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

Posted , 10 users are following.

New case of PMR

Started pred 15 mg with breakfast 3 days back.

First dose gave me some relief during the day- less fatigue, better appetite, less pain.

However, night time pain and morning stiffness was still severe.

Now, even day time relief has gone and back to pre-predinsone level despite on 15mg Pred.

What is your experience? Do I add 5 mg in the night? or 12.5 in morning and 5 in the night?

0 likes, 36 replies

36 Replies

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  • Posted

    Did you immediately go back to normal activity levels once you felt better? It can take up to a couple of weeks for good relief - but it does also depend on you being on an adequate dose and management on your part with appropriate lifestyle changes.

    Another possibility is that you were diagnosed and managed quickly - and the underlying autoimmune disorder that causes the symptoms is still building up and getting worse. This is particularly the case when PMR is a symptom of large vessel vasculitis or GCA.

    • Posted

      Diet, omitting carbs and sugar above all, pacing, trying to avoid too much stress and overdoing things in general. Avoiding too much activity with repetitive muscular actions or doing them in small bites helps. It is a bit different for everyone but keeping a diary relating activities and diet to dose and symptoms is often helpful. Learning what YOUR triggers are is very helpful - providing you then take notice!

      https://healthunlocked.com/pmrgcauk/posts/135650532/fatigue-pacing-spoons-and-a-gorilla...

    • Posted

      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.

    • Posted

      I have replied on your other thread:

      I had significant relief, in particular of the stiffness, with 15mg in under 6 hours. I know others with similar stories.

      Initially, it is better to take the entire dose at once - because you need the full antiinflammatory effect to see if it works at all. You are still only looking at the effect of 15mg in that sense. Only later is it sensible to investigate the duration of that effect.

  • Posted

    PMR is a life changer and you need to slow down and take life easier. Rest, rest, rest.

    • Posted

      Thank you. Rest actually increases stiffness/pain for me and in most PMR. no?

    • Posted

      When I say rest, I mean don't rush around the place, I did not mean rest by lying around in bed all day! Just take it easier. I think a lot of people do need to rest in bed occassionally on the other hand.

    • Posted

      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.

    • Posted

      When you ask a question of everyone following the thread you don't need to post it several times - reply to yourself and everyone will get a notification.

  • Posted

    Hi Vijay, I started on 20 mg but after a bad flare end up on 30 mg for 6 weeks to get PMR pain free. I then started splitting my dosage about 70 % after breakfast and 30 % at bedtime. Currently on 3 mg, but not splitting. We all have different ideas, but I believe an anti-inflammatory diet, staying positive, active and smiling helps a lot. Good luck on the rest of your PMR journey. 🙂

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