Author Topic: Prednisolone  (Read 8366 times)

cari

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Prednisolone
« on: July 01, 2015, 02:14:23 PM »
When did you start taking Prednisone?  It's been three months since I started taking 400mg of hydroxy.  and today I'm in pain as I have been every day for the last two years.  I'm so fed up with being in pain but I don't know how Prednisone works.  My rheumatologist gave me a prescription for a month but I'm not sure how to take it or what kind of effects it has.  I've read that it has pretty bad side effects and I don't know how long the effect lasts. The doctor gave me a shot for inflammation at the end of April and the effects felt like I had sand in my joints.  I didn't feel much better although five days later the inflammation had gone down somewhat but I was still in pain, still felt fatigued just wasn't writhing about.

« Last Edit: July 06, 2015, 01:37:30 PM by cari »

Sleepy In Seattle

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Re: Prednisone
« Reply #1 on: July 01, 2015, 03:44:55 PM »
I'm sorry you're feeling cruddy... :-(

Please get in touch with your doctor and make sure you know exactly how to take the prednisone...it can be very effective getting a disease flare under control, but it's also potentially very dangerous if you take it wrong.

Some people don't tolerate it well, but many do, for short periods of time. Most of the serious side-effects come from taking it long-term.

I hope you get some relief soon!!!
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Carolina

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Re: Prednisone
« Reply #2 on: July 01, 2015, 07:08:16 PM »
Hydroxy is probably Plaquenil, NOT Prednisone.

We each respond very individually to medications, cari, so it's hard to know what will work for you.

I don't take Plaquenil at all. 

Hydroxychloroquine (Plaquenil)

https://www.rheumatology.org/Practice/Clinical/Patients/Medications/Hydroxychloroquine_(Plaquenil)/

I DO take a low dose of Medrol (methylprednisolone) which is like Prednisone.

If it's going to work, Prednisone works right away.

https://en.wikipedia.org/wiki/Methylprednisolone

I'm sorry you're having such a difficult time.

Hugs,  Elaine
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Tharrell

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Re: Prednisone
« Reply #3 on: July 01, 2015, 07:49:49 PM »
I agree with Caroline, it's plaquenil you are talking about since the dosage is 400 mg. you take it either as once a day preferable after a meal or you can split the dose 200 mg twice. I take mine as one dose after dinner. It can take up to 6 month to take effect. I am also on 2.5 mg prednose daily and have been since February for the joint pain.
Hope this helps the confusion.
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rnathans

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Re: Prednisone
« Reply #4 on: July 01, 2015, 08:11:24 PM »
I think the OP is saying she has been on plaquenil for 3 months and was given a script for a month of prednisone but does not know how to take it.

So Cari, if this is correct do not start the prednisone until your doctor explains how to take it and answers your questions about what to expect while on it as well as longer term as a result of taking prednisone.

cari

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Re: Prednisone
« Reply #5 on: July 02, 2015, 04:29:37 AM »
I think the OP is saying she has been on plaquenil for 3 months and was given a script for a month of prednisone but does not know how to take it.

So Cari, if this is correct do not start the prednisone until your doctor explains how to take it and answers your questions about what to expect while on it as well as longer term as a result of taking prednisone.

Yes this is what I meant.  I've been on hydroxy. (we don't have plaquenil in the uk) for three months. I'm still in pain.  The rheumatologist gave me a prescription for a month of prednisone.  I'm so fed up with being in pain that I was thinking of taking it.  I'm concerned that it will do more harm than good and wondered how others had fared on it.  I'm also wondering if I'm not bad enough to take it because I am not on any other pain medication and still feel awful but am not writhing about in agony.  The pain is constant and unremitting but the prednisone was requested by me for when I go to Thailand in case I have a really bad flare and need it as a last resort.

I've looked up the side effects and they are frightening.  So I'm wondering if I should take it before I go in order to be able to have some kind of quality of life (without pain) or to keep struggling, waiting for the hydroxy. to kick in and leave the prednisone for a really bad flare.


Jasper

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Re: Prednisone
« Reply #6 on: July 02, 2015, 07:34:35 AM »
Cari ..... The Prednisone prescription should have very specific directions on the bottle for exactly how to take it. It should state exactly how many tablets to take each day and for how many days. You cannot just start taking any old dose and then abruptly stop it after a month.

If you start taking Prednisone and then abruptly stop taking it, you run the risk of adrenal failure. It has to be tapered over several days.

http://www.medicinenet.com/steroid_withdrawal/article.htm

I have a Prednison prescription to take for flares. These are the instructions:
Prednisone 5 mg
Take 4 tablets daily for 5 days
Then, take 3 tablets daily for 5 days
Then, take 2 tablets daily for 5 days
Then, take 1 tablet daily for 5 days
Then Stop.

BTW, most of the side effects (weight gain, fluid retention, diabetes, etc.) don't occur when Prednison is taken for short periods of time, like for a flare. They occur when one is on long term therapy. So, for short term treatment, like for flares, the main concern is that the Prednison is tapered properly.
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cari

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Re: Prednisone
« Reply #7 on: July 02, 2015, 07:57:39 AM »
Cari ..... The Prednisone prescription should have very specific directions on the bottle for exactly how to take it. It should state exactly how many tablets to take each day and for how many days. You cannot just start taking any old dose and then abruptly stop it after a month.

If you start taking Prednisone and then abruptly stop taking it, you run the risk of adrenal failure. It has to be tapered over several days.

http://www.medicinenet.com/steroid_withdrawal/article.htm

I have a Prednison prescription to take for flares. These are the instructions:
Prednisone 5 mg
Take 4 tablets daily for 5 days
Then, take 3 tablets daily for 5 days
Then, take 2 tablets daily for 5 days
Then, take 1 tablet daily for 5 days
Then Stop.

BTW, most of the side effects (weight gain, fluid retention, diabetes, etc.) don't occur when Prednison is taken for short periods of time, like for a flare. They occur when one is on long term therapy. So, for short term treatment, like for flares, the main concern is that the Prednison is tapered properly.

I understand it needs to be tapered.

What is says on the box is: 28 x prednisolone 5mg five tabs once daily.  He's given me 6 boxes.
http://www.nhs.uk/medicine-guides/pages/medicineoverview.aspx?condition=Inflammatory%20disease&medicine=prednisolone&preparation=Prednisolone%205mg%20tablets

It doesn't say if I take the medication all at once or spread over the day.  It doesn't say to taper.  It says Do not stop taking this medication unless your doctor tells you to stop  so it looks like continuous medication. 

On the leaflet, how to take it says the usual dose is 20-80mg daily as required for control followed by gradual reduction to a maintenance dose of 5 to 20 mg daily.

The side effects are literally insane, triggering suicidal thought, mania and insomnia.  They are really frightening including high blood pressure and congestive heart failure. 


« Last Edit: July 02, 2015, 08:40:50 AM by cari »

Carolina

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Re: Prednisone
« Reply #8 on: July 02, 2015, 08:05:33 AM »
Can you call the doctor and ask him/her how to take the RX given to you?

That would be the best idea.

Prednisone will work amazingly.  Perhaps you are to take 5 mg a day, which is a low dose.   If it doesn't work well within the first two or three days, you can reduce the dose slowly and stop.  5 mg a day is a low dose, IMHO.  But it is the MOST I've ever taken for the pain of inflammation and it works VERY WELL for me. I take the equivalent of about 3.5 mg a day.  And I have almost no pain.  Very manageable. I also take Aleve and Cymbalta for pain.

Hugs,  Elaine
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cari

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Re: Prednisone
« Reply #9 on: July 02, 2015, 08:13:25 AM »
Can you call the doctor and ask him/her how to take the RX given to you?

That would be the best idea.

Prednisone will work amazingly.  Perhaps you are to take 5 mg a day, which is a low dose.   If it doesn't work well within the first two or three days, you can reduce the dose slowly and stop.  5 mg a day is a low dose, IMHO.  But it is the MOST I've ever taken for the pain of inflammation and it works VERY WELL for me. I take the equivalent of about 3.5 mg a day.  And I have almost no pain.  Very manageable. I also take Aleve and Cymbalta for pain.

Hugs,  Elaine


The dose on my medication is 25mg a day.  It's a good idea to phone my rheumatologist and have a chat with him about it as he didn't tell me how to take it.  I just asked for something to help in case I had a really bad flare whilst in thailand as a stop gap in an emergency so he just wrote out a prescription.  I've only just looked at it now.

How long have you been on it and have you had any side effects like anxiety, depression, nervousness or weight gain?  I have a history of depression so I'm very wary about this.  Perhaps the best thing to do is try it for a week, see if it has any effect then taper off it if it doesn't work or if it has a negative effect eg anxiety. 

A day without pain would be such a blessing I think I'd cry from relief.
« Last Edit: July 02, 2015, 08:20:46 AM by cari »

Sleepy In Seattle

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Re: Prednisone
« Reply #10 on: July 02, 2015, 08:58:22 AM »
It seems irresponsible for a doctor to give such vague instructions about taking such a serious medication...are you happy with your doc? Maybe this is just a miscommunication, but please make sure you have all the information you need and really understand what s/he is giving you. Don't ever feel bad about asking questions! :-)

5mg/day and under (of prednisone - prednisolone, while spelled in a similar way, DOES have different dosages, so be sure what you have!)  - anyway, 5mg or less of prednisone a day is considered a "biologic" dose - i.e., the amount most people naturally produce per day anyway, so it usually does not have bad side effects.

Short bursts are also usually not a huge problem -a few days at 20mg, then 10, then 5, then 2, then off.

Some people react badly, but that is typically (though not always) on longer-term situations. Most people can take short courses of it and benefit greatly without bad side effects. Most of us can take low doses (under 5mg/day) for longer periods of time and be fine with that, too. It CAN be very helpful, but should not be taken lightly.

The psychosis side effects are very rare. On higher doses sometimes people feel crabby or irritable, but the really serious problems are unlikely unless you are taking a lot of it (i.e., over 60mg/day) for several weeks at a time.

For some of us, it's really amazing how well it works - makes me feel like a healthy 20-year-old (I'm 47). I wish it didn't have so many serious long-term side effects - if it didn't, all my health problems would be solved! :-P But I don't want to end up with Cushings or have my bones dissolve, so I only take it if I absolutely have to.
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warmwaters

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Re: Prednisone
« Reply #11 on: July 02, 2015, 09:00:05 AM »
And just to be clear - those instructions are going to vary by individual. I also use prednisone to break a flare, but using a different pattern than the one described by Jasper.

It seems to me that it may be worth trying the prednisone now, while you have access to your rheumatologist.  You will find out
1) To what degree it helps you.  BTW, it reduces the inflammation and suppresses the immune system. It is not a pain reliever - though by suppressing the inflammation, it does help with the pain.

2) To what degree you have any short term side effects. For example, I get very wired and irritable after several days of prednisone.  Not everyone does, but it's good to know what your side effects are.

3) Gives you a chance to talk with your rheumy about adjusting the dosing, depending on your reactions.

I assume you have come up with a way of continuing your medical care while in Thailand?  Or have a way of contacting your current rheumy, if you don't plan to use Thai doctors?

Best of luck.

 
Cari ..... The Prednisone prescription should have very specific directions on the bottle for exactly how to take it. It should state exactly how many tablets to take each day and for how many days. You cannot just start taking any old dose and then abruptly stop it after a month.

If you start taking Prednisone and then abruptly stop taking it, you run the risk of adrenal failure. It has to be tapered over several days.

http://www.medicinenet.com/steroid_withdrawal/article.htm

I have a Prednison prescription to take for flares. These are the instructions:
Prednisone 5 mg
Take 4 tablets daily for 5 days
Then, take 3 tablets daily for 5 days
Then, take 2 tablets daily for 5 days
Then, take 1 tablet daily for 5 days
Then Stop.

BTW, most of the side effects (weight gain, fluid retention, diabetes, etc.) don't occur when Prednison is taken for short periods of time, like for a flare. They occur when one is on long term therapy. So, for short term treatment, like for flares, the main concern is that the Prednison is tapered properly.
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Jasper

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Re: Prednisone
« Reply #12 on: July 02, 2015, 09:14:39 AM »
Cari ..... I just thought I would mention that I was on high dose Prednisone for almost a year in 1994 when I had Systemic Vasculitis. I was on 70 mg a day for several months.

I did develop weight gain. I used to be very thin, 118 pounds and 5 feet 7 inches tall, actually underweight. I gained 25 pounds the first year. While I had never had a weight problem prior to taking  Prednisone, I have had a weight problem ever since taking Prednisone. Being on the Prednisone for as long as I was, seemed to change my entire metabolism. I continued to gain weight even after stopping the Prednisone. While it used to be very easy for me to drop a few pounds, now it is extremely difficult to drop any weight.

I also had a moon face and a buffalo hump. The moon face and buffalo hump disappeared after I stopped the Prednisone.

I did not have any Anxiety or Depression from the Prednisone. I did have a lot of energy while taking the Prednisone, but I did not have nervousness. I have a history of Depression (1983 and 2011) but the Prednisone did not cause any Depression.

I have noticed that I have difficulty falling asleep when I am on the lower dose Prednisone for the flares.

Also, I agree with Warmwaters. The Prednisone flare tapers are individual. I was only posting my instructions so you can see how detailed they are (not that you or anyone else should be using my instructions). In fact, my original taper had different instructions and was for a lower dosage and shorter length of time. It did not work due to the low dosage, so my Rheumatologist changed the order to start with 20 mg a day and taper from there.
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Sweetcheex76

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Re: Prednisone
« Reply #13 on: July 02, 2015, 09:48:23 AM »
Hi Cari-

I saw you mentioned you have a history of depression so you have every right to be concerned. Prednisone can bring on anxiety and depression. You may want to mention it to your doctor but usually they just say something like, "it's a low dose so it probably won't affect you", but it can.

I suffer from depression and over the years, before my Sjogrens diagnosis, I've taken several prednisone packs for sinus infections, etc. About 1/3 of the time, I got depressed. A few months ago I was in the middle of the worst flare ever and my doctor prescribed prednisone. The depression and anxiety came on so strongly, I was frightened. I've never felt that depressed before. My doctor had me stop taking it with one day left. I will never take it again.

I guess my point is, everyone is different. Try it and it could be very beneficial and you could have no issues. But, if you feel anxiety or depression, call your doctor right away. Good luck to you and hopefully, it will make you feel much better.
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rnathans

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Re: Prednisone
« Reply #14 on: July 02, 2015, 11:25:46 AM »
If you are in fact being told to take 25 mg a day for 28 days that does seem to be quite a high dose to start out with. For a few days maybe and then taper or a steady low dose for a month but this just seems wrong. And 25 mg a day will likely negatively impact your mood. I get 20 mg of IV decadron ( not exactly the same drug) one day a month with my IV cytoxan and I have a few really rough days. I or my husband have to constantly remind me that it will pass in a few days. I HATE how steroids make me feel. At 25 mg a day you may very well have trouble sleeping too. I know lack of sleep is an immediate trigger for me to feel sad and teary.