PMR Dosages and Managing Symptoms

I am being evaluated for MTX and am concerned that I will only be trading one evil for another. I was hoping getting on MTX and greatly reducing Prednisone would make the thin skin condition better. From what you say, that is not the case.

Chzuck,
I am currently on 5mg per day taking it in the morning. I have taken it your way, am/pm, and now I am taking 7.5 mg meloxicam in the pm to ward of night pain. My prednisone seems to wear off quickly. Maybe just me.
5 mg is not doing the trick. Will discuss next Wednesday with rheumatologist. Hope you get it worked out.
I have the same thin skin issue on my arms but I don’t believe it is caused by the prednisone. I had it long before I started prednisone for my PMR.
Blessings

Hi @napapos, I hope you don't mind but I thought I would reply to your private message in the discussion where you posted about discussing your prednisone dosage at your upcoming appointment with the rheumatologist. I think others will be interested in your update also.

*********** Update from @napapos ***********
So now I am 4 months in since diagnosis.
On 4-27-23 doctor put me on 10 mg pred for 2 weeks, 7.5 mg for two weeks, then 5 mg for four weeks. On 6-22-23, 7.5 for two weeks, then 5 mg for four weeks. My PMR pain level was at 8 in the beginning . Within a few days pain was at 2-3/10. I am on my third taper but he want me to stay on the 5 mg for three months, no taper, side dressing with 7.5 mg meloxicam in the pm per follow up appointment on 8-30-23 . Surprisingly my pain level is stable at 1.5-2.5/10 during the day. Mornings are around 3-4/10. No more Advil. Three 650mg Tylenol three times a day. Hand stiffness is a little better but can’t hope for much with the osteoarthritis. I am using hand tension grippers daily at about 60 reps. Will let you know later if I feel they are helpful or harmful. Today, 9-1-23 was the first day of my garden activity in over two weeks. I am eating an anti inflammatory diet, lots of fish and veggies, no processed foods and little sugar. I think it helps. I just pray tomorrow is not payback time. Wishing everyone wellness and blessings.
***********************

It sounds like you are doing really good with the activity and anti-inflammatory diet. Eliminating most of my sugar intake was really helpful for me as well. Did I read correctly that you are taking nine 650mg Tylenol a day (three 650mg capsules three times a day)?
That adds up to 5850mg daily dose which is much higher than recommended unless you have discussed it with your doctor.

Here is some information on the topic:
"Tylenol is relatively safe when you take the recommended dose. In general, adults can take between 650 milligrams (mg) and 1,000 mg of acetaminophen every 4 to 6 hours. The FDA recommends that an adult shouldn't take more than 3,000 mg of acetaminophen per day unless directed otherwise by their healthcare professional."
--- Is It Dangerous to Take Too Much Tylenol?
https://www.healthline.com/health/can-tylenol-kill-you
I only took Tylenol once in awhile when my PMR was active and mostly for headaches. Have you discussed your Tylenol use with your doctor or rheumatologist?

@johnbishop
No problem sharing my post. I’m slow. Not sure how to post open messages.
And no , I am only taking three, 650 mg Tylenol per day!
Blessings.

Hi @chzuck, I've had two occurrences of PMR. Starting at 20mg prednisone for both. I always took my dose when I got up in the morning per my rheumatologist. I also only tapered when my pain level was acceptable (less than 2 on my scale of 0 to 10). The first time it took 3 and a half years to taper off, the second time six years later took 1 and a half years to taper off. I am also still dealing with thin skin even though my PMR has been in remission for over 5 years now.

What helped me the second time around was changing my lifestyle - eating healthier and exercising more. Probably the biggest factor was eliminating as much processed food and sugar as possible. Do you keep a daily log to record your level of pain in the morning and the dose of prednisone?

John - did you (or anyone else here) go gluten-free? What about alcohol?

Glad your taper has worked well for you so far. If you have trouble tapering from 10 mgs. be advised most recommend not tapering more than 10% at a time, so a 1 mg. reduction from 10. I, too, had little trouble getting to 10, but I've had plenty of trouble trying to get below 10. I continue to try and my next taper will be half a mg. to 9.5.

Hi @napapos, Glad to hear it's just three 650 mg Tylenol per day. Right now I am posting a reply to your post. I started by clicking on the VIEW & REPLY button on the email notification I received from your post which took me here to your post. Then I clicked the Reply button under your post which opened this box (photo attached). If I want to write a post to everyone, I just have to go to the bottom of the discussion and type my message in the Comment box and then click the Post Comment button at the bottom. You can find more helpful step by step instructions in the Help Center here - https://connect.mayoclinic.org/help-center/. There is a link to the Help Center at the top menu at the right side. Hope this helps.

Hi @napapos, I hope you don't mind but I thought I would reply to your private message in the discussion where you posted about discussing your prednisone dosage at your upcoming appointment with the rheumatologist. I think others will be interested in your update also.

*********** Update from @napapos ***********
So now I am 4 months in since diagnosis.
On 4-27-23 doctor put me on 10 mg pred for 2 weeks, 7.5 mg for two weeks, then 5 mg for four weeks. On 6-22-23, 7.5 for two weeks, then 5 mg for four weeks. My PMR pain level was at 8 in the beginning . Within a few days pain was at 2-3/10. I am on my third taper but he want me to stay on the 5 mg for three months, no taper, side dressing with 7.5 mg meloxicam in the pm per follow up appointment on 8-30-23 . Surprisingly my pain level is stable at 1.5-2.5/10 during the day. Mornings are around 3-4/10. No more Advil. Three 650mg Tylenol three times a day. Hand stiffness is a little better but can’t hope for much with the osteoarthritis. I am using hand tension grippers daily at about 60 reps. Will let you know later if I feel they are helpful or harmful. Today, 9-1-23 was the first day of my garden activity in over two weeks. I am eating an anti inflammatory diet, lots of fish and veggies, no processed foods and little sugar. I think it helps. I just pray tomorrow is not payback time. Wishing everyone wellness and blessings.
***********************

It sounds like you are doing really good with the activity and anti-inflammatory diet. Eliminating most of my sugar intake was really helpful for me as well. Did I read correctly that you are taking nine 650mg Tylenol a day (three 650mg capsules three times a day)?
That adds up to 5850mg daily dose which is much higher than recommended unless you have discussed it with your doctor.

Here is some information on the topic:
"Tylenol is relatively safe when you take the recommended dose. In general, adults can take between 650 milligrams (mg) and 1,000 mg of acetaminophen every 4 to 6 hours. The FDA recommends that an adult shouldn't take more than 3,000 mg of acetaminophen per day unless directed otherwise by their healthcare professional."
--- Is It Dangerous to Take Too Much Tylenol?
https://www.healthline.com/health/can-tylenol-kill-you
I only took Tylenol once in awhile when my PMR was active and mostly for headaches. Have you discussed your Tylenol use with your doctor or rheumatologist?

Does the tylenol keep you from taking prednisone? I was taking mobic for the pain and had to stop that once I started with prednisone. I do take tylenol once in awhile in addition to the prednisone.