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← Return to PMR and Methotrexate
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I was diagnosed with PMR 5 months ago. Started on Prednisone 40mg, felt great. Just recently started my taper - my doctor had me reduce it by 10mg/month. I am now on 20mg of Prednisone and all my symptoms are returning. My doctor now wants me to take Methotrexate 2.5mg 4x per week and continue to reduce my Prednisone by 5mg weekly. I'm new to this disease and would love to hear from anyone that has used this approach or hasn't and why.
Replies to "I was diagnosed with PMR 5 months ago. Started on Prednisone 40mg, felt great. Just recently..."
Hello @mbbs, Welcome to Connect. I see that @linda7 has shared her thoughts and experience with you. You will notice that we moved your post into an existing discussion here so that you can meet and learn what others have shared about Methotrexate and PMR.
-- PMR and Methotrexate:
https://connect.mayoclinic.org/discussion/pmr-and-methotrexate/
I'm not a doctor but normally only people suspected of having PMR and Giant Cell Arteritis (GCA) are started on high doses of prednisone. Also 10mg a month taper seems to be a big jump. Does your doctor suspect you have GCA or another condition as well as PMR?
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This seems like a high initial dose and a very fast taper to me. I have had PMR for 15 mos. My taper was: 20 for 3 weeks, 15 for 4 weeks, 12.5 for 4 weeks, 10 for 4 weeks. Below 10 I have had 3 flare-ups and have not been able to keep to the schedule of 1 mg/month drop. I am at 8 mg and my rheumatologist thinks I have been on prednisone too long at higher doses and wants to add methotrexate. I am resisting because of the side effects of methotrexate and uncertainty about whether it will control symptoms and I'll just be on another toxic drug. I have been self-monitoring for side effects of prednisone, checking my blood pressure, blood sugar and heart rhythm. I had my eyes checked for glaucoma and cataracts. No real problems. I asked for a DEXA scan for my bones and we will do that. If all these checks for side effects don't turn up anything I will push for staying on just prednisone for a little longer. My rheumatologist would be much more comfortable if I could get to 5 mg. I don't know your health history and your doctor may have valid reasons to get you off prednisone faster. I do not have have significant health problems other than PMR. I'm 72 yo.