Prednisone Dosage for Rheumatoid Arthritis
Prednisone Dosage for Rheumatoid Arthritis / Disease (UPDATED 2016)
The prednisone debate is actually more than one debate. How much? For how long? Does it only mask symptoms? Or does it slow the disease? At what risk? A wide range in prednisone dosage for rheumatoid arthritis has been used to study its risks and benefits. This makes it more difficult to compare its risks and benefits. This series examines some the most modern theories and studies on prednisone use for Rheumatoid Arthritis.
Interested in the history of steroids and RA? Here’s a couple of articles you’ll love
History of prednisone dosage for Rheumatoid Arthritis
Back when my grandfather and some of our older warriors took glucocorticoids, it was cortisone. The doses were high. The results were great. The side effects were devastating.
Soon doctors recognized the dangers and glucocorticoid use became much more conservative – even scarce. They prescribed aspirin, and gold. Eventually, prednisone gained the trust of doctors because, though a weaker form of steroid, it retains the legendary effectiveness. Steroids have become the miracle drug for many conditions, especially for acute illnesses. However, for Rheumatoid Disease, the debate continues.
“More than 50 years after their introduction into clinical practice, the possible disease-modifying effect of glucocorticoids remains unresolved, as do the differing opinions on their side effects. This leads to totally contradictory statements by respected opinion leaders concerning the role of glucocorticoids in the management of RA,” Arthritis and Rheumatism, Germany.
4 Types of prednisone dosage for Rheumatoid Arthritis
1. Bridge: These days, prednisone for Rheumatoid Arthritis is often recommended as a bridge medicine. It temporarily suppresses the symptoms of RA, giving slower acting treatments time to take effect. This is prednisone at its best, showing off immediate and glorious results and then exiting stage left.
2. Bursts: Another common way that RA is treated with prednisone today is with short term higher doses in a taper fashion. A prednisone burst is often several days to treat an RA “flare,” but can be longer. It varies a great deal according to the philosophy of the doctor.
3. Long-term low dose: When DMARDs are not effective in controlling RA, prednisone may be used as a long term component of the treatment. You might find it interesting to read the comments about the length of time many RA patients have used prednisone on this previous post – click here. There are not very many articles advocating long-term use of prednisone, but there are a lot of doctors prescribing it that way. The notion of how low is a “low dose” seems to vary a lot with doctors, as you’ll see when you read those comments. (Note: low often means 10mg per day or less and very low means 5mg per day or less.)
4. Long term high dose: I’ve never seen this advocated in an academic journal or by a university hospital. There is no way to prove how common this is, but I’ve personally heard from many patients who have lived it. How high is high? How long is long? It’s subjective, of course. But, I’ll tell you what my doctor said when I mentioned some of the doses that I’ve heard from other patients. Doc joked, “Are those rheumatologists in jail?”
Early low-dose prednisone for Rheumatoid Arthritis
There is a lot of talk about treating Rheumatoid Arthritis early with disease modifying anti-rheumatic drugs (DMARDs). In recent years, there have even been several studies on very early treatment in attempts to find the pot of gold at the end of the rainbow a way to bring remission to more patients. Some researchers have shown that the use of low-dose steroids early in the disease increases the rate of remissions and improves clinical status. In the next post in this series, we’ll look closer at the use of low-dose prednisone in early Rheumatoid Arthritis.
Recommended reading:
- Prednisone and Rheumatoid Arthritis
- Prednisone Uses for Rheumatoid Arthritis
- Treatment of Rheumatoid Arthritis Today
- Prednisone Side Effects
Footnotes Many articles provided background for this series; however the following were particularly helpful: Journal of Rheumatology * Interscience Wiley * British Medical Journal
Daily practice shows lots of patients with unnecessary high doses of glucocorticoids! Dose too high, duration too short. Our colleagues 10 km across the Rhine (Ratingen) have shown that low dose prednisolone is very helpful in the magement of rheumatoid arthritis.
Kelly, thanks very much to bring this important tpoc to the public!
Lothar 🙂
Thanks doc! Yes, some of the great articles I read were on studies from from Germany! This is important since it’s the most effective medicine for reducing RA symptoms – and the most dangerous. We need to find the best way to help patients feel better and yet protect them from harm. I know that’s your goal! 😀
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Predisone is the love/hate drug. I love it because I was able to move while trying to get pregnant. I was able to use it during pregnancy. It took 5 years to get pregnant. Well after I had my twins I was move up to very dosage since the RA was so sever. I was up to 60mgs a night. And somtimes 100 mgs a night. I couldnt afford the biologis at the time. So that puts me at using predison for 6-7 years everynight. It made me feel good. But also it gave me Cushings, Nercosis of the hip, OS. I regret it somtimes. But when I look at my babies, I dont b/c I would not have been able to pick them up at the time. Predison works, it is amazing. The side effects are horrible. You have to pick and chose your battles
Pregnancy seems to be one good reason to have pred available. I hear that a lot. Most people have some relief from RA once the pregnancy happens – did you? Those are pretty high doses. Did you have any trouble getting off the prednisone?
I have been on the high dose predisone for almost three weeks . due to a massive flare. the first round of meds only slowed i am now 3/4th the way thru the second round. it is helping this second round. never befor have I had to take two full rounds to stop a flare.bbbut it truly is a wonder drug!
Janie, I hope the flare ends for you soon.
I can’t thank you enough for all this wealth of information. I have been on prednisone for over a year and yes it does make me feel better. I have been very concern about the effects. So far I have seen very little-the round face and some weight gain. I have been on 5-15 mg each day over this course of a year. The Dr. keeps trying to get me off of it and when I am on the lower dose I just plain hurt and a swell. I was surprised to hear that people have been on it for so long. I will know now what to watch for in the future and have more a more educated discussion with my Dr. Thank you Kelly for all your hard work.
Thank you Kristi. You probably already did see them, but the comments on the other pred article might help. What has he tried to get you off it?
I have been in horrible flare for almost a year now….I’ve said no to pred because I am an optometrist and know first hand the bad side effects from long term or high dosage, but I am at my wit’s end… I take methotrexate (8 tabs per week), Indomethacin, Rituxan IV (have had 4 treatments) and pain meds…. I have tried Plaquenil, Humira, and Enbrel without success…. So, my question is, should I give in and try Prednisone or try injectable methotrexate, or something else first? Any advice or experiences would be greatly appreciated! Soft hugs to all!!!
Anna, I understand – I’m in the same boat. I’m not the doctor of course, but I’d personally try the injectable methotrexate – I did. And perhaps in the next few months, your doc will re-assess your biologic. As far as the pred goes, I’m sitting on that cliff with you Anna. The research I’m doing on the new idea of “very” low dose sounds promising. However, most of it is with regard to early treatment. How long have you had RA symptoms? Mine go back so many years that I wonder whether it would work the same.
I was diagnosed when I was 39, I am now 42…. but have had symptoms for years before. I am to the point where I feel like if I want any type of quality life, I am going to have to accept some of the bad side effects…. When I go to the rheumy, I usually see the PA that works with him, except this last time…. I was so discouraged because he said “Well I don’t think your RA is a problem, I think you have Fibromyalgia….” which I understand, however he prescribes water therapy, which would be great if I lived in a city with an aquatic center… I live in a small town and the nearest place is 45 minutes away, and I can’t do that 3-4 times a week and work and take care of house and kids. Ive also been going to physical therapy 2-3 times a week where they “laser” the fibro points and use parrafin for my hands. I tell the rheumy that and he completely doesn’t hear or doesn’t listen. The only fibro points that I have that are tender are my hips, however every joint in my body is swollen and aches and is “hot”. I felt his comments were so insensitive. When I go back next month, the appt is with the PA. This rheumy does not manage my pain, my general physician does that. He also left it up to my general physician to prescribe Savella for the Fibro, which I’ve had to stop and restart at a lower dosage because it made my blood pressure spike. I just don’t know what to do, this is the second rheumatologist I’ve had (the first spent 2 minutes with me each visit, not listen and not see me back for six months at a time while wearing five inch heels to each “visit”) I am so frustrated… don’t know what to do….
Anna, I hear what you are telling me all the time from people. This is a big problem right now & I don’t have a magic answer. I’m “frustrated” about this confusion too because it just does not sound right. Your symptoms sound like typical RA symptoms to me, too. What has helped most people I know is to get another dr. That is completely up to you & all I can do is tell you what I’ve experience or been told by others. That said, did you read the fibromyalgia post & comments (click here)? It’s only a start, but the links there are really interesting for this debate. I learned a lot from them & I’ve been trying to sort this out for a while.
I’m hoping to read the book mentioned in the fibro post and publish a book review soon. There’s new guidelines for calling it FMS now too. Click here.
Thank you, Kelly… I know you hear this all the time, but I am so glad that you have created this place for us to go, when no one else understands, it’s comforting to know that there are people out there experiencing the same things. It is nice to know we are not alone!!! And I am going to do some more research on the rheumatologists that are here… <3
:heart: Anna, I’m sorry if I confused you. I said “I hear this all the time” just to tell you that I think you’re not alone. I mean – it’s not you. It’s a problem that sometimes some rheumatologists don’t “hear” their patients and tell them that they must have FMS if their RA does not respond to treatment (like you said). I think you will see some of that too as you read around on the blog.
I understand! I knew what you meant. I read people’s praises for this site everyday….which is what I was eluding to. It is sad that some Drs. want to be so quick to slap us with a different diagnosis when we’re not responding like textbook patients. I believe I will ask about the MTX injections before succumbing to Pred. I just saw a 45 year old last week that I scheduled for cataract surgery because she had been on Prednisone for two years….
Sigh, I know. If you’ve read much Warrior, then you also know I think we need some new textbooks. 😉
Anna, This happened to me. I was so frustrated after that appointment.I even began doubting my instincts. Kelly helped me see that I was not alone and helped me through it. I have since responded pretty well to Enbrel and switched to a doctor that wrote a book on FMS. He disagrees with my old doctor. I continue to have some flares, so I don’t consider my response remission. I hope that you will get the understanding you need and find relief from your pain. I can see why it’s hard to make the decision whether to take prednisone.
Thanks for sharing that Ronda. I know there are lots of readers who don’t comment (many just email ) and they will find it helpful to hear your story.
If you go on the Methotrexate; please talk to your Dr and make sure they explain all the LONG TERM effects of using this drug. My mistake was not asking questions. I used the pills at first; then I went to the shot. Then back to the maximum dosage amount allowed on the pills. Which led to a lung DISEASE. I had no idea I could bothered by such a disease at this stage in life. My advice is to inform yourself!!! Inform*Inform*Inform
Kelly,
The Dr. has tried to lower my dosage of Prednisone but each time I go lower that 10mg I swell and hurt. I am also on the mtx and enbrel but honestly the pred. works the best.
Kristi
Yes, I hear you. The ideal would be to get a treatment for us (like the Enbrel is for some people) that will make the pred less necessary. I know what you mean though – I hurt too. 🙁
I was on pred. for over a yeah..hated it and loved it…but when i got off it my feet swelled up so bad ..it was horrible..Heres a question for everone! why do we have rheumys when i’m told by mine that if i need pain management I need to see my PCP?..what exactly am I paying a rheumy for? I’m frustrated!
thanks
Kim
Frustrating huh? They can treat the disease with the disease meds, but after that, their hands seem tied. Maybe it’s their training? Some do injections or pain meds, but many do send out for that.
I Have been on Pred for the last year, waiting for all the other meds to work. So far I can’t seem to get under 5mg without crippling up. I love it cause it make me feel normal, no swelling, I can function. But I also have high blood presser now and have put on 50lbs. So what to do..My Father was on hundreds of mgs, this was before all the new meds that are out there. Watching him suffer with some unknown muscle disease was awful. So I’m grateful I don’t need that amount to function, and I have a feeling I will never be able to go without.
Good luck to you Sandi! I know a lot of people who are in that situation & at least it’s a very low dose & it still helps.
I am 46 , was diagnosed at age 42, I have been taking 2 mg of pred a day for about 3 months and subq mtx once a week( for 2 years) with good results, But the most results i have had have been from my diet! I eat Paleo diet, especially NO sugar. Whenever I have even a little bit of sugar I swell the next day in knees and wrists and cant move. I also take apple cider vinegar(with the mother) a TBSP a day in a glass of water. I feel this helps with inflammation. Thanks for your website!!
After weaning off Pred,with the docs help, that lasted about a couple of weeks and I got so bad I could barely walk or lift anything. The doc had me come in to the office and gave me a shot, then put me back on the Pred with an increased dose of 10mg. a day. He also thought the last batch of biologics because of not being iced properly was no good and gave me enough for a month to see if that could have been a part of the extreme flare. Within a week there has been 99% improvement, and I can once again wear shoes, and jeans that touch my ankles. I am terrified of the Pred and after finding out about more side effects, of which I now have Osteoporosis. Of course he upped my calcium w/D and I am supposed to take a pill for the osteo. I am on the Mtx 6 pills 1x a week, and if need be he will have me take the injectable Mtx, but since my last experiences with the vials and needles were not good, I hope not. I too was surprised by the high doses of pred others take and the number of years they have taken it, but if 10mg is considered a lower dose then I guess I’m stuck with it for awhile-or longer. Once again thank you Kelly for all you do in keeping others informed and providing a place to talk, and vent and wine and smile and laugh.
Sorry about the wine, I meant whine-of course.
Hi, thank-you SO much for this site! I feel I’m getting some real info here, and not just what the ads want us to believe. Plus now I know I’m not the only one who feels a bit like a guinea pig. I was diagnosed in December of 2010, and was put on 30 mg of prednisone a day by my family doctor, until I could get to a Rheumy. ( Went from barely able to move to wanting to do back flips) Am now on injectable mtx, which might be working a little, but I’m not too impressed and I think it’s the prednisone, now 10 mg/ that are keeping me somewhat functional. Tried to wean off slowly, ( 5mg am only) but soon hurt too much, so will
start Humira tommorrow with the hope it will help me get off prednisone. I haven’t seen any side effects from the prednisone yet, but my doctor said they can be worse than the side effects of Humira, which also scare me, but not as much as the damage uncontrolled RA can do.
Wish me luck with the Humira, I’m a bit nervous, but will let you know if it gets me off of the prednisone.
Good luck, Bonnie. I didn’t have any side effects from the Humira. I’m sure you’ll be careful to avoid infection – I guess that’s the most important thing.
Hi, so far so good with the Humira. I wasn’t sure it was doing any good, it’s so slow, and I still have pain,but as I look back I realize I can do more than I used to. No side effects , and yes I’m being careful about infections. Currently on 2.5 mg prednisone a day, and yesterday the rheumy said to take 5 mg every other day for a month, then stop altogether. He said I will feel fatigue for a few days, but wanted me to try weaning off this way. Has anyone tried this? Seems a bit harsh to me. Hopefully by then the Humira will really have kicked in, that will be 3 months into it
Good luck Bonnie! I’ve been tapering for mabye somewhere between seven months and a year. Can’t remember! I would not be able to withstand that every other day stuff, especially at 5 mgs. One or 2mgs, maybe. I just cut down to 1mg yesterday. Would like to be off of it before seeing new rheumy, but reasons to get off are other, important ones. I haven’t been off of it in years and years, and those other times was only able to stay off of it for a few weeks. Adding plaquenil, then increasing the mtx dose to 25mg oral, but split to take on Mondays and Friday. I’m told that these two meds work synergistically together, ie that plaqeunil increases the effect of the mtx.
HI
WHEN I FIRST WENT REALLY ILL ,NOT KNOWING MY PROBLEM AND ON HOLIDAY IN EASTERN TRANSVAAL IN THE MIDDLE OF THE DECEMBER HOLIDAY ,WITHOUT A DOCTOR IN SITE,I THOUGHT I WAS A GONNER ,BECAUSE I WAS SO ILL AND MY JOINTS SEVERLY INFLAMED THAT I COULD,T EVEN LIFT MY ARM TO COVER MY SELF WITH A THIN SHEET -I’VE BEEN DIAGNOSED WITH RA ALMOST TWO YEARS NOW AND I HAVE TRIED EVERY MEDICATION AND ONLY PREDNISONE HELPS ME -IM ON A VERY LOW DOSAGE -ONE TAB A DAY ,ONLY THE GENUINE PREDNISONE HELPS ME AND NOT THE GENERIC TYPE ,BUT IN THE MORNINGS I GET UP WITH INFLAMED MIDDLE,THIRD FINGER AND THUMBS ALSO MY LEFT PIVOT ON THE FOOT AND BIG TOE –IF I DO GO HIGHER ON MY DOSAGE THEN IT MAKES ME AGGRESIVE AND ANYTHING TRIGGERS ME OFF–ALSO I NOTICED ULCERATIONS ON BOTH SIDES OF MY TONGUE —
SUFFER WITH MAJOR ACID REFLUX AND I THINK THATS THE MAJOR CAUSE OF RA,WHEN YOUR PH LEVELS IS TOO ACIDIC –
I HAVE TRIED HOME REMEDIES LIKE PINCH OF BICARB IN A GLASS OF WATER 3X/DAY–HONEY AND CINNAMON –WENT ON A RAW VEGGIE DIET -AND RAW FRUIT AND VEG JUICE -THAT WAS THE WORST-ACUPUNCTURE-HERBAL DOCTORS SPENT WEEKS IN HOSPITALS ,RUNNING ALL KINDS OF TESTS AND XRAYS AND FIND NOTHING PHYSICALLY WRONG-AND SPENT THOUSANDS OF RANDS,ONLY TO FIND MYSELF WHERE I STARTED OFF–PROBLEM IS TO CONTROL MY DOSAGE –I USED TO SIT ON THE NET FOR MONTHS TRYING TO FIND SOMETHING OR A CURE OR RELIEF TO RA ,ONLY TO BE DISAPPOINTED -YOU KNOW WITH 6 BILLION PPL.ON THIS PLANET,SURELY THERE IS AT LEAST 2 MILLION PPL WITH RA. CAN’T SOMEONE FIND A CURE FOR THIS AILMENT -ITS REALLY FRUSTRATING –THE ULTIMATE ISSUE IS GETTING THE SPOUSE TO UNDERSTAND YOUR MEDICAL PROBLEM.
HI
READING ALL THESE MESSAGES DOES BRING SOME RELIEF TO US –
CAN’T ALL OF US SUFFERING FROM RA. PUT IN A SUB ON A MONTHLY BASIS TO OPEN UP A RESEARCH CENTRE TO HELP US PPL THAT HAVE CONTRACTED THIS DREADFULL DISEASE AFTER LIVING A NORMAL LIFE,
SURELY THE GOVERNMENT WILL ALSO SUBSIDISE THIS CAUSE-IT WILL BE A BENIFIT FOR OUR CHILDREN AND FUTURE GENERATIONS.
ONLY WHEN YOU HAVE EXPERIENCED THIS SEVERE DAILY INFLAMATION AND PAIN,WILL YOU UNDERSTAND THE AGONY THAT HAS ROBBED US OF OUR PEACEFULL AND JOYOUS LIVES-
I AM GOING TO BE 51 YEARS THIS DECEMBER AND HAVE PREVIOUSLY BEEN VERY ACTIVE AND PHYSICALLY FIT AND ALTHOUGH I TRY TO EXERCISE ,IT IS DIFFICULT
ONE THING I LOVE TO SAY IS THAT WE ARE IN THIS SITUATION DUE TO SOME MALFUNCTIONING ORGAN IN OUR BODIES ,LETS MAKE THE MOST OF IT AND NOT LET OUR PRESENT POSITION DETERMINE OUR FUTURE-
IF GOD IS WITH US WHO CAN BE AGAINST US
Thanks so much for this website. I just saw my rheumatologist yesterday, and he prescribed prednisone for when I have flares. He said to just take it when I feel one coming, and that I could take it for 4 or 5 days, but call him if I feel like I need it longer. (I live about an hour away from his office).
I decided to do some research on it before I ever need to take it, and this was one of the first sites that came up. VERY informative. I like that you can see other people’s experiences with the drug. Medical journals and research are great, but I would rather hear real-life experiences.
I was diagnosed with RA when I was 19, and I’m 30 now. I have acid reflux from all the NSAID’S I’ve been on, and I just wonder what all these drugs will do to me long-term. I am currently taking methotrexate, mobic & humira. That seems to be working pretty well.. I was on enbrel up until about 6 months ago when my insurance made me change to humira. Every once in a while, I just have these flare ups and nothing seems to help. I generally just grin and bear it, and go on about my day. Maybe the prednisone will provide some relief on those days.. just still really ‘iffy’ about taking it.
Please, may I know if it is usfull to exchange data about anti-citrulline presence in blood tests? Your site is great and has helped me a lot to focus on the issue, but I feel a bit “far away”. A message from you would be appeciated. ciao. massimo
I think you are the best thing going on for RA. I think you are the “go to” source for information that is relevant and research-based. And you address issues that people actually living with disease want addressed.
Thanks!
I havesuffered from ra,osteoporosis,austioarthritis , fibermyalgia , burstis for 3 years with different meds….i finally to a turn to i couldnt handle any more pain…i had taken prednizone befor but was taken off of it!???? i called my ra dr and he put ,e on a script you taper off of…..i haveactually felt so good and free of pain i have done house work etc i have neglected due to pain and fibermyalgia……i hope and pray he leaves me on some kind of dosage…it feels so good to feel good!!!!!!!!!
I know this is an old post but I was “googling”. I have used 5mg’s of prednisone for the last two years. I have had a really hard time with other RA meds and have not been able to get the arthritis under control. We are still searching for the right combination. It gets to a point where the short term relief outweighs the long-term risk. I am at that point. I cannot function without prednisone, literally speaking here. The pain is such that I am unable to even hold a coffee cup in my hand, much less actually get ready and go to work. I was really scared about the immediate future. That is when my doc put me on 5mg’s prednisone daily along with a monthly injection of Simponi. Since then I have not missed a single day of work due to my Rheumatoid Arthritis. I know that there could be trouble down the road (I turned 50 this year) and I will have to deal with it but for now, I can actually function and being a single income, I had to make a tough choice. I am praying that the prednisone side effects will take a while to show up and that I will be able to get as close to retirement as possible before it does me in. RA is a life altering and very painful condition where the medications used to treat it can be as harmful as the disease itself.
Hang in there Frankie. Just be sure you are following up with your Doc and pay attention to your body. I am a 54 year old male who has been living with Ra for 7 years. It takes time to figure out what works, but it will get resolved.
Hello, This is the only place to come for real life/real people info. My questions are… How bad should a flare be to up my prednisone? I am on 10mg/2 pills per day. I can only get up to 5MTX pills per day. Who can afford the Bios at $2,000 per month! Dr wants my on 5mg pred and 6MTX. Just can’t seem to get there. Doing what I am works. Only enough to keep me in bed but otherwise quality life. Dr says for flare I can up dose pred for a wk then taper back to usual dose. So, how long before increase wks? Could I take say an extra pill on a bad day? Must it be for a longer time like a week? Example.. Tomorrow is the 4th of July. Long day! Could I just take 1 extra? Would that work or help? Or does it take time? How bad does a flare need to be? This past wk has progressed for passed month my energy and muscle strength have been decreasing. You know, just difficult to move. Pain is not like before meds THANK GOD! Ok so I know med advice is a no no but would Very Much appreciate input PLEASE! Thank You.
I was put on Methotrexate and Celebrex once diagnosed with RA. Three months later I started the Prednisone for six months since the DMARDS were not working 100%. The Prednisone kept all the symptoms under control. I was not able to taper off the Prednisone completely without the symptoms coming back, so I was then prescribed Arava. This combination worked well for me although I now take Naproxen instead of Celebrex. The Prednisone did what it was supposed to do, and I did not suffer any side effects.
Ok, this means I am on a high dose daily. For several years now. Things get very bad very quickly when I try to taper even by 1 mg. I have to be functional for my job. I know there are side effects but functionality outweighs them. Interesting summary of the drug — but some people can’t function without it…my 2 cents!
I have been on a low dose of prednisone for 14 years now. I started on 7 mgs and am now down to 1mg and 2mg on alternating days. I have been doing that for 1.5 years and not able to kick it completely or get it down to 1 mg/day. I used to be on methotrxate injection, but blood test showed it was beginning to effect my liver. i was also taking Enbrel at the time until i had travelling numbness in my legs. Kineret was OK, but the daily shots wore me down, and Humira is my current bilogical – seems to work, but I have had the skin cancer (basal cell) associated with the biologicals – never know what the cause actually was/is. I am currently in a flare with horrible leg pain at night – diabetes is ruled out. My part-time work has become full time since August and my doctor thinks it could be the stress and no time to manage exercise/activity (physical therapy at home). How is one able to afford the treatment and tests without working fulltime? It is a Catch-22… I am a very slight build. Have the studies shown if there are differences with the medications for slight, medium, or heavy builds / gender? I always wonder about taking the same dose as my friend who is about 100 pounds bigger then myself and male. Thanks for the site.
Anne, you would obviously be correct about BMI and medications doses, but I haven’t seen much study on it. Since the dosing is so individual anyway, it would be based on how it affects you & the shared decision of you and your docs.
BTW, I remember bringing up the same point about methotrexate, & docs told me it makes no difference; yet the CDC does have a ml/kg cut-off for “immune suppression” with mtx.
I’ve been on low dose Pred for longer than I can remember, occasionally the dose will go up to help through a flare. The last time I brought up getting off Pred my #Rheumy said most likely never, I don’t know but I assume it’s due to the length of time I’ve been on the very low dose of 5mg.
I was on low dose predisone when first diagnosed. Doc took me off citing bad side effects. I can however take prednisone when I have a flare.I am on methotrexate and Arava(generic). I have many side effects with these medications including intestinal upsets . My last office visit I was told I would need to cut back on my medications because of my liver function. I was offered Enbrel and Humira which I refused. I have had Breast cancer and a double masectomy. I also was diagnosed with a small tumor in my spine which was removed and I had radiation treatment. Those are the reasons I refused the other treatments. The Dr. also gave me some info about another drug treatment Rituxan. I am going to talk about these drugs with my oncologist. This is an awful disease. I sometimes think predisone is better than all of the rest. Thanks for listening.
I am currently 54 year old male. My diagnoses of RA took 2 years. Test did not show any problems. I am 6 years in and ran the gamete of drugs. I am using Enbrel 50 mg injection 1/wk. As of this day the injections are effective in stopping the progression of the disease. However the severe pain is not controlled by the injections. That brings me to my point about Prednisone therapy. I am what is termed prednisone dependent. I cannot function for very long unless I dose. For myself the dosage of 5mg daily seems to work well. Probably 75%. I could dose higher for more relief but really am worried about the daily long term usage. I have tried many approaches to healing myself but sad to say I have failed. What ever the trigger is for this disease, has eluded me.
I was very pleased when I stumbled on this article and want to confirm that I believe this info is exactly what I have experienced. My Dr. is convinced that a dose of 10mg or less daily, long term is an acceptable dose. He actually prefers 7mg or less daily. For some quality of life is only obtainable with the use of these drugs. I necessary trade off I suppose.
Kelly,
I was one of those people on extremely high doses of prednisone without relief. I changed rheumatologists because when I reported pain, my rheumatologist instructed me to increase my steroids. At one appointment, I requested something for pain and he rolled his eyes and told me “you don’t even have erosions”. Well, here I am today with a new rheumatologist who I like very much, and changed off prednisone to methylpred for better absorption and down to under 20 mg daily. I was taking 60 to 80 mg daily for over a year and lesser doses for the past 8 years. Sunday my hip started hurting horribly, and I have had this before. A flare?? When it was still painful 4 days later I went to walkin clinic for an xray. Avascular Necrosis on plain films. Will be having an MRI tomorrow hopefully for staging. This is a risk factor for long term and high dose steroids. ER doctor told me that it is likely that I will require total hip replacement. Wow! On the outside though, I look quite healthy. I will never forget that doctor telling me “you don’t even have erosions”. You certainly cannot judge a book by its cover or by its 5 year old foot and hand xrays.
I think prednisone got me through many flares, but at what cost? I’m with a great rheumatologist now, but there is no undoing what is done. The previous rheum knew the high doses of steroids that I was on to “control the pain. Steroids are important part of therapy, but I think it is taken for granted that they are a powerful hormone that can cause just as many problems if misused or overused. It probably would have been most appropriate and cost effective for the physician to listen to the patient when the patient reported pain.
I am a 52 year old female. I was just diagnosed with RA yesterday. My new rheumatologist just prescribed me pred 5mg 2x’s a day. Am petrified because I personally have seen what it can do to a persons body. I am not prepared to accept my fate at the hands of someone who will never take this type of medication themselves. I also have fibromyalgia for 10 years and only take lyrica which helps me sleep.I just want to say my father had RA and survived to almost 80 without meds and was very energetic and independant. I plan on doing what he’s done because I do not believe in all the so called help drugs when all they do is hurt and harm than help in the long run. I also have a new ulcer which is being treated and do not need something aggravating it. I am going to fight this with or without my rheumstologists help. Thank you for listening
I have recently been diagnosed (Aug 19) with RA at 48, RF-Negative and have a Vectra score of 24.
My Rheumetologist started me on Prednisone (20mg for 7 days then tapering) just over one week ago until the Methatrexate injections begin to work. My doctor is young and does not understand and was surprised when I had a 36 hours flare from my left shoulder to the tips of my left arm.
Here is my question: after 8 days of Prednisone shouldn’t I be feeling better? My hands are still sore, weak, and sensitive so even holding this iPad hurts. Should I call my doctor again or is this pain just normal everyday life now?
Thanks in advance
Annie
I’m new to this subculture of torment as well. I felt literally shot down by the shockingly sudden pain bursts, after only 2 days of steroid. I was pretty much floating with some apparently naive euphoria that I was out of the pain woods, and headed to maintenance meds. Effective ones of course.
I have been having delusions of arsenic poisoning; the true conspiracy behind gluten-free/etc.
Or so I tell myself…nothing short of metal poisoning have such devastating constitutional effects.
Whatever,whenever the answer is available, I have decided early on, before even formal diagnosis: it is bigger than me. I am grateful for support; heartbroken of the suffering of so many behind it.
I will rather stay on prednisone (whatever dose gives me normalcy), for the rest of a shortened probation here on earth, and spend my time growing in the light of beautiful spirits of others. Then morphine me to a better place- I need to leave laughter, understanding, put a smile a stronger person’s face.
For my son, Briar, my firstborn of five, who has told me “I am glad my challenge is Autism…I know all about that…it is Schizophrenia and PMS that scare me; they are the worst things a person can have.”
Thank you for the inspiration, distraction /focus on others is best outcome for my clueless life.
Please rest well, as you all can, brave & valiant Warriors, of the hidden night.
I have glaucoma that is my qualifier for what I am about to report. Prednisone can be a Godsend. I never not have pain and swelling but sometimes it getsbad enough that mtx and sulfsalazine and humira can’t control it so, my Rhumy says prednizone. But I have to have daily eye pressure monitoring by my eye doctor,because ,prednisone raises eyepressures quickly and drastically. Which can lead to blindness. Prednisone is the only time I don’t have pain for a couple of hours aday. Tramadol, vicodin,and/or percocet only makes the pain bareable. It only stops if just for acouple ofhoursis prednisone. Rheumatoid arithritis has caused me to have 5 back surgeries with instrumentation. Fused 5 of seven vertabrae in my neck. Four pins in each shoulder. Burcitis in both elbows. And other joints I cannot remember a day without pain. Now I ain’t nowimp I was a correctional officer for 21 years on CERT Team spec ops prior to that I was EOD in U.S. NAVY.Retired as a Senior Chief Petty officer. pain and swelling is my constant companion I am disabled. Well that’s my story if I want mo pain then I have to go blind. Not a good trade!
Good information, BUT I was looking for help WEANING of prednisone. A link to such information would be very helpful.
Mirah,
See this post – https://www.rawarrior.com/when-you-cant-get-off-prednisone/ and its comments page
How much predisone do yo9u take daily?
I have a bottle of 10mg looking at me. So far I have not been tempted but the last few days the pain is just plain torture. I may just do it. Had my first Actemra infusion last week – not positive effects yet. I hate this disease. Nothing I do appears to work. Have been vegan since January in another desperate attempt.
Hello, I am so excited to find this forum, I feel so alone in this. my RA is so bad, have had it for over 15 yrs, but it got much worse when I moved to TN to be near my Grandkids. I have been taking 5mg a day of the prednisone for a yr and a half now, so far no side effects except for some weight gain, but it sure helps my RA, I cannot even dress myself with out it. I will not do the methexotrate or others, as I know they effect the liver when they want to do blood test every two weeks. I have found out a drug called LDN or low dose Nalpraxone is wonderful, with NO side effects for RA. But drs done want to give it,, hmmm, read up on it,, what can we all do,, God bless all,
Dear Doctor,Kindly share with me your idea on prednisolone for long time.Am a nurse and my mother is treating rheutoid athritis. They started her on prednisolone 40mg for 5 days, then 30mg for 5days ,then 20mg for 5days,then 10mg for 5days then 5mg for 5days.However was treated for same condition years ago with same condition and it has recovered. What duration do you think she should be treated and what method so that it doesn’t reoccurr.thank you
Am a nurse , how long and what dosage can rheumatoid arthritis be treated with prednisolone. Thank you
I am 28 years old with rheumatiod arthrites been suffering for a year with it now my hands quickly started to deform. i am currently on 40 mg cortisone daily and i forget the name now but it was an old malaria pill before that i was on methdroxate but the side effects were severe. I also recently got optic neritis(no signe of MS yet) my question is that is it normal for me to still be getting bad flare ups?
Werner, it is common to continue to have symptoms while on treatment for RA. But it also means your doctor needs to help change your treatment until you are doing better. You should be reevaluated every few weeks if you are still not doing well. This is called “treat to target.” More info here: https://www.rawarrior.com/rheumatoid-arthritis-ra-treat-to-target/
I am 68, was diagnosed at 40, but reading showed me occasional symptoms started as early as 13. At first biologics were a godsend: many years of very few RA symptoms or minor flares. Last Feb 2017, I started with slight swelling in hands which steadily got worse. By May 2017 RA doc decided to try Xeljanx which turned out to be a complete disaster for me. Hospitalized in August for ruptured nasal blood vessels caused by excessive high blood pressure. Swelling had not abated in hands, feet or other joints. Finally after having shingles for 6th time in 3 years, I stopped Xeljanx and am awaiting RA appt later this month. I’m scared that prednisone will be the only drug that gives me some relief until I die!
Hello to all.
I have psoriatic and rheumatoid arthritis. It started in 2000 after a car wreck.
I take 20mg prednisone every other day for long term. And when I get bad flare ups I take 60 to 100 mg daily for 2 to 5 days depending on how sever the flare ups are . It works for me. I have been on most of the biologics. They work for a while then slowly quit. This is my 2nd year for prednisone therapy. My main problem now is pain therapy. I take oxycodone and flexeril together for pain most days. The muscle relaxer makes a huge difference. It’s an absolute must to get exercise. I walk at least 1/4 mile daily. I hope this insight helps someone.
Frank ….. 🙂
I know this is super late but I came across this and very happy I did. I have sero negative RA for the past 4 years or so diagnosed. I’ve tried methotrexate, humira all without any help. As of now I’m on 5mg of prednisone and renicaid infusions every 7 weeks and it’s helped immensely. Problem is if for whatever reason I can’t as of now get my infusion the flare gets soooo bad I have no choice but to jump the steroid to 15/25 mg to force it down. I’m icing and all but not only is my wrists painful my knees are hit, and feet ugh