Posted , 12 users are following.
Hi, I have seen Rheumatologist this morning and they want to add om Methotrexate and gradually reduce the prednisone- currently taking 18.75mgs of prednisone but still sore for at least 2 hours- any advice please
1 like, 11 replies
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3party jan_37704
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jan_37704 3party
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Anhaga jan_37704
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diana21296 3party
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I am on 8.5mg and have started to reduce by .25mg as my body accepts the drop more easily as I am steroid sensitive. I cut a 1mg pill in half with a pill cutter and then cut the halves into quarters on a board using a sharp knife. Pretty accurate and works every time as the pills aren't crumbly.
nick67069 jan_37704
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Adding Methotrexate is usually done after year or two and at best it has mixed results. After only several weeks on pred, it is crazy. When you say "still sore", how does it compare to initial pain you had when you were diagnosed. Even more important, how does it compare to the level of pain you had when you were on 20mg? Many people have some residual pain, and live with ~70% reduction in pain.
ptolemy nick67069
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Anhaga ptolemy
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Oh yes, I'd forgotten that theory. Perhaps that's what's going on here. Should have kept my mouth shut!
constance.de jan_37704
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EileenH jan_37704
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If the soreness is in the early morning that is perfectly normal - that is when the new batch of inflammatory substances is shed and until you take your pred dose and it takes effect you are likley to be sore and stiff. That has nothing to do with the effectiveness of the pred and to me it seems crackers to introduce another medication which has its own set of side effects and which isn't guaranteed to make any difference to how the pred works for YOU at this stage. I would want to try reducing alone, slowly, as long as I could. Many people do get to lower doses realtively easily providing they aren't rushed.
An Italian study found that although adding methotrexate did allow some patients to get to a lower dose of pred initially, I don't think the overall dose of pred wasn't sigificantly changed but, above all, there was no change in the incidence of pred side effects which is claimed to be the reasoning behind using mtx. And whether patients were put on mtx or not - PMR still required pred for up to 6 years.
jan_37704 EileenH
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EileenH jan_37704
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