Has anyone tried Plaquenil to help to taper Prednisone? Rheumy wants me to try this first.
Hi Bob,
I was diagnosed with PMR in March 2015. Started on 10mg Pred along with multiple local kenalog (long acting cortisone) shots over the past 18 months to help with the horrible shoulder pain.
After refusing methotrexate due to my fear of yet more unwelcome side effects, my rheumatologist convinced me to try Plaquenil. I started on 400mg March 2016. After a couple of weeks I developed a "rare" side effect of my ears ringing unbelievably loud. So loud it would keep me from sleeping, and wake me up at night when I did manage to sleep. I contacted my rheumy who said that it wasn't the Plaquenil but I pointed out that was the ONLY drug I was taking besides the pred and had never had this problem before. The pharmacist I checked with said "It's caused by the Plaquenil, and this can result in permanent damage to your hearing". Ugh.
I asked rheumy if I could stop it for a few days, and sure enough the ear ringing disappeared. Rheumy asked me to try 200mg Plaquenil daily which I have done with no problem until about November 1 when the ear ringing started returning with a vengeance. (Plaquenil builds up in your system over time).
I have stopped taking the Plaquenil again for about the past two weeks. The ringing is still there but I do think it is very slightly diminishing, though it's still a problem for me.
Apparently (according to my Google doctor degree) this is a pretty rare side affect.
On a happier note - I am down to 2.5mg pred and hope to reduce completely off by March 2017 which would be my 2 year PMR anniversary. I *think* the Plaquenil has helped reduce some of the inflammation I was experiencing. I suppose time will tell.
All the best to you. MaggiGrace
thanks and best of luck to you. I have been on Pred for nearly 2 yrs and have flared up every time I get to 8 or 7.5 mg. Trying DSNS method and currently tapering to 8 again with so far no problem. However long term use of Pred is reaking havoc with blood glucose, so we're going to try Paquenil to help tapering.
Still working on my Google MD! I'll "watch" for ear issues thanks to your heads up.
There are a few people on the forums who are on plaquenil - most haven't found it helps, several have had side effects and there is no study evidence supporting its use. It isn't mentioned in the most recent recommendations for the management of PMR. Only methotrexate gets comment.
My feeling is it is fair enough to try any of these so-called steroid sparers providing they don't cause any side effects. But they do not replace pred in PMR - unless of course the diagnosis was wrong in the first place and it was actually LORA as they can both present identically.
I can't comment further though - no-one here in Italy ever mentions using these other drugs so it isn't a problem I have!
PS - the usual risk with Plaquenil is eye problems so make sure they are monitored from the start.
Funnily MaggiGrace - my lists have ringing in the ears/ tinnitus as a common side effect of Plaquenil!
Yes, Eileen! Eye problems are a big issue apparently with Plaquenil. I am being followed closely by an opthomologist as well as my rheumy. I found it odd that my rheumy (who i adore) was unaware of the ear ringing/tinnitus issue until I came along.
It's quite maddening at times 😫
That is the understatement of the week!!!!!!!
It worked for me. I could finally taper prednisone from 12 mg to 5 mg with the intake of 300 mg Plaquenil a day within a 7 months period. I have not had any side effects.
Eu fui colocada no Plaquenil como pré-cursor para começar com o Actemra (Tocilizumab), pois aqui na Austrália você precisa ser classificada como tendo AR, e ter tentado todos os outros medicamentos antes de poder começar com o Actemra. Tudo o que fez por mim foi me dar diarreia! Meu reumatologista disse que o Plaquenil não faria nada para a PMR ou redução de prednisona.
Estou tomando MTX há 12 meses, o que ajudou enormemente - eu não conseguia ficar abaixo de 20mg antes de começar. Nos 10 meses seguintes, consegui chegar a 7,5mg.
Três semanas atrás, comecei um ensaio de 12 meses com o Actemra - e já estou com 6,5mg de prednisona, sem nenhum efeito colateral da retirada! Me sinto muito, muito melhor, estou mais feliz e me movimentando mais.
Um tópico fascinante. Tenho PMR há dois anos. Quatro reumatologistas diferentes nunca conseguiram concordar se o que eu tinha era PMR, LORA ou doença de Lyme. Mas o PMR sempre prevaleceu.
Fui colocada em metotrexato no ano passado com a ideia de que ajudaria a reduzir a prednisona, mas não senti nenhum efeito positivo. Depois de ler sobre seus efeitos colaterais, parei o MTX de forma abrupta. Mais tarde, o reumatologista sugeriu o Plaquenil, devido a questões sobre a LORA. Ainda não sei a resposta para isso, mas o Plaquenil definitivamente me ajudou a reduzir a prednisona. Estou com 2,5mg de prednisona e sem surtos.
Parece que o metotrexato funciona para alguns e não para outros. O mesmo para o Plaquenil. A única verdade é que a prednisona sempre funciona. Depois disso, parece ser destino ao vento.
" Paquenil has definitely helped me reduce Prednisone. Down to 2.5mg of prednisone with no flaring"
or, after 2 years, the cause of the PMR symptoms is going into remission anyway. As with pred, you will tell if you get off pred AND Plaquenil - if it is LORA presumably Plaquenil alone will manage it, no Plaquenil won't.