Author Topic: Prednisolone  (Read 8392 times)

irish

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Re: Prednisone
« Reply #15 on: July 02, 2015, 02:16:30 PM »
Have you checked the directions on each box??? Each box may have a set of directions and the boxes may be numbered as 1 through 5. This may be a long burst and taper. If you don't understand then please call the doctor.

Yes, prednisone can have some side effects and you should call the doctor if you have anything that bothers you. Tapering down too fast can give a person some issues, but we are all different and you will have to keep track of how you feel and check with the doctor if you feel the need.

Also, the pharmacist should have talked about the prednisone with you also to make the directions clear. You can call them and talk to the one who filled the prescription. Check the label and you should see the initials or name of the pharmacist. Good luck. Irish

cccourt1942

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Re: Prednisone
« Reply #16 on: July 02, 2015, 03:20:08 PM »
I have received Rx instructions written incorrectly or incompletely more than once.  It happens very seldom...but it DOES/CAN happen.  It may have been an honest mistake.  There are enough responses to verify you need more info...and that must have been written incompletely or incorrectly.
c3
Sjogren's, Psoriasis, Hashimoto's, Osteoporosis, Osteoarthritis, Cold hands/feet,  fatigue,  pilocarpine-25 mg , Restasis, Plaquenil, Low dose Prednisone (2-3 mg daily) Xylimelt, Citrucel, Alcon-Naturale, Tears,Omega 3, Vit.D, Caltrate+D3, Fosamax, CoQ10, Zinc, Oxtellar. Levothyroxene

cari

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Re: Prednisone
« Reply #17 on: July 02, 2015, 03:21:07 PM »
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.

The person who prescribed was my initial rheumatologist (the one who originally diagnosed me).  I'm now with the Sjogren's clinic.  No he didn't explain how to use the medication and it just says on every box, take five once a day.  There is no taper written on the box.  I have Prednisolone 5mg pills.  I understand the side effects are rare but am sensitive to medication and don't want to start hearing voices ;)  Thanks :)

cari

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Re: Prednisone
« Reply #18 on: July 02, 2015, 03:25:51 PM »
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.



I spoke to the rheumatologist before I took the Thailand internship.  He said that this condition is very common in South east asia and doctors are used to treating it.  I don't have a way of contacting my rheumatologist (we can't directly contact our rheumatologist in the UK so I can't just phone to speak to him) except perhaps through his admin.  I will discuss this with him before I leave.  I'm also concerned that this won't help with the pain.  Is so there's no point me taking it.  My inflammation is no where near as bad as when I had the cortisone shot in April.  Doesn't seem worth taking it for the pain then.  Thanks.
« Last Edit: July 02, 2015, 03:38:18 PM by cari »

cari

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Re: Prednisone
« Reply #19 on: July 02, 2015, 03:28:43 PM »
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.

I'm struggling with weight gain at the moment which may be due to hormonal problems so really don't want to put on any more weight.  Not from an aesthetic perspective but from a health perspective.  It puts more weight on my joints adding to the pain and is really unhealthy when my health should be my priority right now.  I also experienced weight gain exactly as you describe after taking anti depressents before, so really dont' want to go back to all that.  Thanks for letting me know about the side effects.

cari

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Re: Prednisone
« Reply #20 on: July 02, 2015, 03:30:37 PM »
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.

This is what I'm really worried about.  I already suffer from anxiety and have suffered from depression in the past.  I'm okay with hydroxy. because it doesn't have those side effects.  I had a shot of cortisone to bring down inflammation in April and am currently feeling down so wonder if it's anything to do with that. 

cari

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Re: Prednisone
« Reply #21 on: July 02, 2015, 03:31:56 PM »
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.

There's nothing on the box about tapering but it does say take 5mg x 5 once a day so that's 25mg for 30 days.  Perhaps the dosing is different to prednisone.

cari

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Re: Prednisone
« Reply #22 on: July 02, 2015, 03:33:31 PM »
Have you checked the directions on each box??? Each box may have a set of directions and the boxes may be numbered as 1 through 5. This may be a long burst and taper. If you don't understand then please call the doctor.

Yes, prednisone can have some side effects and you should call the doctor if you have anything that bothers you. Tapering down too fast can give a person some issues, but we are all different and you will have to keep track of how you feel and check with the doctor if you feel the need.

Also, the pharmacist should have talked about the prednisone with you also to make the directions clear. You can call them and talk to the one who filled the prescription. Check the label and you should see the initials or name of the pharmacist. Good luck. Irish

Yes have checked each box and each box says exactly the same thing.  I'm calling my doctor tomorrow for a chat regarding this and if she's no help, will call the pharmacist.  I've also called the rheumatologist's admin and left a message that I need to speak to someone regarding some medication.  Thanks :)

cari

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Re: Prednisone
« Reply #23 on: July 02, 2015, 03:35:30 PM »
I have received Rx instructions written incorrectly or incompletely more than once.  It happens very seldom...but it DOES/CAN happen.  It may have been an honest mistake.  There are enough responses to verify you need more info...and that must have been written incompletely or incorrectly.
c3

I'm wondering if the directions are correct and it's taken differently to prednisone. I assumed it was the same medication under a different brand name.  I'm going to sort this out tomorrow and am glad I asked because otherwise I would have taken them as described. Thanks :)

cari

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Re: Prednisone
« Reply #24 on: July 03, 2015, 01:57:46 AM »
I called the pharmacist who said that this was a normal dose given for this medication.  He said that it would be very good for bringing down a flare but the amount given was not usual.  He said that with a 'flare' it would be one to two weeks at a high dose with no taper necessary.  He said for longer than that, it would be given at a low dose for a longer period of time (which is usual for rheumatology) and would need a taper over four weeks.  One week four tablets, one week three etc.  He said that he had no instruction from the rheumatologist on how these were to be taken other than five per day and said it was unusual to be given them for a month.  He suggested that if I needed to take them, take them at the dose prescribed and arrange to see a rheumatologist on how to continue or how to stop them.

In the meantime I've called the prescribing rheumatolgoists' office and left a message again for them to call me in order to discuss a medication.  I want to discuss side effects as well as dose. I'll let you know what he says.

angelina

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Re: Prednisone
« Reply #25 on: July 05, 2015, 04:28:07 PM »
I just began treatment for sjogrens too. I take 400mg plaquenil a day and am on 10mg prednisone too.

Different parts of me are attacked each day. Yesterday it was my dry mouth and eyes, today it's my hips and knees killing me........such a weird thing this sjogrens disease.
34 yrs old- sjogrens, lupus, graves disease, peripheral neuropathy, anxiety, PPD- on plaque nil 400mg, prednisone 10mg, celexa 40mg, dairy/gluten free

irish

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Re: Prednisone
« Reply #26 on: July 05, 2015, 07:57:57 PM »
My specialists tend to treat with a burst and taper quite often. The first 5 days of a high dose of prednisone can be taken and no prednisone after that. If a person goes longer than the 5 days with a higher dose then a taper is in order.

As a nurse I have seen the burst and tapers done many different ways and they all work--just a preference that a doctor likes. My hubby was on 40 mgm 3 days, 30 mgm x 3 days, 20 mgm x 3 days, 10 mgm x 3 days, 5 mgm x 2 days and 1 mgm x 2 days. This is just an example of one way this can be done.

Out pulmonologist didn't want him on daily prednisone until later on in his illness. He had severe pulmonary disease and was very unstable. At times he would get off the taper and within 5 days he would get worse and I would call and she would say to start the taper again. This worked well for him and even though it was a lot of work keeping up with all his meds plus this very changeable dosage schedule it kept him from having earlier onset weight gain.

Ask your doc if you could take a taper dose and see how it goes and then have the option to do taper doses in the future. The prednisone shot stays in your body for a longer time, but it also decreases in strength within your body as the days go by. I haven't heard or read much about any depression etc with the shots. April is 3 months back at least and I would be surprised if you would still hae side effects.

If you have depression I would think that there would be a med that would work for you. Truth is, Sjogrens patients have a high rate of depression and anxiety associated with the disease and most people need the antidepressants. I swear that the chemicals produced in the brain that prevent depression also dry up with Sjogrens. I have had Sjogrens about 50 years and just diagnosed in 2003. However, I have suffered from depression and horrible anxiety about 45 years and my life was very difficult until I got started on Zoloft back in 1992. I tried about 5 different antidepressants over the years and kept going back to the Zoloft. It treats the depression plus has a high anti-anxiety affect/

I hope you get this settled and have a good experience in the future. Irish

quietdynamics

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Re: Prednisone
« Reply #27 on: July 06, 2015, 05:33:32 AM »
Dr. @ Sjogrens Center Rx'd prednisone extended trial.
Instructions in my case were:
Quantity 100 tablets @ 5mg. Take 3 once daily for 14 days then decrease by 2.5 weekly until 5mg daily. Stop.

Hope you get clarification from Rhuem on how to take med.

However, in your post "Dr. prescribed for flare during trip (away from home)" so not sure Dr. will be inclined to refill.  I believe they are cautious with Rx at this dose and it is meant to interrupt a flare.. similar to a pulse.

Side effects are usually for those patients who may have a medical condition requiring med long term. As with most medications "benefit vs.risk" in overall disease management/progression.
Even the long term use of OTC aspirin can have risks.. but, some people need the benefit.

As you likely are aware the efficacy of plaquinel is at the 4-6 month mark.
« Last Edit: July 06, 2015, 05:37:38 AM by quietdynamics »
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cari

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Re: Prednisone
« Reply #28 on: July 06, 2015, 09:58:52 AM »
My specialists tend to treat with a burst and taper quite often. The first 5 days of a high dose of prednisone can be taken and no prednisone after that. If a person goes longer than the 5 days with a higher dose then a taper is in order.

As a nurse I have seen the burst and tapers done many different ways and they all work--just a preference that a doctor likes. My hubby was on 40 mgm 3 days, 30 mgm x 3 days, 20 mgm x 3 days, 10 mgm x 3 days, 5 mgm x 2 days and 1 mgm x 2 days. This is just an example of one way this can be done.

Out pulmonologist didn't want him on daily prednisone until later on in his illness. He had severe pulmonary disease and was very unstable. At times he would get off the taper and within 5 days he would get worse and I would call and she would say to start the taper again. This worked well for him and even though it was a lot of work keeping up with all his meds plus this very changeable dosage schedule it kept him from having earlier onset weight gain.

Ask your doc if you could take a taper dose and see how it goes and then have the option to do taper doses in the future. The prednisone shot stays in your body for a longer time, but it also decreases in strength within your body as the days go by. I haven't heard or read much about any depression etc with the shots. April is 3 months back at least and I would be surprised if you would still hae side effects.

If you have depression I would think that there would be a med that would work for you. Truth is, Sjogrens patients have a high rate of depression and anxiety associated with the disease and most people need the antidepressants. I swear that the chemicals produced in the brain that prevent depression also dry up with Sjogrens. I have had Sjogrens about 50 years and just diagnosed in 2003. However, I have suffered from depression and horrible anxiety about 45 years and my life was very difficult until I got started on Zoloft back in 1992. I tried about 5 different antidepressants over the years and kept going back to the Zoloft. It treats the depression plus has a high anti-anxiety affect/

I hope you get this settled and have a good experience in the future. Irish

Thanks for your response.  I made a mistake in the medication that I was prescribed and it's actually Prednisolone.  I am waiting for the rheumatologist to get back to me regarding dose etc. As far as depression medication is concerned, thank you for your concern but I don't want to take anti depressants if I don't have to.  I feel down, not depressed.

Thanks again :)

cari

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Re: Prednisone
« Reply #29 on: July 06, 2015, 10:01:12 AM »
I just began treatment for sjogrens too. I take 400mg plaquenil a day and am on 10mg prednisone too.

Different parts of me are attacked each day. Yesterday it was my dry mouth and eyes, today it's my hips and knees killing me........such a weird thing this sjogrens disease.

Yes it's strange. For me at the moment it's my knee joints and skin of my shins.  They are burning and the joints are very painful.  You never know where it is going to strike next.  Are you having any side effects from the prednisone?