Start of therapy- did u become better within a week?
Posted , 11 users are following.
I had started 15 mg Pred 6 days back, for last 2 days, bumped it to 20 mg.
Taking 15 mg early morning, and 5 mg around 3 pm.
Still no relief in symptoms. Only on first dose, on first day, it seemed better. But it is downhill since day.
So, when you all 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.
Thank you
0 likes, 20 replies
Reeceregan vijay91008
Posted
i was started on 50mg prednisone originally 3 years ago(GCA as well as PMR ) and instant relief within 4 hours. Tapered off by May 2019 but just had to restart at 10mg 2 weeks ago till MTX kicks in. (RA) Again, even at this low dose, pain releif within 4 hours and oain free ever since. That also includes 2 x frozen shoulders. No pain.
EileenH vijay91008
Posted
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.
vijay91008 EileenH
Posted
Thank you
Reeceregan EileenH
Posted
Eileen, I thought I read somewhere that the quick relief within hours is an indication that its PMR rather than anything else, and if no relief it may be something else? . IS that correct or was that part of my pred head confusion? i remember i had to take pred for 48 hours, then go off and if the pain came straight back it was PMR.
EileenH Reeceregan
Posted
To some extent yes - only PMR is felt to respond so dramatically to a moderate dose of pred, 15-20mg being the sort of range, and when that happens the chances are that this is the PMR we discuss on this forum. Lower doses not creating a speedy response are more likely to be due to the fact they are simply not enough - although one study found that 12.5mg was enough to achieve a decent result in a month for 75% of patients. But no-one wants to wait a month do they? But insisting on a 48 hour window is far too short for a majority of patients if they use 15mg and might miss a lot of cases.
Reeceregan EileenH
Posted
Yes, that was it. So may I ask another question if you don't mind...... would you think RA would respond that quickly to say 10mg of pred?
EileenH Reeceregan
Posted
I don't think it is expected to - I did wonder when I saw your other post. Why are they saying RA? By far the most likely thing in the time scale is a return of PMR for which you only needed perhaps 1mg to keep it quiet but no pred just let the inflammation mount up slowly.
Reeceregan EileenH
Posted
He had been suspicious RA was coming into play by the heat and mild ache in my wrists, elbows and my fingers also have OA and can also be a bit achy at times, nothing major though and definitely NOT the severe PMR pain. I had been off pred for a few months but the pain had never gone, it was just at a managable level. The frozen shoulders came back with bursitis and a tear, and the big joints were starting to get very painful again so I said it was PMR. No form of NSAIDS helped at all, at one point I did take a sneaky 5mg pred but it only eased it slightly. No raised ESR or CRP inflammation markers and negative RH factor. Because he knew I wasn't convinced about RA I had a doppler ultrasound of both wrists and hands and the screen lit up like a XMAS tree where the RA was and there is already widespread bone erosion. He prescribed 10mg pred for 1 week, then 7.5, 5, 2.5 each week then off, to ease the pain till the MTX kicks in. The day I took the first 10mg it was total pain relief and total mobility back within hours. I drop to 5mg tomorrow and have the 3rd MTX injection on Sunday and absolutely a new person once I had that first pred.
EileenH Reeceregan
Posted
Hope the MTX works - and the 5mg pred continues the relief.
krillemy vijay91008
Posted
I had started pred. 3 months ago (15 mg). Effect came gradually in 2 days. On day 5 I could not recognize myself. I was not tired, no stiffness (did not realise really how bad it all was on till it was gone), a very clear head and eyesight as well. The pain went away in hands and feed first. I still have issues with my joints though.
Anhaga vijay91008
Posted
I felt an intimation of improvement in about six hours after first 15 mg dose. It was the third morning I got up and realized after a few minutes that I hadn't needed to plan how to get out of bed. The intervening two and a half days are, I'm afraid, a complete blank! But I was definitely completely pain free within three days.
diana21296 vijay91008
Posted
I started on 30mgs taken after breakfast but pain was awful again by 2am and couldn't move. Learnt from forum to split the dose 2/3rds, 1/3rd to get me through the night. Worked well for me.
snapperblue vijay91008
Posted
I started prednisone at 15 mg about 10 days after the sudden onset of severe pain. With no response after 5 days, I went to 20 mg for a few days. Then 25 mg, which finally did the trick. I had to remain at 20 to 25 mg for relief for a couple of months.
Just as we all experience different symptoms, our responses to prednisone can vary widely.
PMR is just weirdly variable.
janet06653 vijay91008
Posted
It took me 5 day to feel "better" and 2 weeks before I felt great.
vijay91008 janet06653
Posted
Thanks, what was the dosage and timing of the dose?
janet06653 vijay91008
Posted
50 mg pred daily. I have GCA and PMR is secondary. That was 5 years ago. I was in alot of pain, had lost weight, was weak, and had blurry vision. I am now on ACTEMRA and 1 1/2 mg
pred daily hoping to go off pred by the end of the year. Had some flairs that required upping pred dose during this period.
krillemy janet06653
Posted
how did they diagnose the GCA? Some people in this forum are talking about a scan? Here in Denmark it seems to be a rather invasive - a biopsy. I had headaches behind my eyes in the morning, and blurring vision. I bought a lot of different reading glasses as I thought it was age related. It did not help. However after I started taking pred. 15 mg it went away! Doctors did talk a lot about GCA, but as I wrote in another thread - they abandoned GCA and PMR due to normal blood test. I am trying to find another doctor
janet06653 krillemy
Posted
diagnoses for GCA was confirmed via Temporal biopsy on both sides of my head. it was pretty painless. If they had not caught it I would have become blind.
I had sharp pains in the pack of my head and blurry vision that was increasing in frequency.
No pain in or around the eyes. Along with other symptoms. Everyone is different. My DR.s are at Johns Hopkins in Baltimore, MD USA
sandy08116 krillemy
Posted
Massive headaches, eye auras and jaw pain. That's what I had. CRP was 76. On steroids, it came down to 4.
EileenH krillemy
Posted
The scan being talked about is an ultrasound technique which a study showed was as good as and sometimes better than the TAB, However it isn't widely available because the capital cost of setting it up is considerable and many places haven't the money . It would have to be very widely available and staff around to do at all times - no point being a test with a month or so wait for an appointment.