PMR - splitting the dose of prednisone
Posted , 8 users are following.
I was diagnosed with PMR just a couple of months ago. I have been on 20 mg of prednisone and 15 mg of methotrexate once per week and the following day leucovorin (folic acid) I have not been pain free at all until today. I had been taking the prednisone with breakfast. Every morning I havef been in terrible pain in my shoulders and my writst. Yesterday I needed both hands to get my coffee mug to my mouth. I decide enoug is enough. So at dinner I went ahead and too a 10 mg tab. I woke up this monring with absolutely no pain!!!! I took 10 mg at breakfast and plan to take theother 10 at dinner. I realize that I dosed myself with 30 mg yesterday. It is now nearly 2:30 in the afternoon and I am still pain free. I have accomplished more today than I have in the past several weeks including a very long walk. Am I delusional due to the fact that I had 30 mg yesterday, or is this new plan apt to work???? When I begin reducing, based upon what many of you have written, I will take the lower dose with dinner. I am in the U.S. and most doctors here want you to go down by 5 mg at a time. Since I have not been on the meds for more than two months, maybe that will work for me. Any suggestions??? I do not see my rheumatologist until the 7th of August. He wanted me to start reducing before then. I will have enough meds to stay on the 20 mg until then. I am thining that if this new routine of dosing twice instead of once, I may start tapering in a week or so. I know womd of you mentioned middle of the ngiht dosing and such. I know this will not work for me. I have restless leg syndrome and would never get back to sleep. Also I need to take the proton inhibitor within the hour of the prednisone, so my plan for breakfast and dinner seems best for me. I could take the last dose with some yogurt before going to bed if that would be recommended. Thanks for any help you can give me. I really appreciate all of the good into that I receive on here from so many of you who have suffered for so long. My best wishes to all of you. Donna
0 likes, 35 replies
jeannae68307 donna60512
Posted
Donna,
i forgot to tell you that I also took Omega 3's. ( Omax 3). That also seems to help with inflammation.
donna60512 jeannae68307
Posted
barb30898 donna60512
Posted
Hi Donna,
i cannot offer dosing advice, as I have been fortunate enough to be o.k. on 1 dose a day, without discomfort.
i was more interested in asking about the RLS (restless leg syndrome) and how, or if it has been exacerbated by the the PMR/prednisone, and
I, also have RLS, which has become more severe, in the last few years.
I currently live in Florida, and doc's here, practice compartmentalized medicine, so they only understand their specialty, and cannot think 'out of the box'. Unfortunately, many of us have multiple medical challenges, which probably left our immune systems, weakened, and which, in turn, brought on the PMR.
That's a major topic all by itself.
Rationally, it seems, in your case, that breaking up your dosage, in 2 parts, is a great idea, as long as you are not upping the daily total.
You are definitely in the best place, with this group to help guide you.
I wish you well.
Barb
donna60512 barb30898
Posted
Hi Barb, I do not think the RLS has been worse, except for when the pain from PMR would hit in the week hours of the morning, then it seemed much more apparent. First I will address my new dosing and then talk about the RLS. I have not upped my dose except for the first day as I was afraid to just take 10 mg in the morning due to the very severe pain. I took 10 mg with my breakfast yesterday, and 10 mg with dinner. I woke up again this morning totally pain free, the first time in months. I am hoping to begin reducing the dinner dose in a couple of weeks if this is goind well. I slept so well last night, only got up once, and my legs were pretty much okay. Now here is what I have done for the RLS which I have had for over 40 years. Seems to run int he family as my two daughters suffer also. The first will sound crazy. I keep a couple of bars of soap between my bottom sheet and mattress in the lower let area. You can Google this and find that it does appear to work and has helped me. Secondly I buy one of those roll on type things that are used for back pain or such. I rolll a genrous amount on both legs. There are also some chewable tabs that are sold at the drug store and they are labeled for restless legs. There is also one for leg cramps. I don't always do the tabs, but the roll on stuff and the soap seems to work for me. Before my new dosing scedule, I was having to repeat the roll on stuff and take the tabs after going to the bathroom in the middle of the night as I just couldn't get back to sleep. This is why I didn't take the advice of several who recommended taking the prednisone at bathroom break in the wee hours. Since I was having so much trouble getting back to sleep, I just figured that would make it even harder to get back to sleep. Yes, you are so correct this forum is great. I have really learned a lot. At first I found it a bit depressing due the the length of time people were talking about having PMR, but I am now seeing this as being realistic and working towards making that time pain free. Thanks for your response. Have a nice day. Donna
Anhaga donna60512
Posted
I've just been reading a book by a medical doctor about magnesium. Apparently a lack of magnesium, or too much calcium in relation to magnesium can be a cause of restless leg syndrome.
donna60512 Anhaga
Posted
That's interesting. I'll have to check that out. I have had it for so many years and my daughers too. I keep forgetting to ask my son if he has ti. I have read that it often runs in families. I have managed pretty well without prescription meds. A person also has to make sure that they drink enough water as dehydration can cause problems. I also make sure that I get enough potassium. Thanks, Donna
Bergey donna60512
Posted
i have not noticed any other discussions that mention this in connection with PMR. Are you aware of any connection? Thank you.
donna60512 Bergey
Posted
Hi Bergey, I am unaware of any connection. I first started to have RLS 40 years ago. It hs onlye seemed worse to me, I think, because of the sleep disturbances caused by the PMR. There is a googy thing you can try, put soap between your sheet and mattress near your lower legs. I also roll on some of the stuff that you can buy at the drug store for sore muscles. I roll that on my calves. There are also chewable tabs that you can buy at the drug store. You could ask the pharmacist about those. Yours may be due to the prednisone. I really don't know. It seems to run in my family. Both of my daughters have it too. Good luck, I hope you can get some relief. It is a horrible feeling to just have to keep moving your legs, yes, it does feel at bit like you have crawly things on your legs. I had never heard of it 40 years ago and used to just describe it as my legs feeling really nervous. LOL Have a good day, Donna
Bergey donna60512
Posted
barb30898 donna60512
Posted
Hi Donna,
i too, have been with RLS, for many years, In fact, I remember having it as a child.
Unlike you, it is at it's worst, in the evenin, when î am tired.
Over the years, it has continued to worsen.
Now, I have it every day, and I must take med's, which don't always work.
I have tried almost everything to control it.
The only thing I have found to help, is eating lightly at night. It seems to take a majority of pressure off.
Even though excercise at night, is not recommended, riding a bike, using an excercise machine, using a roller, as you do, will all help temporarily.
Bergey, it seems your RLS, is caused by the pred, and I assume, when you've handled the PMR, and don't need prednisone,the restlessness will disappear.
Prednisone makes me hyper, and I 'm sure it contributes to my restlessness, too.
donna60512 barb30898
Posted
Bergey barb30898
Posted
Barbara, the feeling of "creepy crawlers" in my legs, and only at night when I went to bed, started occurring when the initial symptoms of PMR started. It lasted almost 3 months, with my other worsening symptoms, until I was initially diagnosed with PMR. Within 48 hours of taking Pred, all of my PMR symptoms, including what I believe is RLS, went away. About 7 weeks after stopping the Prednisone, all of the symptoms, including the leg restlessness returned, and I started back on Pred 15. I am down to 4 mg now and doing the DSNS method, and have had no signs of the leg restlessness while on Pred. That is why I was wondering if it might be a symptom of PMR.
Anhaga Bergey
Posted
I'd completely forgotten that sensation. Oddly enough I only experienced it once, I think it might have been the second night after I started pred. Just like caterpillars crawling around under the skin. Never had it before treatment.
barb30898 donna60512
Posted
Donna,
i agree.
Traveling n planes and theatres are torture, especially, as they don't allow us to stand up and move around.
i will be traveling, next week,at night.
i am trying not to think about it
Barb
donna60512 barb30898
Posted
I hope you have a nice trip. Sometimes just getting away is helpful. I have also put salonpas patches on my calves. You might want to give that a try for the flight. I think it might calm your legs down. It can't hurt and might just be a good thing for your trip. Have fun.
Anhaga barb30898
Posted