Very new to PMR
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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Okay, your doctor knows your specific health issues. I've been told not to touch any NSAID especially while on prednisone, because of the higher risk of gastro-intestinal bleeding and damage. COX-2 inhibitors are also associated with adverse heart events, (moreso than COX-1 which are not as effective for joint/muscle inflammation). Another no-no for me.
Maybe split your dosage 8 mgs at 8 am and 7 mgs at 5 pm that works better for me
There must have been some research a long time ago that said Celebrex was safe to take with Prednisone. I was told when all the NSAIDs were compared, Celebrex was least likely to cause GI bleeding. I also took Celebrex with Prednisone for at least a year but that was ages ago during my early years with PMR.
I had to discontinue Celebrex and was told it wasn't safe with Prednisone. I think Celebrex was stopped because I started warfarin after a pulmonary embolism. The warfarin increased my risk of a GI bleed exponentially since I was still taking Prednisone. I think "stomach protection" was added to my medication list at the same time. Of course, stomach protection was only supposed to be taken "as needed" instead of all the time. That rule was also changed when warfarin was added to Prednisone.
I took Celebrex about 30 years ago for 2 or 3 weeks for sudden onset symptoms that were identical to PMR, but back then it was caused by inhaling xylene fumes for two days while sealing my flooring. Even though I took no other medications at the time, my doctor was reluctant to prescribe it, saying it was "terrible stuff". He told me to stop taking it as soon as I could, which I did. I guess it's a case of listening to your own doctor who knows the whole situation, and hoping they know what they're doing.
I've been splitting my daily dose into EARLY morning (anywhere between 3-5 am ... when I get up to pee) which seems to really help the cyclic morning stiffness/pain. This is physiologic... PMR symptoms parallel the adrenal circadian cycle. I've got 5 mg pills, so take 10 mg in the early morning and 5 mg around 12 hr later.
"I guess it's a case of listening to your own doctor who knows the whole situation, and hoping they know what they're doing."
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That sums it up well.
I like my doctors because they always acknowledge what they don't know.
Maybe they only said they didn't know when I asked too many questions!
Yes ... I did the same thing. Never mind PMR symptoms. I came to the conclusion that it was my body's way of telling me it needed some cortisol since my adrenals weren't producing any.
Honestly, I didn't know what my body was trying to tell me but I knew I had to give it something.
Haha, I ask a lot of questions too. When I know my written questions or issues are more than 3 or 4 things, I make a double appointment. Like you, I like it on the odd occasion my doctor says she has "reached the limit of my experience on this". Then I run to Dr google and she consults with her colleagues so we both come to the next appointment better informed. A doctor you can trust to have your best health interests at heart is everything.
For those of us here just beginning the PMR journey, here is an excellent medical reference on safe tapering:
https://cdn.prod-carehubs.net/n1/748e8fe697af5de8/uploads/2024/02/Brit-J-Clinical-Pharma-2020-Baker-Is-there-a-safe-and-effective-way-to-wean-patients-off-long%E2%80%90term-glucocorticoids.pdf