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I’m Not Responding to Prednisone and I Need Advice
Polymyalgia Rheumatica (PMR) | Last Active: Nov 24, 2023 | Replies (72)Comment receiving replies
My doctor started me with 10mg - after 8 days with limited improvement, I still put a shirt on, and had to think about standing from a sitting position so he increased it to 15mg - again no real difference so - he put me on 50mg - it’s my 1 st day (Nov. 14) it took 4 hrs to kick in but it has put as close to normal as I could expect - still have to see when it will leave, hopefully through the night.
If you research it you will find PMR severity can differ from person to person - I have a severe case you may also have a severe case.
Replies to "My doctor started me with 10mg - after 8 days with limited improvement, I still put..."
Yes, I believe I also have a severe case. Good luck to you. BTW, my doctor wants me to take most of my dose in the morning, because Prednisone can increase energy levels. You may have trouble sleeping. I take 30 mg in the morning and 10 mg in the evening.
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There are cases of glucocorticoid-resistant polymyalgia rheumatica. I was probably one of those cases. When my rheumatologist started me on 20 mg of prednisone, she added that I needed to find a dose that worked. When 20 mg didn't work, I naturally increased my dose to 50 mg. When I reported back that 50 mg worked my rheumatologist rightfully said 50 mg was too much prednisone for PMR.
By definition PMR "should respond" to lower doses of prednisone. The usual starting dose is somewhere in the range of 12.5 to 25 mg of prednisone. There are wide variations in the treatment of polymyalgia rheumatica (PMR) with respect to prednisone dosages, tapering strategies, use of disease modifying anti-rheumatic drugs (DMARDs) and duration of treatment.
The bottom line is --- nobody knows how to treat PMR except to take prednisone.