Pred at 40mg a day

Hello Anthony

Just a quick response to welcome you as it seems your post has been referred to the moderators for some reason - could you have referred to a website perhaps?

Meanwhile I have noted in your profile that you are writing on behalf of your wife and the fact that she has been prescribed 40mgs of steroid following being diagnosed with PMR.

You are right to have noted from previous posts that 15mgs if the normal starting dose for PMR, occasionally 20mgs, but never 40mgs. That high dose is reserved for a diagnosis of a PMR-linked condition called Giant Cell (or Temporal) Arteritis. Some of the major symptoms of GCA are head and jaw pain and vision disturbances - was your wife suffering from any of these? If not, then 40mgs is too high a dose and this should be queried with the GP to avoid any unnecessary side effects that the larger dose could bring.

Look forward to reading the whole of your post but hopefully the above will help in the meantime.

MrsO

Hello Brenda and welcome!

I've already welcomed Anthony as when the Moderators held up the post I checked the profile and found that he had appeared to write the first post.

Perhaps you have already found my first reply helpful and all I really want to ask now is did your high ESR had return to normal before you tried reducing from 40mgs? It is recommended that we don't make reductions until the inflammation is under control as shown in the blood tests.

Also, where are your pains? Although you should not have been prescribed the 40mg high dose for PMR alone (see my earlier post), if PMR was the right diagnosis then you should have had about a 70% at least resolution of your pain and, if the steroids have not brought about this resolution, then it's possible that PMR is not the right diagnosis.

When we hear further from you then I and/or others posting here will be able to hopefully give you further information.

MrsO

Brenda

I would suggest that you re-visit your GP as you do not seem to have seen him/her for a follow up appointment. You also need to be referred to a Consultant Rheumatologist so ask your GP for a referral.

Visit www.pmr-gca-northeast.org.uk and under useful information read, and if necessary, download the British Society of Rheumatologists Guidelines issued June 2009 on diagnosis and treatment of PMR.

Also at the top of the page on Patient Experience, where you come onto this subject ,there is a Heading READ ALL ABOUT IT - follow that link and you can also read up on it there.

PMR and/or GCA is not an illness you can manage on your own, when first diagnosed, it takes sometime to get a handle on it. You will get good advice on this site, but that is not a substitute for medical advice.

When you read the procedures, you will see you need monthly blood tests etc.

Please re-visit your GP.

Brenda...When I was first diagnosed with PMR in January of this year, my doc started me on 40 mg to reduce the inflammation quickly. I was on this dosage for 3 weeks - then 30 mg for 3 weeks - then 20 for 3 weeks and 10 mg for 4 weeks. When going from 10 to 7.5, I had a major flare and had to go back up to 20 for a bit. I'm now at 9 mg. It's a tricky business to keep the inflammation under control and reduce the pred at the same time, but that is always the goal because of prednisone's side effects. I hope you have a rheumatologist who is knowledgeable and compassionate, as that would be your best ally and your best source of information. I wish you well!