Cant seem to get off of the prednisone

[Guest guest]

I have been taking prednisone for what seems like months now. I have

been trying to get the dosage down to 20mg and everytime i do i have

more pain and stiffness. I now have it at 25mg and can just tolerate

the discomfort but i am frequently needing a cane for support and

balance when walking alot. I am quite stubborn about getting the dose

down, but dont know what else to do. I dont want to be on this high a

dose for a long time. I have started my methotrexate treatment, on my

fifth week now. Any suggestions?

[Guest guest]

My rheumatologist started me on Arava and when that didn't work after a couple of months he added Methotrexate. I took myself off Arava for fear of side effects and the Mehtotrexate alone didn't help much. I did manage to get down from 40 mg Prednsione to 25 mg. When I tried to go to 20 I had real problems when I took it all in the morning as recommended but it worked OK when I took half in the morning and half at dinner. About 6 months after I started treatment with Arava (about 4 months after starting Methotrexate) my doctor added Remicade to the Methotrexate. At the time I was on 15 mg Prednisone. I had two Remicade treatments at 3 mg/kg, three at 5 mg/kg, and four at 6 mg/kg. After the second Remicade infusion I reduced Prednisone slowly to 10 mg I didn't get much more help until we got to 6 mg/kg and now I go off Prednisone a couple of days after my Remicade and stay off it for 5 or 6 weeks, and then go back on a little till the next Remicade infusion. I think it's just about impossible to get off Prednisone until the RA is controlled in some other way and then it's fairly easy to get off Prednisone. You need to give the Methotrexate more time, increase the dose of Methotrexate, or add a different DMARD so that your RA is controlled. Then try to get off Prednisone and if you are really controlled it will be easy to reduce Prednisone. Good luck and God bless.

----- Original Message -----

From: quinlan42

Rheumatoid Arthritis

Sent: Saturday, August 16, 2003 7:21 PM

Subject: Cant seem to get off of the prednisone

I have been taking prednisone for what seems like months now. I have been trying to get the dosage down to 20mg and everytime i do i have more pain and stiffness. I now have it at 25mg and can just tolerate the discomfort but i am frequently needing a cane for support and balance when walking alot. I am quite stubborn about getting the dose down, but dont know what else to do. I dont want to be on this high a dose for a long time. I have started my methotrexate treatment, on my fifth week now. Any suggestions?

[Guest guest]

Hi everyone! This is Steph in VA. I agree with GrandpaVan ... I couldn't go lower on the Prednisone until my arthritis was under control & that didn't happen until Remicade. I've been on it for about 3 years now. At my highest, I was on 40 mg/day of Prednisone. Now I'm in the process of going to 3 mg/day (under 5mg/day my rheumy suggests alternating dosages for 2 weeks. Right now I'm in my 1st week of alternating 4mg and 3 mg.)

Have you tried any of the biologics (Remicade, Enbrel, Humira & Kineret)?

Also, methotrexate can take up to 3 months to work.

Take care,

Steph

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> >My rheumatologist started me on Arava and when that didn't work after a couple of months he added Methotrexate. I took myself off Arava for fear of side effects and the Mehtotrexate alone didn't help much. I did manage to get down from 40 mg Prednsione to 25 mg. When I tried to go to 20 I had real problems when I took it all in the morning as recommended but it worked OK when I took half in the morning and half at dinner. About 6 months after I started treatment with Arava (about 4 months after starting Methotrexate) my doctor added Remicade to the Methotrexate. At the time I was on 15 mg Prednisone. I had two Remicade treatments at 3 mg/kg, three at 5 mg/kg, and four at 6 mg/kg. After the second Remicade infusion I reduced Prednisone slowly to 10 mg I didn't get much more help until we got to 6 mg/kg and now I go off Prednisone a couple of days after my Remicade and stay off it for 5 or 6 weeks, and then go back on a little till the next Remicade infusion. I think it's just about impossible to get off Prednisone until the RA is controlled in some other way and then it's fairly easy to get off Prednisone. You need to give the Methotrexate more time, increase the dose of Methotrexate, or add a different DMARD so that your RA is controlled. Then try to get off Prednisone and if you are really controlled it will be easy to reduce Prednisone. Good luck and God bless. > ----- Original Message ----- > From: quinlan42 > Rheumatoid Arthritis > Sent: Saturday, August 16, 2003 7:21 PM > Subject: Cant seem to get off of the prednisone > > > I have been taking prednisone for what seems like months now. I have > been trying to get the dosage down to 20mg and everytime i do i have > more pain and stiffness. I now have it at 25mg and can just tolerate > the discomfort but i am frequently needing a cane for support and > balance when walking alot. I am quite stubborn about getting the dose > down, but dont know what else to do. I dont want to be on this high a > dose for a long time. I have started my methotrexate treatment, on my > fifth week now. Any suggestions? > > >

[Guest guest]

I have managed to get to 10 mg every other day. I found it MUCH

easier to step down by 1 mg every other day than to try every day.

Also, my rheumy recommended getting to every other day BEFORE trying

to step back on the other day as well (i.e., if I started at 10

every day, I would work towards alternating 10 and 0 before trying

to get to less than 10 on the primary day). Also, if it helped me

get to the goal of every other day, I would actually INCREASE my

primary day (i.e. started at 10 every day, at one point was

alterating 13 and 7, worked down to 13 and 5, etc.)

It's another strategy you could consider...

Hope this helps!

Kathy

Southern California

>

[Guest guest]

I think getting off Prednisone is more art than science. The important thing is to listen to your body. When I was reducing Prednisone from 25 mg to 20 mg I had been on 20 in the morning and 5 at night, but when I went to 20 all in the morning I couldn't get out of bed in the morning and had to be spoon fed until my Presnisone kicked in a couple of hours later. Then I went to 10 in the morning and 10 at night and that worked OK. My body apparently either used up or excreted all of the Prednisone in less than 24 hours so I needed more before 24 hours was up. I have since gone off Prednisone but take it when needed when medicines start to wear off.

I think I was able to get off Prednisone because a combination of Methotrexate and Remicade control my RA well enough that I no longer have to have Prednisone. Until my fifth Remicade infusion when it started to work I wasn't able to reduce Prednisone very much but then it became easy to reduce it. I think your ability to get off Prednisone depends strongly on how well your RA is controlled in other ways. What this requires varies greatly from person to person.

Good luck and God bless.

----- Original Message -----

From: Kathy

Rheumatoid Arthritis

Sent: Saturday, August 23, 2003 11:50 PM

Subject: Re: Cant seem to get off of the prednisone

I have managed to get to 10 mg every other day. I found it MUCH easier to step down by 1 mg every other day than to try every day. Also, my rheumy recommended getting to every other day BEFORE trying to step back on the other day as well (i.e., if I started at 10 every day, I would work towards alternating 10 and 0 before trying to get to less than 10 on the primary day). Also, if it helped me get to the goal of every other day, I would actually INCREASE my primary day (i.e. started at 10 every day, at one point was alterating 13 and 7, worked down to 13 and 5, etc.)It's another strategy you could consider...Hope this helps!KathySouthern California>

[Guest guest]

I think you are absolutely correct Harold. My doc tried to get me

down to 0 every other day and it had a catastrophic effecton me. I

had only been on it, and Methotrexate for less than a month.

I had been taking 7.5mg of Prednisone daily so my doc had me go up to

10 mg one day then down to 5 the other day for a week. Then down to

2.5 every otherday for a week, then 0. After to days at 0 I had a

MAJOR flare up. I had to mass dose with Prednisone to get it undrer

control. Now I can't seem to get under 20 mg daily. When I drop to

15mg I have major symptoms.

I finally get to see a rheumy the 27th. With his help maybe I can get

this under control and decrease the Prednisone.

Jay

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