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.

Interested in more discussions like this? Go to the Polymyalgia Rheumatica (PMR) Support Group.

@johnbishop

Hello @dallas, Welcome to Connect. I've had two occurrences of PMR but have not noticed weakened tendons in my knees. My PMR is currently in remission but when it was active I did have trouble with stability and walking due to the pain which went away while on prednisone.

You will notice that we moved your post into the following existing discussion on the same topic so that you can meet other members like @mary4, @raven1955, @tillysam, @naezzo, @kmeikle1, @tsc and others. If you click the link it will take you to the first post in the discussion where you can read through the experiences of other members.

-- PMR Dosages and Managing Symptoms:
https://connect.mayoclinic.org/discussion/pmr-dosages/

How long ago were you diagnosed with PMR and started on 40mg of prednisone?

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1 yr ago…40 mg/daily for 1mnth was too strong/too long

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I would think this might be another reason for trying MSM as it is suggested for artheritis. I definently think there is an overlap in the cytokines involved.

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Just diagnosed a month ago. Taking 15 MG Prednisone in the AM. Keeps the symptoms controlled for 18 - 20 hours then ibuprofin.

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@charlesp

Just diagnosed a month ago. Taking 15 MG Prednisone in the AM. Keeps the symptoms controlled for 18 - 20 hours then ibuprofin.

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Welcome @charlesp, For both of my occurrences of PMR I was started at 20 mg prednisone and it kept the pain symptoms at bay until I took my next mornings dose. I would have stiffness in the morning until I got up and moving. I would also do some mild exercise in the morning which seemed to help.

You might consider keeping a daily log of your pain level when you get up in the morning along with the dosage of prednisone you take that day. It helped me when tapering and knowing when I shouldn't taper. For me, if my pain level was above a 2, I generally did not taper to my next lower dose of prednisone.

I know it's early in your PMR journey since you were just diagnosed a month ago. Does your doctor or rheumatologist have you on a tapering schedule?

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Yes 15 for 1 month 10 for 1 month 5 for 1 month then see whats up. Do you know if CRP level is a positive indicator of PMR? Thank You

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@charlesp

Just diagnosed a month ago. Taking 15 MG Prednisone in the AM. Keeps the symptoms controlled for 18 - 20 hours then ibuprofin.

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Hi
I found that taking Prednisone in the am didn’t last 24 hours but more like you 20 hours. I divided the dosage in half and take am and pm. After a day or so there you are getting effectively the total dosage and there was no gap of 4 hours of pain.

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@charlesp

Yes 15 for 1 month 10 for 1 month 5 for 1 month then see whats up. Do you know if CRP level is a positive indicator of PMR? Thank You

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SED rate and CRP are used as indicators but there are many cases where the tests are in the normal range with PMR present in the patient.
-- Polymyalgia rheumatica with normal values of both erythrocyte sedimentation rate and C-reactive protein concentration at the time of diagnosis: a four-point guidance:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5911650/

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@johnbishop

SED rate and CRP are used as indicators but there are many cases where the tests are in the normal range with PMR present in the patient.
-- Polymyalgia rheumatica with normal values of both erythrocyte sedimentation rate and C-reactive protein concentration at the time of diagnosis: a four-point guidance:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5911650/

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Thanks for the interesting reply. My CRP is 94. 7

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@tomarrieta29

Hi
I found that taking Prednisone in the am didn’t last 24 hours but more like you 20 hours. I divided the dosage in half and take am and pm. After a day or so there you are getting effectively the total dosage and there was no gap of 4 hours of pain.

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Doc was very specific about the dose and time. I can deal with the few hours with 2 Ibuprofen. Thank you

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@charlesp

Doc was very specific about the dose and time. I can deal with the few hours with 2 Ibuprofen. Thank you

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My doctor initially started me taking the dosage in the am when I was first diagnosed with PMR. When the dosage only covered 20 hours she agreed to split the dosage in half and experiment with taking the doses in am and pm since taking it only in the am left me with 4+ hours of extreme pain
In my case, this splitting of the dosage has worked for me .

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