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Asked to cut dose by half

Posted , 10 users are following.

pat73046
pat73046

I was started on Pred. Jan 9 2015. First 10-then 20 Then 30mg. Have gradually reduced to 15 mg and due to labs being normal she wants me to cut the dose to 7.5 mg. No gradual decrease. This doesn't make sense to me, as I decreased by 1 mg at a time 3 years ago. Her reasoning was that my sdimentation rate and crp came down more quickly this time. I think this will be a disaster Eileen what do you think? She mentioned I might not have PMR . She is a nurse practioner in practice with the rheumy. I just cut my dose to 10 mg and have more pain than before. Aching cramping sensation in left shoulder, biceps,left firearm, and across upper buttocks--sacroiliac area bilateral. I am so confused. I thought the purpose of the Pred was to bring these values down and control pain., I told her today I would go to 7.5 but I don' t feel good about it. Thank you. Pat

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  • 3party
    3party pat73046

    Posted

    I recently saw a new rheumy who impressed me a lot.  Here is his take: He disagrees with the orthodox view, as stated almost everywhere, that after proper tapering to zero without pain returning, the problem is solved.  He starts with a smaller dose than most other rheumies, REDUCES THE DOSE BY 0.5 mg once a month, and keeps the patient on a dose below 5mg for life.  In his experience, the problem does not return.  His starting dose depends on severity of symptoms, but 10-15 mg is his usual.  I am impressed by his experience with VERY GRADUAL tapering, then a tiny maintenance dose.  He says that with conventional dosing, the problem often recurs.
    • EileenH
      EileenH 3party

      Posted

      If by "conventional dosing" he means the tapers so beloved of most doctors it will almost always return. But I have to say I have not come across much where they say taper to zero - it always says "depending on symptoms" and it is implicit I would have thought that that meant - stop when symptoms return. Maybe that is too much like logic!

      The difficult thing I find to get through to doctors is that you are not relentlessly heading for zero - the literature says very clearly you are seeking THE LOWEST DOSE THAT MANAGES THE SYMPTOMS.

      Lucky you to have found a rheumy with that attitude - can you get him to publish something? But do hang onto him!

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