Posted , 13 users are following.
Is there a difference between prednisone and prednisolone as far as PMR is concerned.
Is one better than the other for PMR patients. or are they basically the same.
One would think there has to be some differences as far as medication is concerned.
0 likes, 8 replies
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nick67069 BillyP
Posted
no difference. Prednisone is processed in the liver before it is active, while prednisolone is already in the form that body can use.
EileenH BillyP
Posted
They are both moderately acting corticosteroids, methyl prednisolone is another, whose duration of action is about 24 hours (varies from 12-36 hours) so once daily dosing is convenient. Prednisone must be processed in the liver to be turned into prednisolone which is the active substance. This means prednisolone has a speedier onset of action - the processing adds about an hour - but otherwise they are the same with equivalent doses. Methyl pred is slightly more powerful so the equivalent dose is slightly less: 4mg for every 5mg of pred. The methyl group in the structure is said to make it more antiinflammatory but also can increase the adverse effects - which was my personal experience. Neither of the preds have caused any problems for me - and both work equally well.
So totally interchangeable apart from personal idiosyncrasies. They all combat inflammation - which is all most medications that don't target the mechanism of the disease could do.
BillyP EileenH
Posted
Thank you Eileen and Nick. It is some thing i have thought about over the years.Some times the chemist gives me a mixture of each, at first i thought it may have had some thing to do with brand names. I have only been thinking about this for 16 years or so. I am still tapering from my last flare 2 years ago with my modified version of DSNS (1/4 MG per month) but each time i get to 6. 1/2 MG things go pear shape and i go back up to 7 then start again. I am starting to wonder if my adrenal glands are not kicking in . Amazing after all these years my doc and rheumy still cannot answer the vital questions to my satisfaction. I really pity people that have just been diagnosed with PMR , in most cases they have a rocky road in front of them until they get the hang of things and can self medicate to a large degree.( That is, if they really have PMR !!!!)... Thanks for the replies.............
maureen49480 BillyP
Posted
Yes it is a rocky road. I was diagnosed in September and am daily feeling awful.The steroids are doing my head in but I am determined not to give into this disease.
I have just returned from a months cruise in Australia and was certainly a lot better in the sunshine. The last two weeks since I have been home have not been good at all.
I have reduced to 13mg and am trying to reduce further this week. The steroids just do my head in and I feel as if I am going to fall over when walking. I do have a brilliant doctor who understands this condition and is very sympathetic and supportive.
Anhaga maureen49480
Posted
While brain fog can be a side effect of steroid treatment I suspect some of what we blame on pred is actually an effect of the PMR itself. Lovely you could get some sunshine at this time of year. We've had an unusually overcast winter where I live and when we had two days of sunshine this week I swear everyone was out and about! It certainly made me feel better. Heavy rain today but perhaps sunshine again tomorrow. 😃
EileenH BillyP
Posted
No - not necessarily the adrenals, but the fact that however slowly you taper you won't get past the ultimate hurdle: you are looking for the lowest dose that manages the inflammation, you are not reducing relentlessly to zero.
It is unlikely that the adrenal problem would manifest as more than fatigue at 7mg - it may be, but less likely. Some people have PMR for a very long time. I'd think it wonderful if I could get to 7mg ...
EileenH Anhaga
Posted
I agree Anhaga - one thing the 5 years of PMR with no pred taught me was that pred side effects are often as much due to PMR as the pred. At least with pred there is less pain.
Michdonn EileenH
Posted
I only went about 5 months before I started with Pred and the pain and fatigue were unbelievable. I would fall asleep almost as soon as I stopped it was terrible. The key to my PCP was when I told her all my issues and couldn't get up off the toilet. She put me on Pred and referred me to a Rheumey. 🙂 Still taking 2mg a day.