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The lowest effective dose, how is it defined?
Polymyalgia Rheumatica (PMR) | Last Active: Oct 28, 2023 | Replies (56)Comment receiving replies
I think the weight/dose relationship study of 2011 is still valid in that it points out that 78% of people around 67kg responded to a start dose of 12.5mg but non-responders generally weighed more. Just interesting to me that weight makes a difference to the effective start dose.
The updated information link says the start dose should be 12.5mg to 25mg depending on the risks of individual patients. Since I had a heart attack a few years back and am not a skinny person, I'm pleased to have been started on 15mg, and it did work to get rid of pain within a week. Discussion with my pharmacist indicated that 15mg is a usual start dose (Australia) in any case.
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I think a person's weight should be considered. I'm not sure how often weight is considered.
My rheumatologist made some recommendations to me. Mostly she just wanted me to find a "stable dose" that worked for me. She then wanted me to stay at that dose for a month or two before trying to taper. Everything depended on my symptoms.
I'm a big guy so she said 35 mg wasn't that high of a dose for me. Plus, I took prednisone for years at higher doses for other autoimmune disorders before PMR was diagnosed. I had some tolerance for high doses of prednisone. Unfortunately my tolerance dwindled the longer I took prednisone for PMR.
Before PMR was diagnosed, I was always able to taper off quickly.