← Return to The lowest effective dose, how is it defined?

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@megz

That's interesting @pmrsuzie
It seems like 5mg may be your lowest effective dose? Would it be best to sit on that dose for a while longer to stabilise things and take things more slowly, or did you kept reducing beyond that at the same rate? I'm wondering if there is a way to reduce the necessity of keeping going up and down.

Staying on that lowest effective dose would reduce the cumulative dose, at least. I'm hoping to learn from people who have tried different things, as you seem to have done. Was it your doctor who pushed you to keep reducing beyond 5mg, or did you decide on the reduction schedule yourself?

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Replies to "That's interesting @pmrsuzie It seems like 5mg may be your lowest effective dose? Would it be..."

Since this past spring I have been up and down a few times because of my hand problem, not the pmr. My rheumatologist wanted me to go to 10 mg for 2 weeks, 7.5 mg for 2 weeks, then stay at 5 mg. It did not work but I did what he suggested. My hands got better then worse. My crp was up to 24 and my wbc count was 17,000. My hands were swollen, stiff, warm to touch, could not make a fist. I had a lengthy appt with my rheumatologist and a new Dr - a 'fellow' in training. We discussed why this was happening and a plan. He said the 'tapering' can 'trigger' the kind of response I was having.
I'm in my 5 th year of this. My direction all along has been tapering 1 mg/ month at 10 mg. The pmr symptoms have escalated a couple times when I reached 5 mg or lower. I am now taking my entire dose in the morning. Before I was splitting the dose. Getting down to 3 mg made the tapering difficult. I was down to 1 mg morning and evening.
At this last appt I agreed to try methotrexate. Both Drs were in agreement that I needed more than prednisone. I agreed to try methotrexate but have since talked myself out of it. I'm 74, had a lot of medical problems throughout my life and am very nervous about mtx triggering a worse problem.
I'm pretty confident I can get down to 5 mg with no relapse, next appt is in Oct.
I am thinking I should slow the tapering once I reach 5 mg this time. My xrays show definite osteoarthritis in both hands and arthropathy consistent with cppd. My hands are significantly better for now. I am altering my diet, doing some therapy with exercise and heat and cold packs. One day at a time.
suzanne