My Dr. Started me with Prednidone -25mg and 15mg Methotextrate 1x a week and I take 2 mg folic acid daily. First two weeks I was tired, now it is fine.
The logic is that it can take up to 12 weeks for the anti- inflammatory benefit of Methotextrate to kick in. The ideas is to titrate off the prednisone and that the Methotextrate helps to do that. Once off prednisone can try to stop Methotextrate. Methotextrate at this low dose seems pretty safe- been used for 40 years for RA.
They suggest slow taper of prednisone. Once at 10 mg prednisone- go down by 1 mg every 3 weeks. I am at 12.5 mg. Now.
Will see how I do.