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Prednisone?

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Posted 2/10/2010 11:43 PM (GMT 0)
I saw a rheumatologist today for the first time. I've been on a powerful anti-inflammatory (Relafen) for about 5 months now, and I'm interested in getting on other meds to help control my symptoms. After reviewing my medical history (and seeing my malar rash today firsthand blush ), he wrote me a script for 5 mg of Prednisone to take, and wants me get additional blood-work done so he can be sure I have Lupus.

I did a little googling of Prednisone, of course, and the side-effects list is pretty long and scary. Some included joint pain and fatigue, which I'm already battling... how is that supposed to help me? My question is: Since this is such a low dose, do you think I'm less likely to get the side-effects? If you've taken a low dose of Prednisone, what was your experience with it?

Any feedback would be a great help, thank you. :-)
Posted 2/11/2010 12:03 AM (GMT 0)
Hey girl! Low dose of prednisone helped me a lot. Well, the lowest I have been on is 15 mg but it helped my joint pain so much. It gave me more energy than I had had in quite a long time. I don't remember having any side effects at all except feeling better. I personally start experienceing side effects at anything above 25 mg.
Posted 2/11/2010 12:24 AM (GMT 0)
Hi Dino, I know there is a long list of things with steroids they discuss. Even if there is the slightest risk they have to add it. The biggest things I have heard of is bone loss and weight gain as the major complaint. The best thing to always do is make sure you discuss with your rheumy if you are having any procetures done what you should do as far as taking or not taking the predisone.

I am on 10 mil. right now and am not having any side effects. I have been on different doses over the past 3 or 4 years. It seems like over 20 you start getting the round  (moonface) and the burning desire to eat everything that has carbs in it that you can get your hands on.

I don't know the one you mentionedd but if it is that strong I would think the 5 or 10 mil. of predisone would probably be better.

It's just like anything else you have to play it by ear and see how you react. Predisone can be a real life savor. it really goes after the inflamation in the joints and for short term you will notice you have the ability to do more things then usual. You'll get used to it quite quickly and I doubt you  will even notice taking it in short order.

I have found that for me the steroids helped right away and the plaquanil took about 6 months before it started working but the two of them took away a lot of symptoms. and since there is no cure for lupus the best we can really hope for is some releif from the inflamation and tireness.

I would suggest that you take it first thing in the morning. If you take it at night you may have some trouble sleeping. p.s. so what did you think of your rhuemy?

let us know

hugs

carol

Posted 2/11/2010 1:39 AM (GMT 0)
Hey! I am only on Pred when in a flare, the most I've taken is 20mg a day for 3 days and then taper down over 20 days. The only side effect I had was some abdominal pain while on the higher dose but I have a VERY sensitive GI tract so that really didn't surprise me. It worked really well to get my flares under control but my rheumy told me up front that long term pred use was not an option. As you can see in my signature I take LOTS of other meds to help me function on a daily basis.

I hope it helps you. Take care
Posted 2/11/2010 2:20 AM (GMT 0)
Prednisone at such a low dose usually doesn't have side effects. It sounds like your doctor is using it partly as a diagnostic tool to see how you react to it. I would go ahead and take it while things are being sorted out.

That said, the part about joint pain - I didn't have any before pred, have been on it way too long (low dosage) and still don't really have joint pain.

Fatigue??? That's funny. Lots of people on here over the years have taken all kinds of doses for all kinds of time periods, and the almost universal reaction has been inability to sleep! Prednisone supplements the adrenal glands to produce energy -- so I'm not quite sure what kind of fatigue might ensue.

As someone said, it's best to take in the AM, and is hard on the stomach, so make sure to take it with food.

I hope you & your dr find more answers soon,
Posted 2/11/2010 6:59 PM (GMT 0)
Dino,

Prednisone is the first line of attack for treating many different AI diseases and is usually effective.  It has been used for a half century or more so doctors know a lot about how it works and what are the side effects.  Many patients have minimal side effects but some have serious ones and have to stop taking it.  It has saved many lives by suppressing the immune system and stopping it from attacking your body.  Most patients do not experience additional fatigue or joint pain....it usually helps with those symptoms.

Your adrenal glands produce more cortisol (prednisone is the synthetic version) daily than a 5mg dose.  Normally 5 mg would be considered sub theraputic and only a maintenance dose for someone who has tapered from a higher dose and for one reason or another needs to keep taking a low dose.  You should not experience any of the dire side effects you have read about on the internet.  If aspirin was discovered today the list of side effects would prevent it's use.

I have been on pred for 4.5 years and the worst side effect I had was hypertension....and I started out with 60mg (some patients initially take 80-120mg) for several months.  Had a moon face and prednisone belly for a time but they disappeared as the dose was lowered.  No problems sleeping although that is a very common problem and I did not gain any weight which is a common problem.  You need to pay attention to what and how much you eat when you are on pred....no simple carbs and reduce the carbs.  If you are on a higher dose of pred for years you should see an opthamologist annually.

My only question for your doctor would be why such a low dose?  Most start with something higher and then taper to a maintenance dose if it seems to be working.  Depending on the case they might also introduce a prednisone sparing drug and once that takes effect taper pred.  Sometimes a taper can take many months or even a couple of years.

Bill

Posted 2/11/2010 9:29 PM (GMT 0)
prednisone is great except for the bone side effects and 5mg is too low for that to be an issue. If there is a 1 in a million chance of a side effect happening they list it so I try to look at the percentages before I worry about side effects on any drug.
Posted 2/11/2010 10:37 PM (GMT 0)
Most don't have problems with osteopenia or osteoporosis.  A bone scan is usually done when starting long term treatment and drugs like fosamax considered for those with high risk.  Like glaucoma and cataracts this is something to be considered and take the appropriate measures to monitor your condition if you are on pred long term.  Low dose, short term should be no problem.

Bill

Posted 2/12/2010 1:17 AM (GMT 0)
Thank you all for the responses, they helped a lot. I'll take my first dose in the morning.

I like the Rheumatologist. He's a smart man, and has written many articles on various diseases, Lupus included. I got my blood-work and urine sample done today, and I'll go back to see him in 3 weeks.

Bill, I think he gave me such a low dose to start out with to see how I react to it, and because he's not 100% positive that I have Lupus yet. I also have a history of depression, and he mentioned the possible mental side effects. I once took Imipramine (an anti-depressant) for bladder/pelvic pain for a few weeks and it made me extremely depressed and suicidal. Again, thank you all for your help. I am less worried about taking it, and I'll let you know how it goes. :-)

Misty
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