone dosage history has been ? I was DX'd 6.5 months ago, started on 15mg then my Dr. reduced it by 5mg. every other day, I had a terrible crash 6-days into that regime. He returned to the 15mg. daily & then in 10-later upped to 17.5mg., been on that 3-months. Recently & gradually I feel all the symptoms coming back, the worst being the terrible fatigue & overall body throbbing, (is that the inflammation ?). Wondering if a higher dose is in order. Any replies or input is really appreciated. Reggie
    • dan38655
      dan38655 reggie92967

      Posted

      I was first afflicted two years ago, and started on pred after 3-1/2 months.

      I was down to 140 pounds already and started at 15mg/day.

      Was told to reduce 1mg/month, and I actually reduced 1mg about every three weeks until just below 10mg symptoms started coming back.

      When I reached 5mg, I had to go up to 6mg and then back to 5mg for about eight months.

      Then I started skipping one day every week, and after a couple of months had settled into just 3mg/day where I am today.

      Still with various symptoms of soreness and fatigue, but I am able to do long bike rides several times per week almost as fast as I rode before pmr, but just not at my previous strength level and with onset of fatigue after some of my rides.

      I was feeling pretty strong back when I had reached 10mg as I recall.

      Remember that each of us needs a different dose of prednisone, based on both body mass and on the degree of pmr activity, which is quite variable and unpredictable, so dosage adjustment based on real-time symptoms becomes the reality since the prescribing doctor is not in your shoes.

      I would keep the doctor informed, as will be necessary to refill your prescription.

      I haven't seen my doctor or rheumy in almost 22 months now, no tests at all since that time. I was able to refill my prednisone bottles twice but that is all that is allowed, and I have only about a six-week supply left.

      I might also mention that I declined a prescription for a recommended "sulfasalazine or plaquenil" back when I was started on prednisone.

      Supposedly to address "elevated RA factor" levels, but when I studied my blood work the RA factor level seemed to be well within the normal range.

    • snapperblue
      snapperblue reggie92967

      Posted

      I just bet you had a terrible crash reducing from 15 mg at that rate!  You'd have been at zero in 6 days.  As you know if you have been following this forum, most people need to be on prednisone for months, usually a couple of years before the condition goes away on its own.  The prednisone just treats the symptoms.  The only way your doctor's plan would work is if you did not actually have PMR.

      Everyone is different (perhaps the informal motto of this forum).  

      When I was first diagnosed, I needed 20 mg to relieve the pain and stiffness, and this went up to 25 mg if I traveled long distances or had other stress.  This lasted about 3 months, then I was able to decrease to 10 mg. After about 6 months on that dose, I started reducing and am at 7.5 mg.

      So, based on my experience, I would not be alarmed if you need 17.5 mg or more for a while.

       

      However, I am concerned about your symptoms getting worse. Have the pain and stiffness returned?   

      Once I have stabilized on a dose, I have not had the pain and stiffness get worse unless something happened (like surgery) that seemed to explain it. I have never experienced the throbbing you describe  but perhaps someone else can respond to that.

      My personal belief is that I want to keep the inflammation under control- that means I err on the side of taking enough prednisone to essentially eliminate the pain (which indicates inflammation) even though this means more risk from the side effects of prednisone.  Not everyone agrees!My doctor says "Treat the patient, not the average."  Luckily for me, he agrees that the dosage should respond to the symptoms.

      Sadly, the prednisone does not control the fatigue in most people.  

      I'd be interested in hearing how this goes.  Best of luck!

    • dan38655
      dan38655 snapperblue

      Posted

      I'm wondering where you learned about prednisone not controlling fatigue in pmr patients(?).

      I had noticed that when I was relatively under-medicated and with symptoms somewhat "flaring", that a serious increase in fatigue set in, such that coffee did not have the usual effect of boosting my energy level.

      This more-severe level of fatigue seemed to respond very well to even the occasional small increases in prednisone dosage that were needed to bring my musculo-skeletal symptoms back under control over the months that I was holding steady at around the 5mg level.

      I can also recall feeling distinctly more energetic during the two weeks that I was on a test-dosage of 20mg, after months of suffering with un-diagnosed pmr.

    • snapperblue
      snapperblue dan38655

      Posted

      I picked up the generalization that prednisone does not usually treat fatigue from this forum, where so many longterm PMRers are on prednisone and are relieved of the pain and stiffness, but suffer from crippling fatigue.  

      In my case, for months prior to and after the diagnosis, I staggered around feeling like the earth's gravitational field had doubled, wanting to lie down all the time.  I am better now- who knows why!- better at 7.5 mg pred than I was at 25 shortly after diagnosis.  

      I am not sure there is any unqualified statement about PMR that applies to all of us.  It is stangely variable disorder and pred has strangely variable effects.

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