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Prednisone only mildly helpful for my PMR, is this common?
Polymyalgia Rheumatica (PMR) | Last Active: May 29, 2023 | Replies (26)Comment receiving replies
Thank you all for your comments, they're all so helpful. Turns out my initial dose of prednisone (15mg) was too low. At another ER visit they started me on 40mg and the pain decreased within 24 hours. I haven't been able to go below 20mg, however, without the pain coming back completely, which is concerning. (Labs have shown high levels of inflammation) I've made significant changes to my diet and have been exercising as much as I can, but the truth is that so far, only prednisone has made a difference. I have an appointment with a rheumatologist but not until 10/31. (I'm on a cancellation list and will hopefully get in before then.) Fortunately my neurologist works with PMR and is handling it for me until then. I just hope I can cut down on the prednisone. Thanks again, everyone!
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@ldingwall88 even at 20mg a day you need to watch for possible of side effects of long term prednisone. I do hope you are seeing your PCP to help with the effort of keeping an eye on your overall health. Often even a rheumy does not work on the holistic challenge and problems that long term prednisone can present. It will depend on the individual doctor.
Rheumatologist are in very short supply everywhere and needing to wait 6 months or more before a new patient appointment is not unusual.
You mentioned only getting a few hours of relief from a certain dosage. This may be due to the half-life of a drug - this is the time it takes for a dose you took to be half as strong as it was when you took it. Every drug, OTC and Rx, has a half-life. Basically they consider you have to have about 5 half-lives for a drug to be completely out of your system. If a drug has a 4 hour half-life then it would take 20 hours for the amount of the drug in your system to be negligible. If the half-life is 10 hours then it would take 50 hours. Some drugs have half-lives measured in days to weeks, some hours. Prednisone is 2-3 hours.
Possibly you can do the math and track your symptom return on a predictable schedule based on half-life. This type information can help your doctor adjust your dosage or spacing to provide the relief you need. The adjustment may not simply be adjusting one or the other or both - prednisone is a complex drug and you should visit with your doctor about adjustments because there could easily be ways they do not want you taking the drug also. It is one thing to know about you and the half-life cycle, it is an entirely different thing to know what adjustments are medically appropriate.
Your journey will me unique. The combined experiences you can discover here has proven very valuable to me. I wish you well and please check-in from time to time with updates.