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PMR Dosages and Managing Symptoms
Polymyalgia Rheumatica (PMR) | Last Active: Jun 1 1:21pm | Replies (445)Comment receiving replies
Hi. I am new to PMR...diagnosed July 12. I take my prednisone at 9:30 and find it does not really take effect until about 1pm. It wears off by 4 am. I then take ibuprofen and acetaminophen to get me through the night and allow me to get up in relative comfort in the morning. My blood pressure is fine.
Does anyone else supplement with OTC's? Is this an OK thing to do?
Replies to "Hi. I am new to PMR...diagnosed July 12. I take my prednisone at 9:30 and find..."
I agree with taking it at bedtime except I have always been a poor sleeper. It should be a help if sleeping was not an issue.
Hi @elizabethjoan and welcome to Mayo Clinic Connect.
I moved your post to this discussion:
PMR Dosages and Managing Symptoms:
https://connect.mayoclinic.org/discussion/pmr-dosages/
So that you can connect with others dealing with your same issue.
Here is one other you might like to read:
Prednisone tapering is hard: Do complementary therapies help?: https://connect.mayoclinic.org/discussion/prednisone-tapering/
Did you ask your physician if it was ok to supplement with OTC's?
My rheumatologist told me I could supplement with Tylenol or Ibuprofen but not on a regular basis. I know from experience that Ibuprofen affects my stomach and esophagus. Since prednisone also can have this effect it's not a good idea to take very much for me. It needs to be taken with food, which is an inconvenience. I once had a very bad cold and took cold medicine with Tylenol in it for a week, maximum dose and my liver enzymes were elevated, which I suspect was caused by the Tylenol. I am having difficulty tapering below 8 mg prednisone. My rheumatologist suggests that I try using the OTC meds to help me get to a lower dose. If I wake up at night in pain I take Tylenol and can usually get back to sleep. I take my full dose of prednisone in the morning because of sleep problems since I have been on the prednisone. I also want to function well physically in the morning and am feeling pretty good 2 hours after I take it.
@elizabethjoan I've been advised not to take ibupofen while I'm taking prednisone both by my rheumy and the info that comes with my prescription. I do limit it, but once in awhile I need additional relief and take two.
I've also heard that we should take prednisone between 3 and 4 a.m. I don't do that, but understand the reasoning. Some people who don't get 24 hour relief from prednisone split their dose.
When my PMR was bad, no medication helped, including opioids. I have a mild case, which only hurt me at night. I started at 10 mg. and am now taking 1 to 2 mg. daily for the past several months. Since prednisone can disturb sleep, I usually split my dosage and take half in the morning and half after dinner. Hope this helps.
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When I was diagnosed with PMR in March 2021 my rheumatologist told me to take 15 mg of prednisone in the morning when I got up. After three or four days trying that I wasn’t feeling any better. And my wife suggested that I take it before I go to bed instead. I researched her idea and found a study by an Italian professor who looked into when inflammation peaks and determined that a it’s about 3 AM in the morning. His conclusion from his study was that you should take prednisone in the evening or before bed so that its peak benefit takes place about when the inflammation in your body peaks. Once I switched to taking it in the evening, bingo my pain and stiffness were substantially better the next morning. I hope that works for you. Good luck and feel better.