pmr flare up,dr still leaving on 20mg

Cheryl, you've been struggling with this for a while, sounds like you should be thinking about splitting your dose.  If it's any consolation some people who do that find they can even manage on a slightly lower dose because the pain is better managed.  No harm in trying, I suppose.  I haven't had to try the split dose regimen but lots of people on here have so perhaps they'll weigh in soon with suggestions how to go about it.  I think from what I've read you would start with the evening dose, so you\ll already have had a full morning dose.  You then take perhaps 1/3 your normal dose in the evening, say at supper or with food around the time you usually start to feel some pain returning.  The the rest of the dose, 2/3 as usual in the morning.  It seems to be one of those things which needs a bit of tweaking in order to find optimum dosing and timing, but as so many people have found it helpful probably worth considering.  You've given the single dose a day a pretty good shot, haven't you?  Whatever you decide, if you do split the dose, be sure to give the experiment a few days to see how it's going to work, don't start changing dose timing every day or anything like that.  The poor body needs a chance to adjust!

October 12th is about 4 weeks. Not long.

The early part of pmr treatment seems to be about getting some stability. Finding the point where pred reduces the inflammation and the remaining symptoms are acceptable. And us getting used to all the ups and downs. Figuring out what are side effects and what is pmr.

Pred reaches its peak 2-3 hours after taking it. Half life is a few hours. Which means when we take it in the morning its a few hours to reduce the symptoms then they gradually return until we take the pred next morning. Some people find splitting the dose, morning and evening, helps. But I'd suggest first priority is to become stable before changing things.

4 days is not very long. It was a few months before I felt comfortably stable.

20mg sounds a bit high to me. But its obviously not treating all the symptoms.

What else are you doing? It takes more than the pred. Too much activity can aggravate the pmr. Pacing becomes important. And diet.

If I was waking at 4/5 I'd consider taking the pred then, back to bed, and it will have begun working by the time its getting up time.

Hi Cheryl

Within the 1st week i knew i had to split my dose for my pain returned around 4pm. My Rumi agreed so when on 20mg i took 15mg am and 5mg at 3pm allowing it to kick in before the pains came. It truly works for me and when i reduce i reduce my morning dose.

I found that it took some time before i woke up with no morning pains just stiff. I do have pain but alot of it brought on from pushing myself or not pacing.

If this doesn't work i would say you dropped to fast and your inflammation is not under control and you may need to go up.

Good luck

Mariane

Hi Cheryl I have been on prednisolone since August and with working shifts it took me ages to settle into a pattern of medicines and in the end I split my dose when I was at 22.5 mg.

i took 17.5 am between 06.30 and 07.30 then 5mg at 3 pm so I could have sleep on a night, as the early 4am wakening s were getting me down.

i have taken 0.5 mg off each morning and evening dose as my reductions every 3 weeks or so, I know it's slower than normal but I am trying to go back to a strenuous job with 12 hour long shifts, and don't want a flare. 

Hope this is of some help.

Have a good weekend.