1. < Polymyalgia Rheumatica (PMR)

PMR Taper and pain

Posted by riji @riji, Jan 5 10:29am

After 2 years with PMR, about to go to 2 mg of prednisone and feel like I did back 2 years ago...is the PMR still in me or is it the taper or both?
Thanks for any info.

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begonia77 | @begonia77 | May 29 11:37am
In reply to @cavalryman "Hello begonia77, I am now at 3.5 mg per day. I take 3mg in the morning..." + (show)
@cavalryman

Hello begonia77, I am now at 3.5 mg per day. I take 3mg in the morning with breakfast and the half mg about 9pm. I find that works well for me, I have no morning stiffness. My next step is to take 2.5 mg in the morning and half mg at 9pm. You could try 2mg in the morning and the half mg in the evening. I believe that your adrenals will start working better if you are having a lower dose at night when splitting doses. Whatever you choose, I hope it works !!

Jump to this post

thanks cavalryman! I recently tapered to 2 mg evenly split, but I was in pain all day. Yesterday, I tried 1.5 at night and 1 in the day and that worked very well. Maybe it would also work the other way--I will give it a try. It is hard to cut the 1 mg pills in half but even a half mg seems to make a big difference. I wonder if my cortisol circadian rhythm is atypical (I am a night owl, always sleepy in the morning until I drink coffee).

REPLY
1 reply
begonia77 | @begonia77 | May 29 11:58am
In reply to @johnbishop "Hi @begonia77, Welcome to Connect. It sounds like you are doing great with the tapering schedule...." + (show)
@johnbishop

Hi @begonia77, Welcome to Connect. It sounds like you are doing great with the tapering schedule. I started at 20 mg for both of my occurrences of PMR but never had to split my dose due to more pain at night. There are others who have discussed splitting the dose in the following discussions that might have some suggestions for you.

--- Splitting the dose: https://connect.mayoclinic.org/discussion/splitting-the-dose/
--- Divided dose or all at once?: https://connect.mayoclinic.org/discussion/divided-dose-or-all-at-once/

Do you keep a daily log of your pain level when you get up and your dosage for the day? How long have you been on prednisone?

Jump to this post

Thanks John! I started on Pred last April 15mg was not enough so it was 20mg to start that worked. My PMR started very suddenly/very bad a few days after a cortisone injection into my inflamed knee. It was odd.
I had to split my dose from the beginning mainly because if I took it all in the morning I had pain for 3-4 hours before the pred "kicked in". Taking half before bedtime worked. But now that I am at such a low dose, I still have the same problem and wonder if my last taper at 1 mg or half mg will work best taken at night. I guess it may be different for different people. I am amazed that at such a low dose I can still be in pain---although it moves around. last week for the first time it was my hand and wrist worse than my shoulders.

REPLY
cavalryman | @cavalryman | May 30 12:19pm
In reply to @begonia77 "thanks cavalryman! I recently tapered to 2 mg evenly split, but I was in pain all..." + (show)
@begonia77

thanks cavalryman! I recently tapered to 2 mg evenly split, but I was in pain all day. Yesterday, I tried 1.5 at night and 1 in the day and that worked very well. Maybe it would also work the other way--I will give it a try. It is hard to cut the 1 mg pills in half but even a half mg seems to make a big difference. I wonder if my cortisol circadian rhythm is atypical (I am a night owl, always sleepy in the morning until I drink coffee).

Jump to this post

Hello begonia77
Do you have a pill splitter? They are sold in pharmacies and online.

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