Has anyone needed to increase their Prednisone dose?

Hi Valdez it's not for anyone to change your dosage on here, it would be dangerous it is a potent prescribed drug. You can always go back to the doctor and ask them to increase it, or you could try splitting the existing dose, 10mg morning and 5mg evening until you get to speak to a doctor. 

20 mg is a good starting dose rather than 15mg and most doctors ask for a review after a week to see if the dose they started you on is enough. So I would recommend going back to the doctor and asking for an increase, if you have 70% plus improvement on 15 mg re symptoms it is a good start on the 15mg this is what I was advised. 

Take care

I started on 15mg and within the week up to 20mg. I still had afternoon pain and again within the week started splitting 15 mg morning 5mg afternoon. We further refined it to taking the afternoon dose at 3pm to get ahead of the pain. Thats if i remember at 3pm lol.

It took months for morning pain to turn into morning stiffness so now just stiff in the morning so very slow start.

I hope this helps

Mariane Canada

I started on 15mg but had to increase it intially to 20mg. After 2 months I came down to 15mg and then a month after to 10mg. My plan is to drop 1mg each month as long as PMR symtoms don't reappear

It would be helpful to have more details - how long have you been on pred, have you had any relief of pain at all, and when are you to see your rheumy again?

Typically doctors look for a 70% overall improvement in symptoms fairly quickly in PMR - it is fairly unusual to get total relief of pain and symptoms. In some cases patients need more - if they are larger or some people don't absorb all the pred so effectively get a lower dose which isn't enough to get a good result. The most recent recommendations for the management of PMR, published in October 2015, suggest using up to 25mg - they used to use more in the past and then their fear of pred side efects led them to reduce the starting dose to 15-20mg as that worked for a majority of patients. Now they are thinking that a higher starting dose gets a better long term result after all. So maybe your rheumy needs to try a bit higher dose to see if that works.

You will find a link to these 2015 Recommendations in this post:

https://patient.info/forums/discuss/pmr-gca-website-addresses-and-resources-35316

However - PMR is just the name given to the set of symptoms we all recognise - it isn't the disease, that is an underlying "something". In the case of the PMR we discuss here it is an autoimmune disorder that causes the immune system to attack the body by mistake, causing damage that leads to inflammation and pain and stiffness as a result and which pred works well to relieve There are other causes however - and if there isn't a good result in response to pred the rheumy may need to re-think the diagnosis. For example, late onset RA can appear identical to PMR but doesn't always respond so well to the moderate doses of pred. And there are other things. 

And another factor is that the antiinflammatory effect of pred lasts from 12-36 hours, depending on the patient. If you are at the 12-hour end of the spectrum you may have returning pain before the end of the 24 hours - and almost everyone gets pain in the mornings before the next dose of pred takes effect. New inflammatory substances (cytokines) are shed in the body every morning, about 4.30am. The longer after this time you take your pred, the more inflammation has developed. Studies have shown that the optimum time to take your ordinary uncoated pred is at 2am - it takes up to 2 hours to reach the peak level in the blood and then it's ready and waiting to prevent the cytokines doing their damage. Some people do actually set an alarm and do this! However, taking it very early, about 2 hours before you want to get up, also works pretty well - take it and settle down for another couple of hours rest by which time it is working. And some people take about 2/3 of their dose in the morning and the rest later in the day, sometimes as late as evening, and find that also helps with returning pain in the evening and the morning pain problem.

So there are a lot of factors - but as Adette says, not for anyone on a forum to change doses. We can suggest you might need more - but that is up to at the very least your GP to approve. Apart from anything else, you will need more to be prescribed or you will run out which you must not do - you must not stop taking pred sudddenly. 

first diagnosed PMR 9 yrs ago at age 57, treated 1 yr w/pred. resolved. 

It reappeared this summer, and my doc has had me on pred 10-15 mg,   since.

Relief by afternoon, but horrible mornings.  I so appreciate finding its best to take pred at 2 Am to catch those early morning demons from releasing.  I've subscribed to the group and order all of the literature thru Amazon.  Thanks!