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Old 02-12-2010, 09:30 AM #1
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Default Long term prednisone usage

Anyone have any thoughts on whether there is a low dosage level of Prednisone that would be safe for very long term use. I've done well on 15mg every other day, not so good below that and I'm wondering how long I can keep going at this dosage. No significant side effects that I'm aware of while on the dosage level.

I'd prefer not to have to take any Prednisone, but the alternative at this point would be Immuran. Prednisone seems preferable right now, but not if long term use at this dosage will have harmful effects.

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Old 02-12-2010, 10:39 AM #2
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I wish I knew the answer to this {I bet Annie or Alice will} I used to be on high dosage years ago and it has effected my vision. I can no longer take pred but thats OK, my Dr. is against using it anyway.

Have you spoken with your Dr about this? He/she would be able to answer it.
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Old 02-12-2010, 11:08 AM #3
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I have gotten different answers from different docs.

Have you spoken with your Dr about this? He/she would be able to answer it.[/QUOTE]
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Old 02-12-2010, 05:55 PM #4
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I think my neuro once told me that below 10 mg Pred per day, there was no side effects...
Maurice.
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Old 02-13-2010, 03:48 AM #5
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It depends what you consider low. A replacement dose of cortisone is about 5mg of Prednisolone a day. Anything above this leads to side effects long term. A dose about 5mg overrides the body's adrenals and will eventually atrophy them to stop working, so that you are reliant and at the mercy of cortisone tablets to stay alive for the rest of your life ... and need to understand how to manage your newly developed Addisons Disease and stress dose for sickness, surgery,broken legs etc. Its not a good medication but sometimes it is necessary and like all such things the good must outweigh the bad before a decision can be made.
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Old 02-15-2010, 10:11 AM #6
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Unrelated to my MG, I had Cushing's (which is too much cortisol, the equivalent of too much prednisone) and despite measures to control it like pituitary surgery, ended up having my adrenals removed - so I must take steroid replacements for life. It was when my adrenals when out then we discovered to my dismay that I must have been self-treating for MG, as it was then my MG roared to the forefront. But I will not and cannot take steroids due to the damage that has already been done to my body from the steroids.

Now there is a point where your body will *use* the steroid and then it will not be damaged. You will know that by always being able to sleep, never getting cataracts, your bones being fine etc. But Pred has a longer half life than an entire day - being up to 36 hours depending on the body (everyone uses a steroid differently) and does not go into effect right away.

I would keep an eye on the side effects as they can be sneaky and well, not all seen. It may be something to come off the 15mg - cortisol weans can be painful. Just be sure to take care of your bones extra careful while on the med.
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Old 02-15-2010, 08:51 PM #7
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Is anyone here on alternate day therapy? I'm currently at 50/10...Will be at 50/0 in two weeks....Does this reduce the side-effects? Also, when I taper from alternate day, will I have to resume prednisone everyday, just at a lower dosage? Or do people normally taper just from the prednisone day, and continue to not take prednisone on the second day? Sorry, kinda confusing, I know...lol
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Old 02-15-2010, 10:24 PM #8
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Default Long term prednisone usage

Hi Nicky,
I am on alternate day therapy. I have gone from 60/0 to 40/0 which I started Fri. So far I am not seeing any difference in side effects. I still have trouble sleeping and my appetite is huge. I don't think you will need to take it everyday since you are already on an alternate day therapy. My Dr. told me the alternate day therapy reduces the side effects as opposed to everyday.
Kendra
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Old 02-15-2010, 10:38 PM #9
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Thanks, Kendra...

What is the time interval between tapers? Is your doctor going down by 10mgs monthly, or biweekly? My doc. has not suggested that I do any more tapering once I get to 50/0, but I'm thinking of sneakilly doing it on my own (muahahaha)- carefully, that is, though...Just 'cause I'm so sick of this med.. I'm not going to start until I see the second neuro. for the second opinion, but I want to make sure I do it safely if I decide to do it...

You know...I feel completely delusional about some of the side-effects...I thought that I hadn't gained weight, at least on my 'body.' Actually, according to the scale, I haven't- I'm still the same weight (about 135 lbs), but I saw some other pics. from Christmas that my aunt took, and lord have mercy, I was trying to find Hootie in the pics. 'cause the blowfish was definately in town...

I actually thought that there was something wrong with the pics. because I was the only one in some of them, but when I saw the others with my other family members in them too, I realized that there was nothing wrong with the pics. or camera...lol...I look straight-up weird!

Anyway, I guess I have the lipodystrophy because my trunk, face, arms and neck look massive, but my legs look thin...I also have a ferocious case of acne...Prednisone sucks, I will say it again! lol

Nicky
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Old 02-15-2010, 10:53 PM #10
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Default Long term prednisone usage

Nicky,
My Dr. had drop from 60 to 50 for 2 weeks then I dropped to 40. He wants me to stay there until I see him in April but I'm like you and plan to try going down on my own. If things stay ok at 40 I will drop down to 30 March 1.

Oh my gosh I know what you mean about the scales saying one thing but looking at yourself and wondering what has happened!!! My face is starting to fill out and my arms and stomach. According to the scales I have gained about 9 pounds but it feels like 25. I HATE it!!! YES pred sucks. I went to my chiropractor today and he gave me a good talking to about how dangerous this medicine is. He swears it is poison. I feel so much better after getting an adjustment today but am now more scared than ever about the damage this med is doing. He suggested going on a gluten free/dairy free diet at least for a few months to give my body some time to kind of work on healing itself. As bad as I want totally off the pred I don't want to take cell cept or Imuran either because they have serious risks also. I don't know what I'm going to do if my symptoms come back like they were before. I am going to get serious about changing the way I eat and exercising regularly. I take several vitamin supplements too. I figure anything is worth a try if it will help me feel better. How are your symptoms from tapering? Are you staying pretty level?
Kendra
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