Prednisone dosage am and pm | Arthritis Information

I am new to this whole message thing-so if I am totally stupid-blame it in the drugs--I "came down" with Polymyalia 28 days after my 62nd birthday. 15 days later recieved the wonderful diagnosis and the prednisone. I think I am doing fairly well, except for two major set-back (including one I am in the 6th day of ). Both of these set-back have come when I have decreased to 10 mg in the am and nothing in the pm. Is that the normal decreasing method? It just seem to me that I would be better off with 8 in the am and 2 in the pm.I have had to incease to 10 and 2-just to kept the pain down to a low roar and throwing in a vicodin once a day. So my question is -what is the decreasing method. Dr says decrease all of the pm and then start on the am as pain allows. I do not think it is going to work for me, but would like someone elses opinion. Thank you, I wish I would have found this board sooner-just reading it has been benefical.

Lonna D

Hi, Lonna D,

Welcome to the forum! You don't mention what dosage you are decreasing from. Last year I was on 10 in a.m. 5 in p.m., then gradually decreased the 5 in p.m. - just what you are doing, to 10 - 4, then 10 - 3, then 10 - 2 - they suggest you decrease by no more than 3 mg. per month when below 20 mg. or so. Below 10 mg., you might want to decrease your total dosage even more gradually - possibly only 1 mg. per month.

Prednisone withdrawal itself can cause muscle aches & pains, so when reducing the dosage, you have to give it a couple of weeks to know whether it's the withdrawal causing the pains or if it's the PMR, in which case you may have to increase dosage again for a few weeks before trying to decrease again.

I hope this is of some help.

Best wishes.

Ruth,

I started at 20 (10&10)mg. I think you my be right-I was decrease to fast. 1 mg every 10 days to 2 weeks. But when you get to 10mg-do you spilt it up between am and pm? I know I am just to anxious to get off of this stuff. The 30 lbs is really depressing me.

Lonna

Hi Lonna...I believe the medical theory for just taking the prednisone in the am as soon as possible is to preserve your adrenal gland function (one of which is secreting cortisol). Apparently the adrenal gland kicks in at night and prednisone inhibits that response since it would be doing the job instead. Are you able to take NSAIDS? I have found that taking ibuprofen 200mg or 400mg (depending on how the day has gone!) helps me through the night, plus I take another 200 in the morning. I am now down to 7mg in the am and although I am not pain free it is nothing like it was at the beginning and I would rather endure some pain in order to lower the prednisone, preserve my adrenal gland function and eventually get off of this stuff. I know it can be frustrating to say the least....what a long process this is. I am 71 and was diagnosed last October. Initially I was started on 30mg/day. When I first went below 10 all hell broke loose and I had a little set back...that's when I started supplementing w/the inbuprofen. Take care and let us know how you do! Gmama

Okay,I never understood that before. Probably was expained to me,but I have been overwhelmed.

And what is NSAIDS?? ADVIL?

Lonna

Yup! Advil, aleve etc..that stands for non-steroid-anti-inflammatory drug

The rheumy split my dosage so I was taking 5mg twice a day and then gradually reduced it 1mg every two weeks, alternating AM and PM decreases. AM: 4-3-3-3-2-2 and PM: 5-5-4-3-3-2. Hope that made sense.

From everything I've read, the once-a-day dose, taken in the mornings, is the norm. I'm not quite sure why my rheumy prefers to split it.....maybe because he's done it that way for 40 years? He's retiring now, so it'll be interesting to see how his replacement does things.

Louann