1. < Polymyalgia Rheumatica (PMR)

PMR Dosages and Managing Symptoms

Posted by maryft @maryft, Aug 16, 2021

I've read through the discussions and note all the different dosages of prednisone, different lengths of time taking prednisone, plus the addition of other meds, for PMR. I also note that the tapering of dosages and time frames are so varied from person to person. It appears there is not a set standard among physicians. How does one know if they were/are receiving the right dosage? Obviously, if symptoms subside, the dose is working, but after tapering if the symptoms return, was the initial dosage correct? I've also read that a person shouldn't be on prednisone long term, but there are many who've been on it for a few years. Its all very confusing.

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pmrsuzie | @pmrsuzie | Sep 13, 2023
In reply to @sunshine4u "I was on 20mg for 2 months and because that was working pretty well, my rheumatologist..." + (show)
@sunshine4u

I was on 20mg for 2 months and because that was working pretty well, my rheumatologist had me taper to 15. After 3 days, the pain increased so she told me to up it to 17.5. I was on that for a little over 2 weeks and 2 days ago went back down to 15. Pain has increased, but I am going to try and stick with the 15 for a full week and see how I am doing. It is easy for me to overdo exercising so I am sticking with swimming and pool yoga before I make a decision to go back down to 15 to make sure I am not doing too much. Walking is good and I do 20-25 minutes of various stretching in the morning so I am able to stand straight and walk.

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I would try alternating 17.5 and 15 for a week before attempting days in a row of 15. Or try 17.5 to 16 then 15. Seems like 17.5 to 15 is too much of a jolt for 'you'. Slow and steady.
suzanne

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rtuna | @rtuna | Sep 14, 2023

Recently tried dosing prednisone morning and afternoon instead of 3 times daily. Had extreme dizziness (swimmy headed) shortly after increased morning dose. Does this relate to anyone? I was trying to improve sleeping.

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1 reply
chzuck | @chzuck | Sep 14, 2023
In reply to @rtuna "Recently tried dosing prednisone morning and afternoon instead of 3 times daily. Had extreme dizziness (swimmy..." + (show)
@rtuna

Recently tried dosing prednisone morning and afternoon instead of 3 times daily. Had extreme dizziness (swimmy headed) shortly after increased morning dose. Does this relate to anyone? I was trying to improve sleeping.

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Currently I am on 9mg. I take 5mg at breakfast and 4mg at the evening meal and do not have any issues.

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barracudacool | @barracudacool | Sep 14, 2023

I have hit 9mg of prednisone with 25mg of methotrexate. With the drop to 9mg I am really having some problems. Not pain so much or stiffness but overwhelming fatigue. The kind I had back when all of this started back in December. Ringing in my ears as well for the last two days. Both were triggered when I dropped from 9.5mg to 9mg of prednisone. So frustrating.

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1 reply
mistyrags | @mistyrags | Oct 9, 2023

Hi: I would like to know if anyone has had success with their PMR by going on an anti-inflammatory diet. I have been on this diet for 3 weeks, but no change so far. This is one of the most debilitating auto-immune diseases I have ever been through. The pain is excruciating. Sure, prednisone helps in the daytime, but by nighttime you feel that PMR coming on again, and sleeping through the night is impossible. Mornings you don't even want to move it's so bad. I just started 20 mg of prednisone, so hoping it can help, but on average, how long does a severe attack last? My previous 2 attacks only lasted about 5 days with help from prednisone, but this attack I have had for a month at least, and have been basically bedridden. I am going to stay on this anti-inflammatory diet, and hope for the best, but how the heck can someone live each day with this and enjoy yourself? I'm a positive person, never depressed, but this month has really knocked me flat on my back and I feel very depressed, because I am usually always doing something and not just lying around! The attack came after I hurt my back months ago, and I'm wondering if that is linked to causing this flare-up. Any suggestions or answers? Thanks in advance.

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2 replies
barbsnow | @barbsnow | Oct 10, 2023

I am using the anti-inflammatory diet guidelines. It is hard to know if it helps or not, but I think it can not hurt.

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nancy334 | @nancy334 | Oct 10, 2023
In reply to @mistyrags "Hi: I would like to know if anyone has had success with their PMR by going..." + (show)
@mistyrags

Hi: I would like to know if anyone has had success with their PMR by going on an anti-inflammatory diet. I have been on this diet for 3 weeks, but no change so far. This is one of the most debilitating auto-immune diseases I have ever been through. The pain is excruciating. Sure, prednisone helps in the daytime, but by nighttime you feel that PMR coming on again, and sleeping through the night is impossible. Mornings you don't even want to move it's so bad. I just started 20 mg of prednisone, so hoping it can help, but on average, how long does a severe attack last? My previous 2 attacks only lasted about 5 days with help from prednisone, but this attack I have had for a month at least, and have been basically bedridden. I am going to stay on this anti-inflammatory diet, and hope for the best, but how the heck can someone live each day with this and enjoy yourself? I'm a positive person, never depressed, but this month has really knocked me flat on my back and I feel very depressed, because I am usually always doing something and not just lying around! The attack came after I hurt my back months ago, and I'm wondering if that is linked to causing this flare-up. Any suggestions or answers? Thanks in advance.

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I found using hot tub in morning and at night really helped reduce pain and feelings of tightness in hips and knees

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nancy334 | @nancy334 | Oct 10, 2023
In reply to @barracudacool "I have hit 9mg of prednisone with 25mg of methotrexate. With the drop to 9mg I..." + (show)
@barracudacool

I have hit 9mg of prednisone with 25mg of methotrexate. With the drop to 9mg I am really having some problems. Not pain so much or stiffness but overwhelming fatigue. The kind I had back when all of this started back in December. Ringing in my ears as well for the last two days. Both were triggered when I dropped from 9.5mg to 9mg of prednisone. So frustrating.

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That was me too…I am now about to start Actemra injections on top of my methotrexate injections ….will let you know outcome

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jsrask | @jsrask | Dec 2, 2023
In reply to @kmeikle1 "Glad your taper has worked well for you so far. If you have trouble tapering from..." + (show)
@kmeikle1

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.

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My prednisone comes in 5 mg tablets. Does yours come in smaller doses?

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1 reply
megz | @megz | Dec 2, 2023
In reply to @jsrask "My prednisone comes in 5 mg tablets. Does yours come in smaller doses?" + (show)
@jsrask

My prednisone comes in 5 mg tablets. Does yours come in smaller doses?

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Depending on the country you are in, prednisone comes in 1mg, 2mg, 2,5mg, 5mg and larger dose tablets. In Australia where I am, we have 5mg and 1mg only. The 1mg tablets are essential for making accurate reductions. Just ask your doctor to prescribe the smaller dose tablets as well as the 5mg.

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