Very new to PMR

Posted by jenimom @jenimom, Nov 25, 2023

I am weaning down and am currently in 15 mg prednisone, down from 40. Was doing good but 2 days ago started feeling aweful. I get up at 4:30 so I can get to work by 8:00. The pain is not really tolerable until mid afternoon. Does anyone take their prednisone at night? I am a nurse and I need to work

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@wfroslansky

I have been on 15mg of prednisone for three weeks which I take in the morning. I have some pain in the morning but usually feel pretty normal by early afternoon. Should I inquire about increasing the dose or be content now that life has become manageable enough? Just beginning to do small amounts of exercise again. I am a very active person typically. My doctor also prescribed ibuprofen which I take 200mg morning and night on bad days. I have read warnings about the Ibuprofen. I am 65 male.

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You did not mention it, but I presume you have been diagnosed with PMR, and that diagnosis included one or more blood tests like SED and CRP which are measures of inflammation.
The general rule seems to be to take sufficient prednisone to cause your PMR to go into remission, as measured by repeating the tests and considering pain levels. If it is not in remission, a dosage increase might be indicated. If you need to take ibuprofen, you are probably not in remission.
About taking ibuprofen while on prednisone, literally everywhere says to not do it. Tylenol is permitted, however.
My experience was to start on 20. After one week, I still had pain. My dose was increased to 30. The pain stopped. After one month, I tapered at 5 per month to 10. At that point, my SED test was in the normal range, and my doc said that the PMR was in remission. We then started a taper of 1 per month, and any pain was treated with Tylenol.
Pain while tapering after your PMR is in remission is normal. Pain until your PMR is in remission as measured by testing probably means you should be increasing your prednisone.
There is a lot of good information in other threads in this forum that would be of benefit to you.
Best of luck. This is not an easy journey.

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@wfroslansky

What is a safe alternative to Advil to go with my prednisone? I am curious why my doctor prescribed both. Thanks for your replies. Bill

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Tylenol (acetaminophen) is okay to take with prednisone. It's called Panadol (paracetamol) in Australia. My doctor recommended the slightly stronger version of Panadol - Osteopanadol - which is a modified release paracetamol that works for longer.

I agree with what @art43 has said. I only need to take Osteopanadol on the odd occasion that the aches are more than usual for some reason, sometimes when tapering or sometimes when I've overdone an activity and the body complains.

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@wfroslansky

What is a safe alternative to Advil to go with my prednisone? I am curious why my doctor prescribed both. Thanks for your replies. Bill

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There is a post in this thread by edwardh that I will repeat:
https://www.verywellhealth.com/can-you-take-advil-with-prednisone-5095941
I had a friend that was not aware of this drug conflict some years ago, took both, and ended up with abdominal surgery to repair the damage to her stomach.
Suggest you take up the contents of the article above with your doc.

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I think it's preferable to take Prednisone in the morning when your cortisol levels are the highest.

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Try taking g prednisone 3 hours before you need to get up. When you wake it will have kicked in- by about 15 minutes after you start moving around.
It will hold all day.

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@janetilley

Try taking g prednisone 3 hours before you need to get up. When you wake it will have kicked in- by about 15 minutes after you start moving around.
It will hold all day.

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I see other people have suggested this too, and it seems to work for some. A meal or at least a snack needs to be taken with the prednisone to protect the stomach lining, and a few people mentioned that they set up a snack or piece of cheese at the bedside to take with it. Whatever works and does no harm, good!

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@megz

I see other people have suggested this too, and it seems to work for some. A meal or at least a snack needs to be taken with the prednisone to protect the stomach lining, and a few people mentioned that they set up a snack or piece of cheese at the bedside to take with it. Whatever works and does no harm, good!

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Yes a small yogurt does the trick along with some water. Need food definitely. Works for me. It still takes a few minutes to be pain free on waking but not long once you get moving.

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@wfroslansky

What is a safe alternative to Advil to go with my prednisone? I am curious why my doctor prescribed both. Thanks for your replies. Bill

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Celebrex

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In reply to @jeannewa "Celebrex" + (show)
@jeannewa

Celebrex is another non steroidal anti-inflammatory drug (NSAID) that shouldn't be taken with prednisone.

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Celebrex is a COX-2 inhibitor and associated with less bleeding risk and ulcer formation when comparing to the other NSAIDS. My MD said it is fine to take with prednisone.

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