In the words of Dolly, "Here you come again, and here I go." down from what dose, Are you tapering on your own or are you following a schedule sent by your doctor You haven't been on the plaquenil long enough for it to help yet. Have you tried naproxen? It helps me quite a bit. I sympathize. I have been down to 5 mg for a couple months now and feel lousy. You may need to be on the pred a bit longer. Call your dr and see what they reccommend. Hope you feel better soon. Laker
Pred really is a nasty nasty med. And we really don't want to be on it any longer than we have to. During a taper, your body has to get used to the reduction in pred. Sometimes that results in the swelling, inflammation, and pain we experience at different levels of pred. I am on 7.5 right now and going to 5 tomorrow and I know for sure I will be all inflamed and icky tomorrow night. And cranky lol. Laker is right with the you haven't been on plaquenil long enough yet for it to start helping. It can take a good 3 months for it to kick in. You really might want to think about a switch from pred to an nsaid. Naproxen, mobic, etc. instead of the pred for inflammation. Believe me, if I could switch to an nsaid I would but I can't due to some non ra meds I am on. Interaction issues. Bleargh. When I was first dx'ed I took Relafin with my first DMARD. It's an anti-inflammatory use to help with inflammation and pain. Naproxen is the same as aleve. Relafin is very simular. Try taking 4 advils or IUB and see if you get any releif from that. That would be 800mg and that's what a prescription strength anti-inflammatory would be. I just use OTC IUB these days because I can control the amount I use easier that way. I just buy huge bottles of generic IUB at Walmart or Sam's it's about 0 for a HUGE bottle. Sometimes I'll take 4......but often I can get by on a lot less. None of them are good for your stomach so you need to be careful about takeing these too much. I drink sweet ginger for cold flu. It is a good remendy for flu, fever, headache, body ache, lack of sweat, poor appetite and nausea. Very simple ginger, brown sugar and hot water, that's allKoko at it again. Why didn't you ever become an MD koko? Anyway, I refused Pred when it was initally offered to me. i am presently on Enbrel, Arava and my dr. gave me Relafen on an "as needed" basis. I am pretty well lately. Fatigue but there's no cure for that except rest. Blessed, I hope you're ok now.
MD knows best about meds, I am not. I use natural and simple foods to treat. Nonsense is what you think. I use the simple and natural way and it works most of the time, so to me you're posting nonsense
You're shooting yourself because it is the reflection. Honey, you know the drugs at you finger's tip you're suitable to be a MD. Whenever I use herbs and natural foods to treat symptoms and diseases, I will get so many objections, rejections, remarks, names calling etc.. Are those continued using many centuries old herbs and natural foods commit frauds? Is it a crime for not using meds?????.Koko, you're right. You should write a book. I'm sure we'd all line up to get a copy. Put your vast knowledge in print!
LMBO! He could call it The Cure for Every Disease Under The Sun! Honey, there are books available but you all are running away
So why need nature and correct foods as you practically outsmart nature can provide. You would step on humble simple foods and dismiss them as nonsenses. To all those who love nature and have benefited for using correct natural herbs and foods know they are saviours and treasures. To all of you they are trash. We can do without a single drug for arthritis but not without correct foods to reverse and cure.
Yeterday, I posted I went down to 5mg Prednisone that morning. I started feeling bad last night. Now today I have gotten worse. The good ole flu-like symptoms are back. The pains are flashing like a beacon in my toes, arches, heels, wrists, fingers, elbows...need I say more?
So the million dollar question is...when you're trying to taper down off the Pred, when do you stop or go back up. I am so new to the game...i don't quite know all the rules.
Lorster has me so afraid of the Pred, that I want off of it yesterday! Thanks Lorster
off this med. Try all other measures to come off this drug and stay off it.
You will be better off down the road.
can get off of it easier. The pred is great for today, but when it wreaks
havoc on your back and adrenals and every other organ, it is usually too late
to get it all under control.Hi, now i'm confused. I've been told if the other meds are working for you, you should be able to get off of the prednisone!? Reducing over a period of time, whatever the doc says. lv, sarahWell Hurts. I believe what happens is when pred is taken for a long enough
time and a person starts to wean down, the adrenals have become lazy and
apparently they revolt. The PDR suggested every other day dosing to allow
the adrenals a day of rest and recoup. I don't think that is what is
happening and people are taking it daily. I think if we can do every thing
possible to get off the pred, until othr meds kick in that is the way to go. I
think pred has a mind of its own and disturbs the rest of the body enough to
create certain symptoms in people who are trying to come down off of it.
These symptoms are undesirable and probably mimic RA symptoms. If you
can get through these episodes with other measures, that is what you
should do. I have seen the fall out of prred and I won't go near this drug.DOSAGE AND ADMINISTRATION
The initial dosage of DELTASONE Tablets may vary from 5 mg to 60 mg of
prednisone per day depending on the specific disease entity being
treated. In situations of less severity lower doses will generally suffice
while in selected patients higher initial doses may be required. The initial
dosage should be maintained or adjusted until a satisfactory response is
noted. If after a reasonable period of time there is a lack of satisfactory
clinical response, DELTASONE should be discontinued and the patient
transferred to other appropriate therapy. IT SHOULD BE EMPHASIZED
THAT DOSAGE REQUIREMENTS ARE VARIABLE AND MUST BE
INDIVIDUALIZED ON THE BASIS OF THE DISEASE UNDER TREATMENT AND
THE RESPONSE OF THE PATIENT. After a favorable response is noted, the
proper maintenance dosage should be determined by decreasing the
initial drug dosage in small decrements at appropriate time intervals until
the lowest dosage which will maintain an adequate clinical response is
reached. It should be kept in mind that constant monitoring is needed in
regard to drug dosage. Included in the situations which may make dosage
adjustments necessary are changes in clinical status secondary to
remissions or exacerbations in the disease process, the patient's
individual drug responsiveness, and the effect of patient exposure to
stressful situations not directly related to the disease entity under
treatment; in this latter situation it may be necessary to increase the
dosage of DELTASONE for a period of time consistent with the patient's
condition. If after long-term therapy the drug is to be stopped, it is
recommended that it be withdrawn gradually rather than abruptly.
ADT® (Alternate Day Therapy)
ADT is a corticosteroid dosing regimen in which twice the usual daily
dose of corticoid is administered every other morning. The purpose of
this mode of therapy is to provide the patient requiring long-term
pharmacologic dose treatment with the beneficial effects of corticoids
while minimizing certain undesirable effects, including pituitary-adrenal
suppression, the Cushingoid state, corticoid withdrawal symptoms, and
growth suppression in children.
The rationale for this treatment schedule is based on two major premises:
(a) the anti-inflammatory or therapeutic effect of corticoids persists
longer than their physical presence and metabolic effects and (b)
administration of the corticosteroid every other morning allows for re-
establishment of more nearly normal hypothalamic-pituitary-adrenal
(HPA) activity on the off-steroid day.
A brief review of the HPA physiology may be helpful in understanding this
rationale. Acting primarily through the hypothalamus a fall in free cortisol
stimulates the pituitary gland to produce increasing amounts of
corticotropin (ACTH) while a rise in free cortisol inhibits ACTH secretion.
Normally the HPA system is characterized by diurnal (circadian) rhythm.
Serum levels of ACTH rise from a low point about 10 pm to a peak level
about 6 am. Increasing levels of ACTH stimulate adrenocortical activity
resulting in a rise in plasma cortisol with maximal levels occurring
between 2 am and 8 am. This rise in cortisol dampens ACTH production
and in turn adrenocortical activity. There is a gradual fall in plasma
corticoids during the day with lowest levels occurring about midnight.
The diurnal rhythm of the HPA axis is lost in Cushing's disease, a
syndrome of adrenocortical hyperfunction characterized by obesity with
centripetal fat distribution, thinning of the skin with easy bruisability,
muscle wasting with weakness, hypertension, latent diabetes,
osteoporosis, electrolyte imbalance, etc. The same clinical findings of
hyperadrenocorticism may be noted during long-term pharmacologic
dose corticoid therapy administered in conventional daily-divided doses.
It would appear, then, that a disturbance in the diurnal cycle with
maintenance of elevated corticoid values during the night may play a
significant role in the development of undesirable corticoid effects.
Escape from these constantly elevated plasma levels for even short
periods of time may be instrumental in protecting against undesirable
pharmacologic effects.
During conventional pharmacologic dose corticosteroid therapy, ACTH
production is inhibited with subsequent suppression of cortisol
production by the adrenal cortex. Recovery time for normal HPA activity is
variable depending upon the dose and duration of treatment. During this
time the patient is vulnerable to any stressful situation. Although it has
been shown that there is considerably less adrenal suppression following
a single morning dose of prednisolone (10 mg) as opposed to a quarter of
that dose administered every 6 hours, there is evidence that some
suppressive effect on adrenal activity may be carried over into the
following day when pharmacologic doses are used. Further, it has been
shown that a single dose of certain corticosteroids will produce
adrenocortical suppression for two or more days. Other corticoids,
including rnethylprednisolone, hydrocortisone, pednisone and
prednisolone, are considered to be short acting (producing adrenocortical
suppression for 1 1/4 to 1 1/2 days following a single dose) and thus are
recommended for alternate day therapy.
The following should be kept in mind when considering alternate day
therapy:
Basic principles and indications for corticosteroid therapy should apply.
The benefits of ADT should not encourage the indiscriminate use of
steroids.
ADT is a therapeutic technique primarily designed for patients in whom
long-term pharmacologic corticoid therapy is anticipated.
In less severe disease processes in which corticoid therapy is indicated, it
may be possible to initiate treatment with ADT. More severe disease
states usually will require daily divided high dose therapy for initial
control of the disease process. The initial suppressive dose level should
be continued until satisfactory clinical response is obtained, usually four
to ten days in the case of many allergic and collagen diseases. It is
important to keep the period of initial suppressive dose as brief as
possible particularly when subsequent use of alternate day therapy is
intended.
Once control has been established, two courses are available: (a) change
to ADT and then gradually reduce the amount of corticoid given every
other day or (b) following control of the disease process reduce the daily
dose of corticoid to the lowest effective level as rapidly as possible and
then change over to an alternate day schedule. Theoretically, course (a)
may be preferable.
Because of the advantages of ADT, it may be desirable to try patients on
this form of therapy who have been on daily corticoids for long periods of
time (eg, patients with rheumatoid arthritis). Since these patients may
already have a suppressed HPA axis, establishing them on ADT may be
difficult and not always successful. However, it is recommended that
regular attempts be made to change them over. It may be helpful to triple
or even quadruple the daily maintenance dose and administer this every
other day rather than just doubling the daily dose if difficulty is
encountered. Once the patient is again controlled, an attempt should be
made to reduce this dose to a minimum.
As indicated above, certain corticosteroids, because of their prolonged
suppressive effect on adrenal activity, are not recommended for alternate
day therapy (eg, dexamethasone and betamethasone).
The maximal activity of the adrenal cortex is between 2 am and 8 am, and
it is minimal between 4 pm and midnight. Exogenous corticosteroids
suppress adrenocortical activity the least, when given at the time of
maximal activity (am).
In using ADT it is important, as in all therapeutic situations to
individualize and tailor the therapy to each patient. Complete control of
symptoms will not be possible in all patients. An explanation of the
benefits of ADT will help the patient to understand and tolerate the
possible flare-up in symptoms which may occur in the latter part of the
off-steroid day. Other symptomatic therapy may be added or increased at
this time if needed.
In the event of an acute flare-up of the disease process, it may be
necessary to return to a full suppressive daily divided corticoid dose for
control. Once control is again established alternate day therapy may be
re- instituted.
Although many of the undesirable features of corticosteroid therapy can
be minimized by ADT, as in any therapeutic situation, the physician must
carefully weigh the benefit-risk ratio for each patient in whom corticoid
therapy is being considered.
HOW SUPPLIEDI hate the predisone to I was on 30mg a day and now I tryed to get down to 13mg and I went into such a flare I don't know how to get out of it. I had to raise the predisone to 20mg. I am hoping I will feel a little better by tommorow. I really hurt from neck to toes and have a very bad headache all the time.swollen hands knees, feet, fingers. I am just so sick of it. i feel like I have the flu all the time. So I know how you all feel. I am going enbrel 50mg 1 a week. But I just got over a sinus infection and flu so I don't know what is going on now. Or when I should give myself a shot I am scared to death of it. Hope you all get off the predisone soon wecked stuff. I have been on it for 8 months .
Koko, don't shoot me any nonsense. oooh I feel it coming.Honey - "Duck" - head down - quick!!
Angel~ Call your doc about when you should resume taking your shots. I have to see my doc for an all clear after I have been ill and off my meds. Not all docs do that tho. Some do it with just a phone call.
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