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        Cluster Headache Help and Support >> Medications, Treatments, Therapies >> Prednisone Advice Please and STAT
        
(Message started by: rickyshot on Nov 21st, 2006, 2:52pm)
Title: Prednisone Advice Please and STAT
Post by rickyshot on Nov 21st, 2006, 2:52pm
Kevin KMG is getting hit real hard and many times. He has a bottle of Prednisone his neuro perscribed but can't remember dosing instructions. They are 10 mg each. Does anyone know the usual dosing instructions. Please replay ASAP. I know someone out there has an answer. KMG's computer is acting up so I will print the instructions. He has a call into his neuro but with the holdiay we don't want to take a chance on him not calling back right away.
Title: Re: Prednisone Advice Please and STAT
Post by Richr8 on Nov 21st, 2006, 3:08pm
Not advice or a recommendtion, but my schedule is as follows:
Start at 30 mg and increase by 10 mg every 3-5 days until cycle breaks.  I have never had to go beyond 60mg.  Once the cycle is broken, reduce by 5mg every 3-5 days until completely weaned off.
BTW- I have heard and read many variations on this.
Title: Re: Prednisone Advice Please and STAT
Post by Margi on Nov 21st, 2006, 3:24pm
??  if he has a bottle of it, the dosing instructions should be on the label, aren't they?  Can't he call the pharmacist to ask what dosage was prescribed?  They're more available than doctors.  Everyone is different and isn't dosage determined by body weight/height?  My Mike only did a 17 day taper and was only allowed to step up by 5 mg increments and he STILL got all the nasty side effects.  I wouldn't rely on the internet when playing with this stuff.  Call the drug store at least, please?
Title: Re: Prednisone Advice Please and STAT
Post by The mad viking on Nov 21st, 2006, 3:28pm
all i can say here is what the doc give me:

80mg for 10 days then tapering with 5 mg every 4 days

yess starting at 80mg on day 1

But the best advice is to call teh doc about it


Svenn
Title: Re: Prednisone Advice Please and STAT
Post by kissmyglass on Nov 21st, 2006, 3:29pm
The instructions on the bottle were wrong ..."50g a day for 7 weeks then taper as directed" so thats worthless but also why I have like a million pills :)
fuck it,I
just gunna wing it.

Thanks all
Title: Re: Prednisone Advice Please and STAT
Post by Margi on Nov 21st, 2006, 3:38pm
Kevin, please be careful.  Don't just wing it.  Please call the drugstore where you got the pred.  As you can see in this thread, everyone has been prescribed differently.  7 weeks is an extraordinarily long taper!  As I said, Mike's was only 17 days and it was enough to break that cycle and give him a few days' break.  Please just make one quick phone call to the drug store?  SO much quicker than waiting for the doc to call you back.
Title: Re: Prednisone Advice Please and STAT
Post by kissmyglass on Nov 21st, 2006, 3:45pm
Thanks Margi, I won't do anything stupid. The 7 weeks should have been 7 days (i think) but pharmacy didn't catch it and filled the script  for 7 weeks worth....
I just remembered I have an old script  that I never filled so I'll get the directions off of that
Thanks again!
Title: Re: Prednisone Advice Please and STAT
Post by BB on Nov 21st, 2006, 4:00pm
This is a general guide and not meant as a recommendation as Margi is correct that the dosage depends a bit on body weight ( not so much height ) , the person's general condition, age,  liver and kidney conditions, any other medical conditions and what other meds are taken.

Whether one starts low and builds up or one starts high immediately then tapers depends on how bad the CH attacks are. If you just start a cycle and the hits arent bad and you just need to have some coverage while the preventatives kick in then is better to start low and build up until its effective then stay on that dose for 7 to 10 days then tapering off. If the attacks are bad and many then start high straight away to get it to act quickly to control the hits, then stay on it for 5 to max 14 days then tapering off.

The minimum effective dose for CH varies from person to person but usually is between 50 to 80 mg. The maximum time one should stay on the high dose at any one time is 14 days, usually 7 to 10 days. When tapering up its usually 10 mg every 3 days. When tapering down its better to go more slowly to allow the body to adjust , usually at 5 mg every 4-5 days.

If a person has taken prednisone previously and had no side effects and the doctor knows your body well, he/she may be able to give you a quicker tapering dose to achieve max effectiveness in a lesser time frame than above. But the above regime is safe for most.

Its a tricky situation and its best to check with your doctor. If your pharmacist knows you well you can ask them too.

Best of luck

Annette


Edited for sp mists !
Title: Re: Prednisone Advice Please and STAT
Post by chewy on Nov 21st, 2006, 4:18pm

Quote:
Whether one starts low and builds up or one starts high immediately then tapers depends on how bad the CH attacks are


I have never heard of any sufferer starting low and building up on pred.


Quote:
The maximum time one should stay on the high dose at any one time is 14 days, usually 7 to 10 days.


The usual for the max dose is 3 days.

Annette where are you getting your info from?

Kev dont base your decisions on any advice your reading here. Get advice from your own Doc.
Title: Re: Prednisone Advice Please and STAT
Post by Karla on Nov 21st, 2006, 4:52pm
Good luck on getting a quick answer from your dr or pharmacist.  I will say a prayer for you.  Take care and hope this brings you some much needed relief.
Title: Re: Prednisone Advice Please and STAT
Post by vietvet2tours on Nov 21st, 2006, 5:06pm

on 11/21/06 at 16:18:21, chewy wrote:
I have never heard of any sufferer starting low and building up on pred.


The usual for the max dose is 3 days.

Annette where are you getting your info from?

Kev dont base your decisions on any advice your reading here. Get advice from your own Doc.
         Yep what Chewy said exactly
Title: Re: Prednisone Advice Please and STAT
Post by BB on Nov 21st, 2006, 6:18pm

on 11/21/06 at 16:00:51, BB wrote:
This is a general guide and not meant as a recommendation as Margi is correct that the dosage depends a bit on body weight ( not so much height ) , the person's general condition, age,  liver and kidney conditions, any other medical conditions and what other meds are taken.

Its a tricky situation and its best to check with your doctor. If your pharmacist knows you well you can ask them too.




I NEVER mean to  give medical advice, just sharing information given by the two neurologists we saw.

OK, it would be better if I just share what my husband was prescribed instead.

At the start of the CH cycle, he was given prednisone by the first neurologist at 50 mg per day for 3 days then tapering down by 5 mg every 5 days. This didnt work at all. He continued to get 3 hits per day. About 6 weeks into the cycle the hits suddenly rammed up to 5-6 per day. At this time he was on Verapamil and Lithium. We were seeing Prof Spira then . He said maybe the last dose of prednisone wasnt high enough and not taken for long enough so he suggested we tried prednisone again, this time started at 75 mg for 7 days then tapering off by 5 mg every 3 days. This worked a lot better.

I did asked both of them what the minimum and maximum dosages and the minimum and maximum length of time that one can stay on prednisone for cluster headaches  and that was what they told me.

There is no absolute number , just a guideline and it depends a lot on the person. Obviously if the first prednisone taper worked at 50 mg for 3 days then  my husband would not ever been given a higher dose.

The person's age, weight, other medical conditions, other medications taken and previous drug reactions all need to be taken into account. If everyone posts their prednisone taper regime here, you will see all different numbers. The point is you wouldnt see anyone given more than 80 mg per day for longer than 14 days and not lower than 50 mg for less than 3 days. Also the tapering step is usually 5 mg every 3-5 days. Its a guideline only.

The same with say Verapamil, different levels work for different people, some needs higher dosage some needs lower dosage, but the highest would be 1000 mg per day and less than 240 mg wont work for most.

I am only sharing information I have learnt, ALWAYS follow the advices of your own doctor/specialist. Whatever I post here should be taken the same way as anyone else on the Board.

Annette
Title: Re: Prednisone Advice Please and STAT
Post by kissmyglass on Nov 21st, 2006, 7:21pm

on 11/21/06 at 16:00:51, BB wrote:
This is a general guide and not meant as a recommendation


Thanks Annette and everyone else too!!!
Title: Re: Prednisone Advice Please and STAT
Post by MJ on Nov 22nd, 2006, 2:15am

I know the answer has been found. but just to add to the pot.
When I used pred tapers way back the only dosages that worked for me were above 120 mg and a few times at 160 or 180mg to start when the lower dose didnt work, and then tapered down over maybe a couple weeks.

This allways provided a much needed break at times if only for a few days and was the only thing that ever helped in the past.

At the higher doses one gets a bit cranky. but if relief is whats needed.

Definately consult a doctor before using prednisone.
Title: Re: Prednisone Advice Please and STAT
Post by Ozark_E on Nov 22nd, 2006, 9:55am
I just got off an effective Pred taper not long ago from a good neuro.  IT was 60mg per day for 10 days.  Then taper by 5mg per day until off completely.  So a total of 22 days.  At the same time I was tapering up on Topamax.  By the time I was of Prednisone, I needed to get uo to 200mg per day of topamax to keep CH in check until 8 week cycle was over, which is just about now.  Pednisone/topamax combo, with occational imitrex/o2 as needed has made for a relatively manageble and mostly PF cycle.  Best of luck.  Find a good Neuro if possible.
Title: Re: Prednisone Advice Please and STAT
Post by UN-solved on Nov 22nd, 2006, 10:49am
I agree with some of the others that said ask your doc ... don't ask here. (not about that kind of stuff anyways)

Steroids are prescribed differently for many ppl.

50mg per day for 7 weeks and I guarantee that you'll look like a balloon that floats down the street in the Macy's parade. You probably would have trouble just walking after such a long dose of steroids like that. Then it would have to be tapered (or you could die from abruptly stopping this med)

Get ahold of your doc

UNsolved
Title: Re: Prednisone Advice Please and STAT
Post by Bob P on Nov 22nd, 2006, 2:05pm
Doc Goadsby's article says,

Quote:
We start patients on oral prednisolone 1mg/kg to a maximum of 60mg once daily for five days, then decrease the dose by 10mg every three days. Unfortunately, relapse almost invariably occurs because the dose is tapered. For this reason, steroids are used as an initial therapy in conjunction with preventatives, until the latter are effective.
Title: Re: Prednisone Advice Please and STAT
Post by thebbz on Nov 22nd, 2006, 5:55pm
Can't go wrong with Goadsby can ya Bob?
Get to the doc.
all the best
jb


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