Hi, all I'm new to this I have just been diagnosed with PMR, my doctor has prescibed a 30mg a day, from what I have read it seems a very high dose to start on, any advice please
Is this your trial period with pred, to see if it works, or have you already had the trial? A week on pred, usually at a slightly lower dose, say 15 or 20, sometimes less, is often the major diagnostic tool because PMR is one of very few ailments which will respond quickly to these lower doses. You could ask your physician why s/he thinks 30 is appropriate for you.
Have you high blood markers? Mine were ESR 132 and CRP 100+ so my doctor put me straight on 30mg to 'zap' the PMR. It did within 6 hours. Unfortunately after a few weeks the blood markers started rising and rising so the doctor put me up to 40mg.
This is not usual in PMR and many start on 15 to 20mg and are quite happy with the result. All of us are different.
It also depends where you live. In America and Canada the doctors usually start new PMRers on low levels of Pred. See how you go and listen to your body.
I have had two eoisodes of PMR, five years apart. The same doctor treated me on both occasions and the first time started me on 30. I was completely pain free within 4 hours and it took me three years to get to zero pred.
Second time I remember him saying" We'll treat it less aggressively this time ( no reason given and, stupidly, I did not ask. Second time I started with 15. There was not the dramatic pain relief as before but tolerable level. As I reduced there were many many ups and downs not a smooth reduction as first time and, although I have never done the sums, I would think I ended up taking more in total than on the first episode. It took five years to get to zero but, four years on from there I have not had any recurrence. Best wishes.
I was started on 15 and was completely pain free within three days, although I felt some relief within hours! I have been taking pred for a little over two years and have had a steady taper to, currently, 1.5mg.
Hospital put me on 30mg as had to go to A&E ... so much pain and high markers. Stayed on it for 6 weeks to control the symptoms before coming down to 25mg. Now on 10mg and feel almost normal with a busy life style. Every case is individiual.
Hi jean07565, I started on 20, took several days before I got any relief, 4-5 weeks before I felt PMR pain free. On my flare had go to 30 to get relief and stayed on 30 for 6 weeks, now down to 20. Each individual is different and it appears each case is different. Try and listen to your body and don't reduce if you are in pain. Keep smiling and good luck. 🙂
It is quite high, the most recent recommendation for management of PMR say "the lowest effective dose in the range 12.5 to 25mg". However, they used to use 30mg as a starting dose - the only disadvantage is that you have the extra bit to reduce.
And I started on 15mg and was 80% pain-free and toally mobile in under 6 hours!
As many have said, it varies by each individual. I started on Pred at 20 mg 9 months ago but have flared up twice when I've gotten down to 15 mg. The 2nd time the PMR flared up I had to go to 30 mg to get to a painless starting point again. Currently at 20 mg and the dropping in a week to 17-1/2. After that will be dropping veryyyyy slowly so I hopefully don't flare up. In the meantime, side effects are tolerable and I'm still able to do my physical work at about 90% of what I've done in the past. I am so thankful for Prednisone!
Hi TheRaven, when reducing did you reduce by more than 10%? Like your next reduction is 2.5 mg which is greater than 10%. I am at 20 mg also, but reducing to 18 using DSNS.
I started on 15mg last August and must say did not get much relief from the pain just stuck it out did not go higher am now down to 5mg and pretty much pain free just a little stiffness now and then but nothing like at first , decreasing very slow by 1mg per month
Did you try the DSNS method of reducing? Or just 1 mg per month? What dosage did you start 1 mg per month? Thanks 🙂
Michdonn, yes the reductions so far are more than 10%. I have read that reducing more than 10% isn't as much of an issue until you get down around the 15 mg range which was my previous experience. Both flares happened when I was directed to drop from 20 to 15. I figure the 17.5 is very close to 10% so I'm willing to take a shot at it. Then I have to hold at that level until my September appointment with my new rheumy (current one is moving - darn). Hopefully he'll agree to keeping the reductions to 10% or less. If not, I'm just going to do my own reduction schedule. I'm still able to handle with the physical work load but will admit that fatigue catches up to me at the end of the day. The recliner chair is often the "sleep chair" about 8 pm.
Forgot to mention what the reductions have been - was at 30 for a month then reduced to 25 and held for 3 weeks. Same at 20 mg but will be holding at 17.5 mg for 6 weeks, probably only because that gets me to the next appointment.
TheRaven, my bad flare was when I drop from 8 to 7 mg. Had a bad time, I want to be more careful this time. I going to take it real slow and easy! Let s keep in touch on the way down!
TheRaven, I waited at 30 till PMR pain free, then reduce 2.5 every 2 weeks till 20 mg. I doing a lot of walking, my wife got me a Fitbit so I can track my walks. I also find in have doze off in the recliner, but I been doing that for years!
What is DSNS not familiar with that . I went from 10mg to 7.50. Then. 6. Then 5 July 1st
Hi donna25417, DSNS is a method of tapering. DSNS https://patient.info/forums/discuss/reducing-pred-dead-slow-and-nearly-stop-method-531439
Here is the link I have saved. Good luck keep smiling! 🙂
On diagnosis, my Dr put me on 50mg with the words "we'll hit it hard" and I then dropped to 25mg the first week, 20mg the second and 15mg at the end of the first month.
I really don't think it makes much differnece in the first instance - the goal is to find the lowest possible dose that reduces the inflammation significantly enough for you to function effectively.