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Taper / Prednisone Flare / Upped my Preds ??

Posted , 7 users are following.

dea13
dea13

Hi everyone, I have not been on here for awhile. I am just still battling through after 2 years with PMR and on Prednisone. Started at 40, lots of interruptions along the way.

Now down to 22 mg and also the Rheumy just put me on MTX 8 weeks ago which so far is doing nothing to help, if not worse.He also put my Preds up from 10 mg to 25 mg, going only off my blood test. I told him I had no pain and felt good, but being a Rheumy I took his advice sad 

My question is, I had a flare this week, after 4 days could not stand the pain and went from 22 mg back up to 24 mg yesterday. After some hours my pain settled, which did show me it was PMR flare and not my OA ... this morning my pain has been ok also, need to take Preds soon. I have been tapering slow.

How long would you say I should stay up on the 24 mg ? few days? or until my pain is comfortable? a week? I don't want to undo any hard work I have done tapering so far.

And don't get to see my Dr for another week... Any advice would be great as I know many on here are professionals and know what they are talking about. 

Cheers Thanks Dea 

0 likes, 4 replies

4 Replies

  • Michdonn
    Michdonn dea13

    Posted

    dea, sorry to hear of your problems. I never reduce my dosage if I have any PMR pain. I think you have to get the inflammation stabilized, then start your taper. I use the DSNS method to taper. I know it is slow, but I have been am to control the PMR and live a normal active life. Good luck try to stay positive and smile. ☺️
  • EileenH
    EileenH dea13

    Posted

    If you are still requiring 24mg after 2 years I would have thought your rheumatologist should be putting his thinking cap on - that is a high dose, higher than most people start on, and to have problems at above 20mg does make me wonder if it is PMR. Don't be misled - other things besides PMR respond to pred, especially at that sort of dose. The introduction of mtx does suggest the rheumy is thinking about it but unfortunately even in inflammatory arthritis it can take up to 6 months before you can say it isn't working and in PMR there may be no sign the dose can be reduced for anything up to a year to be able to see the benefit.

    You can drop straight back to the previous dose even after up to a week of a higher dose if you think that was enough to calm a flare down.

    • dea13
      dea13 EileenH

      Posted

      Thanks Eileen I knew you would come to my rescue, How are you? 

      One reason I am on 24mg now is I did start at 15mg when diagnosed 2 years ago, then after a month had eye problems so they put it up to 40mg thinking GCA, I did start to taper when felt ok, then had to stop in the mid 30'smg due to them finding I had breast cancer a few months later, waited 2 months for operation, then was tapering waiting for 5 weeks radiation, got to high 20's and stopped again for the 5 weeks. Then started again and 1 month later found a blood clot behind my knee on thinners for 3 months... Then started to taper again in march 2017 and got to 10mg in Feb 2018. Saw Rheumy then and he said my SED was up and he was not happy with the way I was on Preds and wanted me to go back up to 25mg and on the MTX...  And that the MTX will help me taper... It has made it worse not better so far after 9 weeks of being on 20mg week, I know they said it can take 4 months or more to kick in... But now I am on 2 potent drugs and not happy. Even my Dr could not understand why he put me back up to 25mg when I told him I had no pain... Not sure what his plan was, I have been tested for RA, I do have osteoarthritis bad in facet joints and knees... I only can get to see him the Rheumy every 6 to 7 months which is annoying... Better off with just my Dr I think.

      I will take your advice and see how I go with this flare in a few days time, then drop back to the 22mg, is that what you meant?  I have also downloaded the DSNS and will follow that.

      Not seeing my Rheumy until July, so think I will give him a miss.....

      Many Thanks I really appreciate all you advice and help once again; Cheers Dea 

    • EileenH
      EileenH dea13

      Posted

      I'd go back to your GP and ask to discuss it in depth with them - if the mtx isn't helping, and even making you feel unwell, what is the point of being on it? Your sed rate could have been up for all sorts of reasons and expert opinion is that raised sed rate alone without symptoms should not be a reason to raise the pred. What was his reason for "not liking the way I was on pred"? It seems a very nebulous reason for raising your dose so far.

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