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PMR Dosages and Managing Symptoms
Polymyalgia Rheumatica (PMR) | Last Active: Jul 27 8:00am | Replies (468)Comment receiving replies
There is so much in our group about prednisone but I am still confused. I have been diagnosed for a month. Started on 20mg OD, decrease to 15 mg OD after two weeks and supposed to go to 10mg tomorrow. My clinical picture is ….I take prednisone at 9:30 am. They take effect by 1pm. I am virtually pain free from mid afternoon until 4am. I then wake and the pain increases very rapidly over the next few hours to a level of about 7 or 8. Also the stiffness returns but not too bad. I supplement with Tylenol and/or Advil and that does give me some relief.
Question….should I decrease to 10mg tomorrow as scheduled or should I have less pain before decreasing? What are the thoughts of taking 10mg at 9:30 am and 5 mg, say, 4pm or with supper?
Will be interested in the opinions of others who have dealt with this much longer than I have.
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Welcome @elizabethjoan, It can be confusing trying to treat your PMR symptoms. You will notice that we merged your post into the following existing similar discussion so that you can meet other members and learn what they have shared -- PMR Dosages and Managing Symptoms: https://connect.mayoclinic.org/discussion/pmr-dosages/ .
If I understand correctly, you were only diagnosed with PMR about 1 month ago and started on 20 mg prednisone and it provides pain relief until early morning. That part sounds fairly normal and similar to what I experienced except I always took my prednisone dose early in the morning with my breakfast or before. Then you mentioned decreasing to 15 mg after 2 weeks. That seems pretty aggressive for tapering. I know we are each different but my rheumatologist had me on a monthly taper but it was flexible depending on the pain I was feeling and I was told not to taper to the next level if the pain was too much. He had me keep a daily pain log along with the dosage of prednisone. If my pain level was 1 or 2, I felt I could taper to the next level. If it was above a 3, then I would increase my dose by half of the previous taper down dosage. If I dropped 5 mg for the last taper, then I would go up by 2.5 mg. He got me scripts for 5, 2.5 and 1 mg tablets so that I could easily adjust the dosage while tapering down.
Other members who have split their prednisone dosage between morning and evening and may have some suggestions for you. Are you able to discuss the tapering schedule and that it may be a little aggressive with your doctor or rheumatologist?