Prednisone duration

You should work with your rheumatologist to see what dose of prednisone you should be taking. He or she can tell you if you still need it for PMR and how fast you should taper. Prednisone can cause osteoporosis, but PMR and GCA are worse problems than osteoporosis, so people with those problems need to take prednisone and other drugs like Actemra. A lot of people taking prednisone also take drugs like Fosamax to help prevent or minimize osteoporosis. That's something else your rheumatologist can help with. I am taking 10 mg per day of prednisone now for GCA and PMR, so my rheumatologist referred me for a bone density test to see if I need to take a drug to strengthen my bones. I'll take that test next week. I tried taking Fosamax pills a few months ago, but they caused acid reflux, so I had to stop. Some people get the drugs to build bone strength through IV infusions. If I need that kind of drug, I'll take it through infusions.

My bone density wasn't the greatest, when I started on 60 mg. Prednisone in July 2024. I'm down to 12 mg. and I started Actemra infusions a week ago. I'm going to ask my rheumatologist to order a bone density scan for me. What drugs do you get through IV infusions for building bone strength?

I don't know a lot about it, but my sister gets a yearly infusion for her osteoporosis. I just did a Google search, and got these matches. There might be more than these.

Zoledronic acid (Reclast)
Given as an annual IV infusion, this drug can treat and prevent osteoporosis in postmenopausal women and men. It can also help prevent new fractures in people who have recently broken their hip.

Ibandronate (Boniva)
Given as a quarterly IV infusion or monthly pill, this drug is FDA approved to treat osteoporosis in postmenopausal women.

Pamidronate (Aredia)
Given as a slow IV infusion every 3 to 4 weeks, monthly, or every 3 months, this drug is used to treat osteoporosis, hypercalcemia from cancer, and Paget's disease.

Thanks! I misunderstood your comment. I thought you were taking the infusions. I appreciate your reply!

If you have PMR it can be problematic stopping treatment suddenly. Your eye doctor is concerned
about prednisone contributing to cataract development.
You can request the bone density test to monitor your
risk of long term treatment. Are you taking adequate
calcium and vitamin D?
Exercise such as walking and weight bearing as much as you can should help. Rely on your rheumatologist for advice on tapering and minimizing side effects.
Ask them to explain your lab numbers and systemic inflammation.

You may want to investigate how each of the "bone building" drugs work and their long term effects. It's not all good. If they can be avoided and bone building exercise and dietary changes can be made instead, the long term outlook can be so much better.

Here is one of many good explanations of how they work that made me very wary of "bone building" drugs.

@ddr, @ropnrose, and all... You are correct to watch your bone density and talk clearly with your rheumatologist about all the effects, both needed and unwanted, with our treatment. I began taking Prednisone when I was 40 years old and developed Sarcoidosis, very heavy dosage for almost a year. When I could no longer tolerate the mental and physical effects of the medication, my rheumatologist immediately began a tapering, slowly and carefully of the Prednisone. This is one of the drugs we taper slowly and very carefully watching the effects of each small reduction. It is not a medication we can stop or reduce quickly. Our bodies must adjust and the disease we are treating may not respond well to lower doses. So, work carefully and openly with your rheumatologist to handle your illness and treatment well.

I take Prednisone as needed for various autoimmune diseases... Sarcoid, PMR, GCA, Vasculitis, and whatever else. I have a love/hate relationship with this medication. It saves my life and makes life livable. And, it causes me to retain fluids, gain weight, enlarges my belly, gives me a moon face for a time, and at times my hair on my head may thin in places and grow on my face as a lovely fuzz...yucky yucky, but I deal with these issues as best as possible since this medication works wonders to contain the effects of the disease. Love. Hate.

Two years ago I have a Reclast IV infusion to hopefully strengthen my bones and prevent a break in a fall, as I do have a balance issue and fall prone. I was scheduled to have a second Reclast infusion a year later, but have not been well enough to have the infusion. I don't want it now as I was one who reacted poorly to the infusion. I had normal difficult reactions, but most patients do not experience all the possible side effects and full blown. I did. So, it can and does happen, but I continued to remind myself this medication is helping me stay safer, stay alive longer with better days. The bad effects lasted 3+ days, but gradually I was better and I planned to take the next infusion even with side effects since I do want the benefits. I suppose we must weigh the facts and possibilities of treatments and make logical, thoughtful decisions.

So, yes, Prednisone can cause your bones to thin or become brittle. It can cause other effects in your body that create issues, but it also can and usually does reduce the effects of the illness you are treating. You and your rheumatologist address these issues and make clear decisions for your best treatment. Then, go for it!

Advocate for yourself, with clear discussions with your doctor. I find it helpful to be logical, learn to emotionally accept your situation and fight for treatment and improvement, but use your energy for positive fighting. No more fight or flight activity which becomes injurious to your body, fighting for your best treatment with knowledge is positive.

Hopefully my input is helpful. Blessings as you walk this journey...Elizabeth