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Prednisone maintenance doses?

Question:

Hi Thanks for the replies about a possible release timeline for Enbrel in Canada.  While I’m waiting, one of the things that my rheumatologist suggested was low dose treatment with prednisone.  Are many people doing this?  I’ve used it with absolutely fantastic results as a pulse therapy, that is one week on it and all the pain dissapears.  If it even works almost as well as maintenance, I think it  will be well worth a try. A couple of questions though if you can help.   What kind of dosage are we talking about here? I’m thinking it has to be less than I was taking when I had it for a week. That was 12 pills a day and I don’t think that would be too good for me over any kind of long term. Do you acquire the famous "moon-face" even on low dose therapy and if you do is there anything that you can do to minimize the effects.  I have kind of a square head anyway and I don’t think it would be all that flattering to me. :-) Thanks for the help. Kurt — To reply by email, please remove the three spams from my address.

Response:

Hi Thanks for the replies about a possible release timeline for Enbrel in Canada.  While I’m waiting, one of the things that my rheumatologist suggested was low dose treatment with prednisone.  Are many people doing this?  I’ve used it with absolutely fantastic results as a pulse therapy, that is one week on it and all the pain dissapears.  If it even works almost as well as maintenance, I think it  will be well worth a try.

Well,   IMO, the pulse method is the best with periods of time where none is taken. A couple of questions though if you can help. What kind of dosage are we talking about here? I’m thinking it has to be less than I was taking when I had it for a week. That was 12 pills a day and I don’t think that would be too good for me over any kind of long term.

You can get prednisone in 5mg and 1mg pills normally.  The amount you have taken can be very different depending and you are right that no matter which sized pill you are taking, its not to be taken for the long term without side effects. Do you acquire the famous "moon-face" even on low dose therapy and if you do is there anything that you can do to minimize the effects.

Yes, I have and I have been taking it for lots of years at 5mg or less a day. I am taking 4mg/day and am thinking about 3mg a day or every other day.  It is very hard to get off of if you take it everyday.  I have kind of a square head anyway and I don’t think it would be all that flattering to me. :-) Thanks for the help. Kurt

Good luck with it Kurt.  I hope your find what works best for you. Harv Houston,Tx

Response:

What kind of dosage are we talking about here?

Kurt: If you check on drdoc’s website, you will see that he generally uses a maintenance dose of about 7 mgs a day. Check at http://www.arthritis.co.za

Response:

Long-term Prednisone use can be very dangerous, especially for those on doses over 7.5mg/day. There are risks to the eyes (cataracts & glaucoma), bones (osteoporosis), muscles (steroid myopathy), and many other organs or systems. Prednisone is similar to a hormone secreted by the adrenal glands. They produce the equivalent of 7.5mg per day. When the body realizes that it is receiving more than that, it signals the adrenal glands to slow down and sometimes causes them to stop producing the natural hormone altogether. When this happens, there is the chance that, even when Prednisone is discontinued, they will not begin to work again. This can result in a person having to take Prednisone for the rest of their life. If you do decide to do this, ask your doctor about alternate-day therapy. You take the Prednisone one day, skip the next, then take it again on the 3rd day. This forces the adrenals to keep up their work. As for the "moon-face". Yes, even on very small doses (5mg or less) this can occur. Also, Prednisone can cause you to essentially lose all willpower when it comes to food. You eat almost everything in sight. This worsens the higher the dosage. Good luck to you and I hope Enbrel comes out soon there. :-) Krystie Rose

Response:

Hi Want to second what Krystie said as it all happened to me. Was on high and low and the "chubby cheeks and round face was there. If you are in crisis that is one thing but the odcs are realizing the seriuosness of the drug as with Minocin, the antibiotic and enbrel, you can go off pred( I take minocin and got off of it and just see that people using enbrel seem to have luck as well) Good Luck and keep researching! Marge Marge

Response:

Sorry Krystie..hit the wrong button! :( Thata kind of day! Marge Marge

Response:

Hi Thanks for the replies, I’ll look at prednisone with a little more respect now.  The way my GP talked about it, it sounded like the side effects were pretty minor. If I do wind up going on some form of low dose therapy I will be most careful. Thanks again. Kurt — To reply by email, please remove the two spams from my address.

Response:

kurt, please take a look at this url/a study on pred that should be considered. http://pharminfo.com/pubs/ranews/ranews1_52.html johnie

Response:

But how does one know if the adrenal glans HAS stopped working after discontinuing Prednisone? Are there certain tests and symtoms that signify that the glads are no longer working the way they should. I am on Deltasone,now down to 7.5 mg and yes it is hard to get off of it. One of my Drs said something to the effect the body likes it and doesn’t want to give it up.etc.etc. Bill   –   LI,NY  (but no tumbleweeds..!)

Response:

First symptom is usually a very low blood pressure. Last time I went into adrenal crisis my pressure dropped so low that I had to be admitted to CCU. I kept passing out cuz of it. I really don’t remember much of what happened while I was there, except that they told me not to go below 7.5mg/day of Prednisone. They went on to explain the adrenal’s function in the body (which I couldn’t remember today if my life depended on it {Lupus brain fog}). I only know of one test which measures the adrenals level of function. It is called an AM Cortisol. They draw a blood sample in the morning before you do or eat anything. This test isn’t very accurate if you are taking Prednisone at the time, though. There may be other, more accurate ways of testing adrenal function. You might want to ask your doc. Good luck. Krystie Rose

Response:

The use of Prednisone can be minor if administered correctly. I have been on a high dose, every other day, for the last seven years. I have never been below 30 mg, but as high as 90 mg every other day. I have ocular myasthenia and use it for my treatment. You should read some of the literature. If you want some sites to read drop me a note. T. – Hide quoted text — Show quoted text – Hi Thanks for the replies, I’ll look at prednisone with a little more respect now.  The way my GP talked about it, it sounded like the side effects were pretty minor. If I do wind up going on some form of low dose therapy I will be most careful. Thanks again. Kurt — To reply by email, please remove the two spams from my address.

– C

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