Does it make sence to increase predisilone from 15mgs to 30mg?

Just to say that for me, it took about a week for it to really help me at 15mg. On saing that from day one id say it was more like 50% better.

I know 2 people who had to start with 20mg. If it was me I would try 20mg for a few days first unless your doc had some other reason for starting at 30mg.

I was on 15mg of predisone and things were going well until one day the pain went into my upper body like you, whereas before in had only been in my lower extremities. I felt like I was back at square one and in a lot of pain. Every day was a little different as to where the pain was strongest. My neck, shoulders, arms, back...etc, were all affected. I couldn't even sneeze or cough as the muscles wouldn't allow it.

My doctor suggested we double the dose to 30mg and things improved immensely.

So far no side effects worth mentioning. I do however split my dose, one half first thing in the morning and the rest mid afternoon. It has been 5 months now and working out quite well. Next week I will start reducing the prednisone very gradually and get down to a much lower dose.

I hope this helps, and one more point to remember. Everybody is different and I am finding out that what works for some doesn't necessarily work for others. My doctor has been very supportive and suggestive....lucky for me.

Take care and good luck.

Shawn 

I started on 20mg and experienced a wonderful relief but not 100%, and so my kindly gp put me up to 30mg.

Since then I've learnt so much from this forum, esp from Eileen and Mrs O (who I'm sure will reply soon and I realise that going to 30 prob didn't do me any favours.

From what I've read most pmr sufferers shouldn't need more than 20mg to bring it  under control, and 70% control of symptoms is anaverage

I wanted to add that I'm now in the reducing stage, have managed 30 to 27, to 25, to 22, to 19 all pretty good -now gone to 17 and started to struggle a bit. I do wonder whether having to come down from a higher dose is more difficult.

I've just seen Shawn's reply and his point that everyone is different is so right. Do read some of the older threads and discussions, there's so much useful info and experience there.

Glad you've got a supportive doc, me too, although my consultant rheumy wasn't quite so friendly. Im due back to him in 3 weeks time and by his timetable I should be down to 10mg.

all best wishes to you -very interested to see other replies and opinions.

Jen

Hello Liam

You've had plenty of good advice from the others, and Jenny Sussex is quite right in saying that most pmr sufferers shouldn't need more than 20mg to bring the symptoms of PMR under control, with around 70% improvement being experienced in a few days by most people.

15mg is the usual starting dose but some patients do find they do better on 20mg - weight can also be a factor in deciding the necessary starting dose.

As Shawn has said, we are all different and therefore can expect differences in the way we respond to both the illness and the treatment.  So whilst many patients will have a rapid response to 15mg, sometimes within just a couple of days, for others it may take another few days for their symptoms to improve.  It's also worth bearing in mind that only a few lucky people achieve complete resolution of their pain down through the doses.  If you are someone who had high ESR and CRP blood test markers at diagnosis, then, together with your symptoms, you can use repeat tests as a guide as to whether the inflammation is sufficiently under control to try a reduction.

I suggest giving the 15mg another few days, and then if there is still no further improvement in your pain, try going to 20mg.  If that doesn't improve things, then perhaps the diagnosis should be queried.  Good luck.  

I feel that 4 days into treatment isn't sufficient time to judge how well the 15mg is working

Don't expect to be 100% pain and stiffness free - whatever your GP suggested, it doesn't always happen unfortunately. I was at a meeting with rheumatologists recently where they said to us "You mean you don't go back to how you were pre-PMR with the pred?" - NO, we don't, that is a dream...

Certainly give it a week and then maybe try 20mg, but I really wouldn't go higher. The higher you go, the worse the side effects and the higher the total dose you will have to take overall. And it is often more difficult to reduce from higher doses. When you DO start to reduce - slowly, in tiny steps is the way to go. Some people manage 2.5mg at a time, others struggle with 1mg - and we have reductions plans that do work well it seems so ask when the time comes. But don't be in a hurry yet - you need to be at 15mg for 6 weeks before even thinking of reducing.