Hi all,
I have just decreased my dosage from 12.5 to 10 mg and the nightime and morning pain are quite serious. The nighttime and morning pain did not appear suddenly after going from 12.5 to 10. The pain has been slowly increasing ever since I went from 15 to 12.5 mg -- but now it's worse than ever.
I'm on demand this week (working) and am wondering if I should take 5 mg in the AM after breakfast and then another 5 mg in the PM before bed.
What do you think?
Hi Bob, I was a lot more cautious reducing down from 15mg and I also went thru' a reduction plan as well - take it steady it's worth it in the long run. It could be just dropping by 1mg per month will get the body to adjust to change. It's far better to take the whole dosage in one go in the mornings as early as possible rather than splitting. Are you taking any calcium tabs? If you are don't take them at the same time as the preds
Hi Oregon John,
I guess I'm Virginia Bob.
I am chewing 2 tables of Tums each night. I know I'm not supposed to take calcium and prednisone together.
If I cannot take 5 and 5, then I might have to go back up to at least 12.5 again. This isn't pretty.
Thanks for the advice.
I did not know that one should not take calcium with prednisone. I usually take all in the morning....calcium, magnesium, vitamin C, D .....and prednisone. What would be the reason for separating them?
Erika, the prednisolone inhibits calcium absorbtion so it's best to take them well apart - pred for breakfast, calcium for lunch and tea.
Bob73442 - I think your reduction rate is far too fast and that you may have to go back to 15mg and stabilse on that before even thinking about reduction. The aim is to get to the lowest comfortable dose - not to reduce pred to zero in 3 weeks. If you current comfortable dose is 15mg then so be it. If you continue to reduce you will have all the PMR pain and discomfort breaking through without any benefit from the pred, and you are given it to relieve just those symptoms. It isn't a cure - there current isn't one - but these symptoms can be managed with steroids to achieve a better quality of life.
Thanks, I did not know......I will not take the calcium with prednisone together in the future.
I've already told you on the other thread and I see Nefret has too - far too big a drop in one go! I know Quick and Kirwan say it can be done, but a 20% drop from 12.5 to 10 is far too much to do from one day to the next. No drop should be more than 10% of the current dose - so at the very best it should be 1mg at a time. And for many people that is still a big ask. Spreading the drop over a week or two helps, for me I had to do it over 4 weeks!
In addition, whilst 12.5 may be more than you need AT THE MOMENT it is possible that 10.5mg would be enough AT THE MOMENT. If you drop in smaller steps you don't miss the current optimum dose. It doesn't mean you won't get lower at some point - just not yet. And yes - half a mg can make that much difference!
Hi Eileen,
Please don't get annoyed at me -- I'm still confused. I'm not criticing you -- that's for sure. But I thought I understood YOUR reduction plan and now I know I don't. There's a lot to take in on this forum and sometimes it can be overwhelming.
Again, please don't get annoyed but what IS your reduction plan?
Hi Erika.- Cut and paste from an article from the PMRGCAUK Newsletter:
"Q I have only learnt recently that I should not take Adcal and
Prednisolone close together. Why?
A Adcal contains calcium carbonate, which is a calcium salt used mainly to supplement calcium in the diet, and colecalciferol, otherwise known as vitamin D3. Adcal’s active ingredients decrease absorption and
so effectiveness of prednisolone."
On a personal note after reading the article I did a bit of research, as I to took everything straight after breakfast, but sometimes left the Calcium until later - I discovered I was better on the days I left it (or maybe forgot it!) and since have confirmed the preds are doing their job more consistently.
All answered over on the other thread!
The 15/12.5/10mg reduction is the one from the Bristol rheumatology group. For some people the 2.5mg drops are too much - looks like you are one. This link
https://patient.info/forums/discuss/pmr-gca-and-other-website-addresses-35316
takes you to a thread where the Bristol group pape ris in the first post - and further down in posts 4 and 5 you will find MY "Dead slow and nearly stop" scheme with explanation.
Hi Virginia Bob - I think several have come up with the same answer - just take it in small reductions - it's a long haul! Left OR many years ago, live in the deep south - of the UK!! Hope all goes well with your meds - remember the tortoise and the hare! Oregon John
John, thank you --- it is most helpful to know what works together and what does not. I will take my calcium at lunch time and then again at dinner time because I am supposed to take 1000 mg according to my GP here in Oregon. I also take magnesium which helps my blood pressure because it is calming for the nerves and all.
So many things to take into consideration.....never thought getting "older" would be such a challenge, but then it's worth trying to make it through the day.....:-)
The other little bit about calcium and vit D is that it should be taken with at least a small amount of fat so it is absorbed better. Just the milk in a cup of tea is enough in the UK providing it is real milk not skimmed (very bad for you, can't absorb the calcium in it at all, a fact taht is never mentioned!). And you shouldn't really take more than about 500mg of calcium at one time because the body can only absorb so much at one go!
Meant to say - no, you are quite right Erika: getting old is not for the faint-hearted! You need to keep fit just for that!
Just reading the ingredients on my version supplied by the NHS - Calichew - D3 Forte.
Each tab contains 1250mg calcium carbonate ( equivalent to 500mg calcium) and 400IU colecalciferol (equivalent to 10 micrograms vitamin D3). Also includes sorbitol (E420), isomalt (E953), sucrose, aspartame (E951)
The E numbers are a European standard most likely not on your label. The dosage seems to be about the same 2 tabs a day = 1000mg.
Oh My Goodness! It nver seems to end.... docs never mentioned that the calcium shouldn't be taken with the Prednisolone. I will obviously separate them from now on. Thank Goodness for this forum.
So skimmed milk is no good, what about Soya Milk? Is the calcium absorbed from it?
What about semi skimmed Milk?
Full milk and semi-skimmed are fine - enough fat to transport the calcium. Soy milk is only any good if it is fortified - the calcium in soy is attached to the bean and the human gut can't cope with it. Careful with soy if you have any tendency to gout because of the purines in soy! You do need some animal fat - despite the stories of the last 30 or 40 years it is essential to life!
The pharmacist should have mentioned the spacing of your medications! - I don't imagine the average GP is aware to be honest!
Just take them covered in butter!!
Now there is an idea! I've just been singing the praises of a German delicacy called Schweineschmalz: pork or goose dripping mixed with crushed garlic and onion. Perfect...