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The lowest effective dose, how is it defined?
Polymyalgia Rheumatica (PMR) | Last Active: Oct 2 7:26am | Replies (141)Comment receiving replies
Thanks Megz for sharing all your knowledge. My experience in PMR kind of mirrors yours. After starting prednisone at 10 mg I can’t seem to get any lower than 7. I have flared twice and the second time I was out 8 weeks on 8 mg. I am increasing tomorrow back up to 8 mg to try to give some relief from the stiffness and pain. My Rheumatologist told me just to stay on the 8 mg for awhile and try to taper later. He has mentioned Kevzara but I want to keep trying prednisone tapering if I could do it correctly. Would you have any recommendations on my taper going forward?
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Have you seen the various graduated reduction schedules? They can give a 1mg reduction in 7-8wks reducing by .5mg at a time, but with a softer more gradual taper. For example, this is my reduction schedule. An 8mg reduction would go:
WEEK 1: 8mg / 7.5mg / 8mg / 8mg / 7.5mg / 8mg / 8mg
WEEK 2: 7.5 / 8 / 7.5 / 8 / 7.5 / 8 / 7.5
WEEK 3: 7.5 / 8 / 7.5 / 7.5 / 8 / 7.5 / 7.5
WEEK 4: Stay on 7.5mg to stabilise and monitor for pain
Others have shared their variations on graduated reductions. Some go straight to alternating days of the existing dose with the new dose to give a .5mg (or 1mg) reduction over a couple of weeks or more.
Do you record your daily morning pain levels on a 1-10 scale to keep an eye on changes as you reduce? It was a suggestion I found here at Mayo that has been very useful. For now, staying on 8mg to stabilise for a while as suggested by your rheumatologist sounds sensible. I do hope you find a graduated reduction schedule that works for you. Keeping inflammation under control consistently without flares seems to be key in getting over PMR.