Down to 4mg Pred - but suddenly up to 80mg
Posted , 8 users are following.
My first post was in August 2017 under the heading "Is this just a blip?"
To explain my alarming new title: I'd been gradually reducing and had reached 4mg per day. All was well and I had a blood test before seeing the French rheumatologist again last month. He told me to stay on 4mg and come to see him again in August. All being well, I would then drop by 1mg per month.
However, from time to time (perhaps once a year) I get an asthma flare-up, often associated with bronchitis. Such a flare-up occurred at the end of last week and I wheezed and coughed my way to a GP, who has put me on 4/5 days of 80mg plus a short course of antibiotics. As is nearly always the case, this high dose is sorting out the asthmatic / bronchitis coughing and I'm confident it will have gone away within the 4/5 days.
I have stopped my daily 4mg (for the PMR) during this period but am wondering whether this sudden surge up to 80mg will mess up my gradual reduction programme. I mean, will it be a shock to the system if, in a couple of days, I suddenly drop back to 4mg?
I have plenty of Pred available so should I cut back to, say, 40mg or 20mg before dropping back to 4mg? If so, for how long?
It really is Sod's Law that I should get this asthma fit just as my pred was decreasing so nicely!
Comments and advice greatly appreciated.
ATGB
0 likes, 6 replies
Anhaga AsTimeGoesBy
Posted
My daughter in law's father has been on pred for PMR for several years. I think he was at something like 5 or maybe a bit more when he had a serious issue which required a massive dose. The doctor had him wean quickly off completely - obviously oblivious to the fact that he still needed a small dose for PMR. Very quickly he went back on, but only at the level he'd been on for the PMR control.
Michdonn Anhaga
Posted
Anhaga Michdonn
Posted
EileenH AsTimeGoesBy
Posted
It shouldn't do if you are only on the very high dose for a few days. If you weren't on pred at all then you would take the course (though it does seem high, my daughter has never had that high a dose I don't think, 40mg is the usual) and stop.
Some people get a bit wobbly even after that short sort of course - but I don't think that going via 40 and 20 would make any significant difference apart from extending the time you are on pred at a high dose. Above 20mg is considered high dose and is enough to upset adrenal function which is the crux.
AsTimeGoesBy
Posted
Thanks for the replies ... especially to EileenH. Well, in the event, I dropped day-by-day from 80mg: to 40mg, then to 20mg and finally back to 4mg again. I've been on 4mg for some days and am glad to report that the asthma/bronchitis has cleared up and that I don't have any PMR pains. So I'll press on with the 4mg till the end of August and take things from there. One thing I forgot to mention: the French rheumatologist prescribed a gastro-resistant variety of the once-weekly Risedonate 35mg, which means I don't have to take it on an empty stomach. The local chemist had to make a special order for these.
ATGB
EileenH AsTimeGoesBy
Posted
Good! How interesting about the gastro-resistant version. Is your French good enough to get more details? I imagine you could get it here in Italy - my husband used to get custom-made warfarin doses from the chemist but somehow I can't imagine many UK chemists being able to compound in the shop.