Advice on how to change dosage (or not)
Posted , 7 users are following.
Have been on medrol for two and a half years. For well over a year and a half I've been steadily decreasing dose by no more than 10% at a time and holding for at least a month.
For the past month I've been on 5.3 mg/day (6-4-6) down from over a month at 6mg/day.
I've been feeling steadily worse during the past month. No major pains, just more stiff and achy muscles - all bilateral.
Should I just hang in there, wait for major pain before increasing dose, or bump up dosage?
If bump up then how much for how long?
1 like, 3 replies
EileenH philoso4
Posted
I'd go back to the last dose where you felt good. It sounds as if you have overshot the dose you are looking for: the lowest dose that manages the symptoms as well as higher doses did.
alan769008 philoso4
Posted
I've got the same issue, doc wants me down to as low as possible. I started on 20mg 2 years ago and now on 8mg but it appears anything below 10mg and i'm in a lot of pain/stiffness. I keep thinking I should go back up 10 10mg
Alan
EileenH alan769008
Posted
You probably should, yes. It took me over 4 years to get reliably below 10mg with prednisolone.
Doctors forget that the bioavialabilty (the amount the patient absorbs) of pred varies from 50% to 90% (it is mostly quoted as 70%). The 90% patient on 10mg is getting the benefit of 9mg, the 50% patient would need an 18mg dose to get the benefit of 9mg or, conversely, apparently on 10mg, they are only getting 5mg-worth,
After a hiccup on methylprednisolone where 20mg did not a lot except cause side effects, I was switched to a form of prednisone and was able to reduce to below 5mg. Then I had a flare which took me back to 15mg, now I am on 7mg and just holding, no stiffness but wrist pain. That is after 8+ years - PMR only lasts 2 years for 25% of patients. For half it is 4 to 6 years - and it usually takes them longer to get to a low dose.
I'm sure your doctor wants you as low as possible - but as low as possible is what works for you, not what he wants. The PMR is the boss - and it won't listen to him!