methylprednilisone dosage | Arthritis Information

Hi again....
About 10 days ago, I tapered from 18 mg of methylprednilisone to 16 mg. I take the whole dose in the morning. Since then, the pain in my shoulders and hips has gotten worse again, and now it's even in my right wrist! Not as bad as when I'm on a lower dose, but it takes until about 2:00 p.m. for the pain to lessen.

I'm teaching in the mornings this year, so having the pain not get better until the afternoon isn't the best thing for me! Would it help to take half the dose in the a.m. and 1/2 before bed?? My rheumatologist isn't sold on this idea, but I was wondering if anyone out there had tried this successfully.

I'm limping around the house this morning, hurting just to lift my coffee cup, and even considering increasing the dose of prednisone. Should I increase back up for awhile or just try splitting the dosage?

Thanks so much for any help you can give me...

Jannie Hi Jannie

I replied to your earlier post a couple of days ago but it has disappeared somewhere in cyberspace???

When to take Pred is a trial & error and I think I have tried most. Even splittling am and pm to get some constant relief.

I have a very DH who gives me breakfast and pills around 6 - 7am, then I tuck down again and when I wake up usually around 9/ 10am I get up and start the day, a whole lot better than any other way.

I try not to make any appointments before 11am.

Have a GO at everything splitting, very early am, very late pm ect. You will know what works for you! I hated it when I could'nt even lift the coffee cup too !!!!

This is my 4th year with PMR and I have had to adapt my way of life to get quality of life. The road has not always been this simple and I was so sick and in pain in the early days.

I feel for you, its just miserable having this disease that no one has ever heard of, the pain, the fatigue, feeling like ********** , the side effects from Pred and trying to keep life ' normal '

Sending you gentle hugs, ask anything, vent, anything, we are all here for one another,

Lyn

good morning

there seems to be an awful lot of self adjusting doses needed in this disease. i know i have written my own book on it. my doctor could give me only general instructions. everyone has this different and has to work on a schedule that works best for them, so i encourage you to experiment for the best results, you can always go back, but such a relief when you can push forward. i know exercise, walking works well for me, although painful at first. it seems to help the pred work. i top it off with naproxen and it helps a lot to control the inflammation. but that is me, try a little different approaches, til you find something that works, but don't be surprised if it only works for a few days, then you slip back, but keep on with it and it will smooth out and relief will come back. my pain level never seems to stay the same, it goes up and then down. i finally got used to that, for a while i thought i had found a miraculous cure, only to find it was a temporary thing, and it was normal for me to change from bad to good and back to bad again. who knows what makes the difference, i don't. cheers, keep fighting it and working on it.

Thanks to all of you for your posts. I guess I've been thinking that I could just find a one time "fix it" dose with the prednisone and then feel okay until this XX@#!X! disease decides to go away.   Hearing from you helps me to be more realistic. Tonight I think I will add back in a little prednisone, so that when school starts on Monday, I'll be able to function.

When I decrease again, I'll try a smaller amount with more time in between tapers. The reason I've been rushing it is because of all the UGLY (moon face, etc.) side effects. At least the moon face is smoothing out all of my wrinkles! HA!

Thanks for being there...
JannieHi again Montana Woman

I know its difficult to get your head around everything but thank you for telling me the difference. I am off to explore it all.

However, can I just say that I can see where your Rheumy is coming from - here in the UK they all insist - am dose.   Like others I find taking it early (cup of tea, toast, then pills) one hour just hanging around - then it seems to kick in.   Your adrenal glands which normally make your own supply, which are not working now, generally replenished overnight - that's why its an am dose. Well, that's how it was explained to me.

When you take a drop, of whatever size, the first week is murder - I generally try and make it a light week, when I know I am able to take a drop. Also remember your math - its easier to take a drop percentage wise on a high dose - its more difficult on a low dose.   So you need to work out what sort of percentage drop you are taking on the methly stuff. I am no good at maths, I need someone else to work it out for me. If after the first week the pain has not eased - check your esr and crp markers - and increase the dose to where you are comfortable, that's what its for.   PMR and GCA decide for themsleves what they will do - you are looking to be comfortable as possible.   Yes you will get peach fuzz, it goes away after about 6 - 8 weeks I found, Yes you will get a moon face, but that goes away also.   Weight increase - well that's steroid's for you - but as you drop down it eventually goes and the day you get to 7.5mg and below you start to shed it.

After two and a half years on a roller coaster and an increase of 4 stones, I have discovered that I have dropped nearly two stones in the last six months. Yes I finally got to 7.5mg and holding so far.

Too high a drop too quickly leads to problems.

Take a look at www.pmr-gca-northeast.org.uk the site is very informative and that is just not me saying it - others have let us know.   In particular look under Resources and the latest paper published by the BSR (British Society of Rheumatologists) which has been sent to all Rheumy's in the UK

Good Luck and remember the medication is not the enemy - pmr and/or gca is.

Oh and by the way, feeling sorry for yourself is OK, its partly the pred and partly frustration - have a damn good cry and then shout at the moon.   Does you the world of good.

Bugger Mrs UK ..... I'm still shaving sides of face, have not lost an ounce of weight,still have hump on back of neck, face down some ( only slight wrinkles) and I'm at 4mg Pred!!!!!

Apart from that all the advice you give is just Great! The pmr-gca-northeast site is extremely helpful, thank you!

Hugs Lyn

Hello Again.

Something I forgot to mention before....PMR does go away as I am the poster lady for that. I have lost the moon face, never did have the camels hump because it slipped to my bottom, still have the jelly belly. I think the biggest thing for me to get over was the fact that I had this rotten disease. I finally accepted it and just tried to manage it with the thought that it would go away. I still had tons off days that the frustration set in and when things got really bad I called on my PMR friends and they came to the rescue. Great people here and there is always someone to come to YOUR rescue....all you have to do is holler. You will be fine Jannie and cowgirl. Just hang on. Take care of them Lyn.

Pat

Hi Jannie,

I went thru the same problem waiting for the morning dose to kick in. Here's a suggestion that may be useful for you when you have to go to work. Put your dosage and a glass of water on the bedside table, set your alarm for say 0300, take the pill and go back to sleep. It worked for me, and may help you.

I also tried splitting the dose...2/3 in the morning and 1/3 at night. That seemed to help too, although most folks recommend against the evening dose.

Hi, I'm the same guy...I forgot my username and had to register again and now I've remembered my name! Not the fault of pred...

I suggested taking the pred early in the morning with a glass of water. I just recalled that I actually took it with a glass of milk for the stomach's sake. I used a one-cup thermos and filled it with cold milk just before bed. Worth trying.