how to know how much to increase Prednisone dosage during flare

Get hold of your doctor for advice as soon as you can before the inflammation settles in. Some doctors say to take a higher dose for a few days or a week before starting a quicker reduction that must be done within two weeks, after which time the reductions have to be done more slowly again to avoid prednisone withdrawal, so you don't want to go higher than you need to. One day of a higher dose will not fix a flare. Does your doctor have another doctor they work with who can advise you instead?

Thank you, Megz! I was able to get through to the doctor, and for the last 2 days I have increased my pred to 5 or 6 mg/day, which seems to be enough to calm the symptoms. My CRP has been fine for about a year but today it was 48 so this is definitely a flare, not an adjustment to tapering. It sets me back, but not as much as I had feared. I am not sure when I can start tapering down from the new dosage.

A few flares that I experienced can be attributed to ‘day before’ activity or diet. Eg I had red meat once and a severe flare followed the next day. Another time, I stood around too long at a concert and legs were unbearable next day. Keep notes. Nothing hurts at the time but 12 hours later- bam!
But we’re all different.

Thank you! That makes a lot of sense to me! I had a rough week last week, then Flare. How long have your flares lasted/did you have to backtrack several months in your pred dosage each time you had a flare? I've had some bad days while tapering, but this time--it was really much worse, as my crp test confirmed. I will need another crp test before I taper now, I think.

I had a few “worsening” of symptoms after doing some activities , but nothing that didn’t go away with a dose of pain medicine. I would not call these a “flare”.
Any adjustments of your prednisone should really be supervised by your doctor.
Good wishes on your health journey.

Then I’m not sure if what I experienced can be called a flare. Excessive increase in pain. I didn’t increase prednisone but took two Tylenol and waited it out. Day and an half thereabouts. Extra careful on stairs etc. ,
extra careful about diet. I’m a recent widow and have very helpful friends.

I’m so sorry you are a recent widow 🥲, but so glad you have helpful friends….
All of this must be very stressful for you and I’m sorry if I confused you with my comment .
It is pretty normal (at least for me, lol) to experience muscle and joint pain for s day or two after you overdo it with activities. I’m also dealing with inflammatory arthritis as well as PMR.
I would suggest trying some extra-strength , rapid release Tylenol gel capsules and get a topical creme like Aspercreme, original formula and massage that on the painful areas. Use your judgement—if you feel the pain is excessive and you don’t get any relief from OTC remedies, you should consult your doctor.
Hope this helps you.

Many of us seem to have age-related arthritis and perhaps other conditions that has been masked until now by our natural production of cortisol. As we taper, and the prednisone is no longer sufficient to suppress the symptoms, we experience various levels of discomfort until (hopefully !) our cortisol production improves to again keep the inflamations in check.
All this presumes that your prednisone treatments have been of sufficient dosage and duration to put the PMR into remission. Until and unless that has been achieved through testing, starting a taper program will probably not be successful, and the pains might be PMR and not those which are better treated by something other than prednisone. Best of luck to everyone.

Experiencing a v similar situation. Off pred for 2 weeks and symptoms came back last night like a speeding freight train. Can barely move. Just took 10 mg, perhsps should be 20. Traveling and nowhere near my doc

Bad luck! But at least you have pred with you so you can relieve the pain. Do you have PMR and just had a flare 2 weeks after you completely tapered off? Or had you been taking Pred for some other ailment? I think it makes a difference.

Can you contact your doc by phone/internet? Or go to Urgent Care or ER?

I have PMR and was able to contact my doc via email. I was down to 2 mg/day but when the flare occurred I had to go up to 5 mg/day to relieve the symptoms. Also had a blood test that showed my inflamation marker crp was way high the level I had before my initial diagnosis.

You MAY be able to taper off the 10 mg faster than 1mg a month depending on what is going on with you. Best of luck.