I have pmr

You need to take the second part of the split dose (if it is prednisone) at least 2 hours before you expect the pain to return - it takes that long to reach its peak in the blood and work. Prednisolone works faster.

Thank you, this is all new to me. Started on 20mg prednisone a day for PMR and pain went away in one day, then went to 15mg a day a month later, then all the pain came back. Went back to 20mg daily, no change. Doctor put me on 30mg daily for 30 days, pain did not go away until i split the dose 10mg at night and 20mg morning. Then Doctor put me back to 20mg for 3 weeks and i split the dose 5mg evening and 15mg morning. Now i am on 17.5mg daily, 5mg in the evening and 12.5 of morning. Pain is coming back just a little but i can live with it. The Doctor wants me to go to 15mg next week and i will split the dose 5mg evening and 10mg morning. The big reason i am trying to get low as i can on Prednisone, i have osteoporosis and it was getting worse before i started Prednisone. I am also starting on Fosamax next week but i am scared of the side effects. I already have a bad stomach and i am worried the Fosamax will only make it worse. How can i get my prednisone dose down as fast as possible without causing the pain to return. Also do you know the best medication for osteoporosis that has the least side effects. My stomach i am afraid will not take the Fosamax, i have to take rolaids and tums now and that doesn't go well with Fosamax. My Rhuemy and my GP seem to think all is well, just take the Fosamax and you will be fine, i am not that convinced.

" How can i get my prednisone dose down as fast as possible without causing the pain to return."

You can't - and your doctor is setting you up for another fail and return of symptoms. Every time you do it it may get harder to get the symptoms under control again. You have to go about it slowly to find the right dose without causing a steroid withdrawal flare or overshooting what you need - especially at the start. 

All the bone-building medications have potential side effects but some have more gastric ones than others. If you already have gastric problems why are they so keen to use oral bisphosphonates? There are others given by infusions which reduce that problem. And many people are on something like Forteo or Prolia while taking corticosteroids. 

You can also do a lot yourself - Anhaga on this forum got her t-scores from -2.1 to -1.6 in a year without taking bisphosphonates, just with diet, supplements, a weighted vest and the right exercise.

I've been taking Fosamax once a week for 3 months.

Have had no problems with it.

Starting on 17/7, 3 months ago, I'm now on a 10/7 split.  If my dose is a little too low, PMR inflammation begins to show itself, after a few days, as bilateral pain in the outer shoulders.  

Interestingly, I have found that any attempt to reduce the 7 mg evening dose still leads to PMR pain from 3 am to 6 pm.  So, beware of reducing the evening dose!  I am entirely pain-free so, perhaps, your evening dose is too low.  

I’ve heard about feeling lightheaded on low doses before on this site.  I get so “fuzzy” so often and can never explain it to a doctor (I think most of them think “what do you expect at 78”).😡  I’m now on 4 mgs (again).  5 1/2 years with PMR.  Oh I do hope the “six” years the experts say is the upper time (usually) for PMR.  I know there are many of us who go on longer (grrrrrr!) but I’m not losing hope - yet!

What kind of supplements and diet did you do to help your osteoporosis. My osteoporosis is real bad in my back and neck and would like to rebuild my bones with diet, supplements and excercise. I am not sure exactly how to do it.

I'll private message the little essay IO wrote and you can take from it what you will.  I firmly believe that even the people who take the medication should also be doing everything they can to improve their bones with nutrition and appropriate exercise, especially as it becomes more clear that the risks of the drugs go up after a couple or three years.

Thank you.