Need help- Pred starting dose 15 mg or 20 mg or split

You might try 7.5/7.5 for a few days. If bilateral pain persists, no harm done, try 10/10.

On a single dose, I also had PMR pain all day. After a month, I began a 17/7 split dose and, on tapering, kept the evening dose high. Evening pred after the meal never affected my sleep. I stopped splitting at 7 mg pred.

When you stopped splitting, when did you take the 7mg pred? I'm taking 4 in the evening and 3 in the morning, but this doesn't work consistently. Sleep is not an issue with me either.

I tapered to 7.5 mg pred in nine months and was stuck thereabouts for a whole year, with several unsuccessful tapers. Your current daily 7 mg may well be a little low, just as I experienced.

At 7.5 mg, I experimented with different split doses and tapers, starting with 4 after breakfast and 3.5 after tea and, six months later, settling on the reverse.

After another five months, I transitioned to a single dose of 7.5 mg after breakfast and, soon, after began the successful taper towards 4.5 mg pred, PMR pain free.

I began taking pred two years ago today.

thanks, evening pred leads to adrenal gland suppression. Isn't that true?

I thought pred led to adrenal gland suppression!

All pred above about 8mg/day leads to suppression of natural cortisone production - whatever time you take it. Yes, it was found that 5mg at night suppresses more than 15mg in the morning but that is really more relevant to short term use of pred - up to a couple of months. If you are on pred for years there will be suppression so it makes sense to use the pattern of dosing that gets the best result for the lowest dose and consider trying to get to morning only dosing once you are down to about 7mg/day. But once you are low enough it will usually come back anyway.

Thank you

when you started taking pred, in how many days you felt better? Understand that lot of people get better from 1st day, But read an article that said median response time is 10 days.

Any advice for me? I am 68 yr, have occasional low grade fever, ESR is 90.

Thank you

when you started taking pred, in how many days you felt better? Understand that lot of people get better from 1st day, But read an article that said median response time is 10 days.

Any advice for me? I am 68 yr, have occasional low grade fever, ESR is 90.

Thank you

when you started taking pred, in how many days you felt better? Understand that lot of people get better from 1st day, But read an article that said median response time is 10 days.

Have bumped my dose to 15 in morning and 5 at 3 pm. Still no relief. Only on first dose, it was a little better.

Any advice for me? I am 68 yr, have occasional low grade fever, ESR is 90.

I had a miraculous improvement fifteen hours and twenty five minutes after taking the pred for the first time. Most people on this board seem to have a reaction in the first three days or do. I am surprised that you have read it is 10 days as a median point, but it could be correct.

ptolemy, each of us are so different. My first dose was 20 mg it took several days before I noticed any significant difference and at least a month before I was PMR pain free. After a bad flare I had to increase to 30 mg, I was on 30 for 6 weeks drive me and everyone else nuts before I was PMR pain free. 🙂

I have never been PMR free, you are very lucky, as I understand very few people have no pain at all.

It had been my impression, from the forum, that many are PMR pain free. I only have bilateral pain if I forget a tablet or taper too rapidly.

I suspect there are many who say "pain-free" when really it is relative. But I really am PMR-pain-free because I refuse to compromise on the pred dose - not totally pain-free though.

As Eileen says quite a lot of us are not quite pain free it seems! I have always had a small amount of pain. It would be great if I were. On the other hand the change is a miracle compared to how I felt initially.

ptolemy, when I first came down with PMR my Rheumey was rushing off the Pred. Then I had a terrible flare. Since then I manage my dosage. I was first PMR pain free after 6 weeks on 30 mg. The Rheumey was furious, but I would not reduce if I had pain and still won't! 🙂

I do not understand doctors who do not have any empathy. Some of them seem to work off a tick off list, forget about the patient, just follow the pre set rules!

Ptolemy, that really seems to be what they are doing. I been in the ER a few times lately. The ER doctors work really quite different. They are not rushed, at least at our little town. One doctor who works in a Los Angeles hospital come here couple months a year to unwind. Lucky us. 🙂

The doctors in UK all go on how hard they are having to work and cannot get things done properly. Recently it was suggested that pharmacies could help out, but the medical profession thought it a bad idea. Probably because they did not want to admit that other people could do some of the things they can do and may even do them better.

Hmmm - my experience with pharmacists hasn't been great! I think a better option would be to persuade former paramedics who have had to give up being on the road because of injury to work in GP surgeries and the ED in an office.

Probably a good idea but doctors would not like it as they are not as qualified as them in their opinion. Doctors really do not help themselves they are too busy and exhausted they say but not willing to accept anyone else's help.

Paramedics are good enough to replace GP house calls but their greatest qualification is that they know enough to know when they are out of their depth!! Better at reading ECGs usually too!

I cannot see some of our GPs going to the level of care paramedics go to!! On the other hand GP house calls are as rare as hens' teeth nowadays.