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How to address PMR pain while decreasing prednisone
Polymyalgia Rheumatica (PMR) | Last Active: Nov 6, 2023 | Replies (747)Comment receiving replies
I've had PMR for over a year and tapering is frustrating. Started at 20mg and easily got to 10mg and have tried twice to drop the dosage further... Got to 5 once but had to go back up due to pain. stayed at 7.5 for a few weeks, but Doc did blood tests and CRP jumped up too high so increased to 10 again. Stayed a month and CRP dropped down. Started tapering by 1mg every 2 weeks and was feeling pretty good at 8mg. had a plan to keep dropping by 1mg, but Doc called with blood tests and CRP jumped again, so back to 10mg. Anybody have this problem? What did/are you doing? Anyone successfully get off pred after the tapering seesaw like this? How long did it take?
Replies to "I've had PMR for over a year and tapering is frustrating. Started at 20mg and easily..."
The bottom line is each of us is different and her rheumatologist are different and PMR pain is absolutely no fun!!!! I started prednisone at 10 mg in April now I am down to 1 mg for three weeks and then my rheumatologist said she does not believe in medication unless the pain is intolerable!!! The mornings are the worst I can hardly move every joint hurts as the day goes on and improves a little but not good. I am going to take one day at a time and see how things work out with the pain.
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1mg every two weeks under 10mg is a very fast reduction schedule which would likely invite a flare. I was reducing at about that rate (my idea, not the doctor's) when some pain started at 8mg. I was determined not to have a flare so told my doctor I wouldn't reduce further till pain was resolved.
So I moved up to 9.5mg for a week then dropped to 9mg for 4 weeks. No pain. I resumed the reduction more cautiously at .5mg every 3 weeks (1mg every 6wks - the recommended reduction schedule is 1mg every 4-8wks under 10mg). Have just reduced to 7.5mg and am doing fine so far. I alternate doses between the current dose and new dose each day in the first reduction week, to soften the reduction.
Going a little more slowly can avoid having to go back up in dose - which gives us a higher cumulative dose and takes longer to get off them. I'm no expert, just winging it like you and everyone else. Started on Prednisolone 5 months ago. I hope you find a good solution.