Hi, yes, I know anything above 20mg is unusual. Unfortunately, 40mg was the only level that calmed down the flare. (Once I hit 40mg, it went away almost like magic.) My dr said that it's unusual to start as such a high dose, but it does happen. Obviously I'm not thrilled to be on prednisone at all, much less so much, but I'm happy to have been able to start tapering and hope I can continue to get down to a low level. The side effects are awful!