What steroid dosage did you start on? Did you find the right dosage?

Posted by abbeyc @abbeyc, Feb 5, 2022

Hello I am wondering what dosage of Prednisone everyone started on and how long (days) did it take to get complete 100% relief (if ever). Or how long did it take to find the right dosage? I have trialed 3 different steroid doses (with help from my doctors) for the past month and no success yet controlling all the pain 100% or determining the right dosage for me. Maybe I'm impatient.

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10 mg took 90% of pain and immobility away overnight!

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15 mg took 100% of pain after about 24 hours

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10 mg made a huge difference, but my hands were still painful. My doctor called to check on me and said, “Don’t be afraid to double the dose.” Although I was completely pain free, my doctor kept me on 20 mg for 3 months, because my CRP and ESR were still elevated. I took a year to taper after that, with great success. Now I’m having my 2nd bout with PMR - started at 15, and that again was not enough. Only stayed on 20 for 3 weeks this time, before tapering. My hands have had some amount of pain from 15 mg down, and now at 6 mg wish I’d stayed on 20 mg longer. I’m tapering much slower this time (7 weeks per mg), but I’m going to taper even slower going forward (1/2 mg every 8 weeks). I’ve removed wheat, alcohol, and sugar from my diet this week - and I believe it’s made a difference. We’ll see what the blood numbers say in March. Good luck.

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@susan63

15 mg took 100% of pain after about 24 hours

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Wow. That is low dosage and amazing recovery! How long did you have the PMR pain and symptoms before you you got your first dose? How did it go after that? Did it stay at 100%?

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@microbe1943

10 mg took 90% of pain and immobility away overnight!

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that’s pretty good! What happened after that? Did you stay at 90% or work to get it to 100%?

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@priscillat

10 mg made a huge difference, but my hands were still painful. My doctor called to check on me and said, “Don’t be afraid to double the dose.” Although I was completely pain free, my doctor kept me on 20 mg for 3 months, because my CRP and ESR were still elevated. I took a year to taper after that, with great success. Now I’m having my 2nd bout with PMR - started at 15, and that again was not enough. Only stayed on 20 for 3 weeks this time, before tapering. My hands have had some amount of pain from 15 mg down, and now at 6 mg wish I’d stayed on 20 mg longer. I’m tapering much slower this time (7 weeks per mg), but I’m going to taper even slower going forward (1/2 mg every 8 weeks). I’ve removed wheat, alcohol, and sugar from my diet this week - and I believe it’s made a difference. We’ll see what the blood numbers say in March. Good luck.

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this is great information! Thank you for sharing! I am having suspicion that my first Primary doctor who put me on my first dose at 24mg (great relief) with a 4 mg daily decline in 6 days messed up my system as this was obviously too fast a taper. I was in herendous pain after the script ran out and almost went to the hospital as she would not refill the Prednisone for some reason. Finally got into see a Rheumatologist a week after that but struggling to get the 100% relief. He doesn’t want to go above 20 mg w me for some reason. still learning how this all works. Thank you!

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@abbeyc

that’s pretty good! What happened after that? Did you stay at 90% or work to get it to 100%?

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It took maybe another few days for 100%! I was good at this level until I had an episode of diverticulitis that i had to have IV antibiotics for 18 days. Hospital 7 of those. Then, 2 weeks later I got the quadravalent flu shot (the strong one for older people). 2 days later I have fever, chills, night sweats. I felt like a huge mack truck hit me., Was hospitalized for this with fevers up to 100.8. More strong antibiotics IV. Rheumy put me up 1 mg to 11 mg prednisone for the "stress" of all the medical conditions. I was on 11 mg for 10 days, then back to 10, i began to taper after 2 weeks, to 9 one day, 10 the next for a week. Then 9/8 (alternate days for 2 weeks). I was okay until I hit 7 mg and my back muscles, shoulder muscles, neck muscles, side of body muscles and profound exhaustion hit. Went back up to 10 mg. it has not worked as well. The 13 mg for 3 days, then 12, 11, 10. I can reach, turn over, get up from sitting position, no pain in hips, shoulders or elbows sleeping at night, just awful muscle distress in back muscles...which is where first
PRM hit. i lived with this pain and the galloping other symptoms---THIS back muscle recurrences is a nightmare. Now I am on Flexeril...i took it twice and slept the entire day....pain relief...but next day not so much as I only took half the dose. I do not want to sleep all day!! Not sure what is up but my oncologist says we have to get me off the steroids...my blood sugar is insane...up to 350 daily...i am now on 3 insulins. Kidneys compromised anyway but now worse...BP increased so I am on double the BP medicine. I don' t know the next step...he is conferring about it but some "steroid sparing" agent" but not Mtrexte...Will write in when I know the plan. Sorry so long a post but your question deserved an answer. Oh, my sed rate in hospital last time was 100 and the crp 47.5. CRP normal now. Sed rate 53.

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Typical starting dose is 15-20 mgs. I took 15 mgs. and it took three to four days to get complete relief.

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This is a great discussion and a good companion to this related discussion for anyone interested in this topic:
- PMR Dosages and Managing Symptoms https://connect.mayoclinic.org/discussion/pmr-dosages/

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I am fairly sensitive to medications and have had 3 bouts of PMR. With this latest bout, I started on 10 mg with complete resolution of symptoms. I have also learned to decrease slowly. About 2 years, I was started on 10 mg, then decreased 1 mg a month until I was down to 7 mg, then decreased more slowly. Now, 2 years later, I am on 3 mg, starting the decrease to 2 mg which I hope to get to sometime in March. The last 2 mg need to go really slow for me. The one time, I was able to get off prednisone in less than 1 year led to a reoccurrence 8 months later. The first time, I was off in 2 years and in remission for 12 years. At this point, I will focus on decreasing slowly, I am 75, active, daily walks and a zoom exercise class, plus help with grandkids. I’ve found patience to be the key.

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