After being diagnosed last September my neuro started me on Mestinon, which helped deal with the symptoms of MG and all seemed to be going well until this past May when I added Prednisone to the mix to deal with slurred speech and neck weakness isues.

I slowly ramped up to 40 mg / day of Pred and anywhere from 60-120 mg Mestinon every 3-4 hrs and for the past 4 months and felt better than I had since being diagnosed.

Unfortunately, the past few weeks I've gone downhill and am having issues with double vision in the morning and drooping of both eyelids on and off all day.

I'm wondering if more Prednisone would help? I've been fortunate in that the only side effect I've experienced is some mild acne. My neuro has been slow to respond to my requests for advice since a call to him last week so I'm just reaching out to others to see what your experience has been with increasing dosages and dealing with eye problems while I wait for his advice.

FYI, I'm 43, male in god health other than my MG.

Hi drpdhmr,
The max dosage for Pred is 1 mg/kg of weight, you should be about half that dosage?
Normally the dosage is slowly increased to that maximum or until an improvement is noted. An immunosuppressant is also prescribed to be able to later reduce Pred intake, because the immunosuppressant are rather slow to kick in.
Some precautions are to be taken with Pred intake to minimize the side effects which are probable, such as weight increase, loss of potassium, risk of osteoporosis, glaucoma, etc...I suppose you were informed of all this, if not maybe you should look to another neuro more competent with MG...
Take care,
Maurice.

I'm ~80 kg so at my current dosage I could probably go up some to see if it helps. I'm well aware of the side effects of Pred, but I've been fortunate not to have much of any issues so far at 40 mg. Thanks for the feedback!

Long term prednisone leads to steroid dependence as I'm sure you know. For some, it's the only answer but I'd exhaust all other options first.

I would ask about other immunosuppressants like Cellcept and Imuran.

good luck
kathie

I have resisted taking prednisone so far. Today my neuro suggested using
prednisone as a pulse steroid, taking one 20 mg every three or four days. She said that it would help, and the side effects would be minimal. She said that pulsing steroids is new. Has anyone tried this?