← Return to PMR - Decreased prednisone and pain returned

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@guillamocan

The general advice I've seen is to increase the prednisone to the level where you didn't have symptoms. Yes, the decrease from 2 mg to 1.5 mg seems like a small amount. But, in relative terms this is a 25% reduction from the 2 mg dosage. Its the same relative difference as going from 25 mg to 20 mg. Maybe, the body is reacting to that relative change. One of the strategies I've seen is to alternate the 2 mg with the 1.5 mg dosage and then slowly wean down. One rheumatologist recommended a very slow schedule like: 1st week Mon - 2 mg. Tues - 2 mg Wed 1.5 mg Thur - 2 mg Fri. - 2 mg Sat - 2 mg - Sun - 2mg. 2nd week Mon - 2 mg. Tues - 2 mg Wed 1.5 mg Thur - 2 mg Fri. - 1.5 mg Sat - 2 mg - Sun - 2mg. 3rd week - 4 days with 2 mg and 3 days with 1.5 mg. And then you could do the same schedule going down from 1.5 mg. This was in Kate Gilbert's book "Polymyalgia Rheumatica and Giant Cell Arteritis: a survival guide. 2nd edition". Hope this helps and good luck.

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Replies to "The general advice I've seen is to increase the prednisone to the level where you didn't..."

this is the protocol which has worked well for me. It does take a considerable amount of weaning time, and patience with yourself, but for me, so far so good. It has taken me quite a while to reduce from 7 mg - 7/6/ for 4 weeks 6/6 for 4 wks, 6/5 and so on. Now at 4 mg for another 2 weeks. This is my 3 rd round of PMR each one 11 years apart. But by far this is the most challenging one to wean down. At 4 mg I am experiencing mood shifts, de-personalization, crying jags and restlessness. No pain and amazingly low CRP number 2.7! My philosophy is that if I have to go back to 5mg and then have to stay on that indefinitely, that's what my individual body needs. the goal for me is to lead a full, and conscious lifestyle - Joy is my goal lol