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Psoriatic Arthritis (PsA) Dosage of Prednisone for Flare?

Psoriatic Arthritis (PsA) Dosage of Prednisone for Flare?

I had a prednisone warrior ask about psoriatic arthritis.

I have inflammation from PSA. Finger joints and lower back. Doctor prescribed prednisolone for short term usage. Have not taken this for a while. I have 25mg and 5mg bottles. My fingers are especially stiff, swollen last few days. I recall him saying take for 5 days. But not sure what dosage. Also on Methotreate and Pyralin.

Watch now!

Psoriatic Arthritis (PsA) Dosage of Prednisone for Flare?

Transcription autogenerated from the video above so some errors are possible.

I have to say before I can give you advice, this is not medical advice, and based on the very limited information I have here and I am not your doctor. Your best information is from your doctor. But what I’m inferring based on what you’ve written here is first that PSA stands for Psoriatic Arthritis, a type of joint pain from arthritis-related to psoriasis. 

Prednisolone for Psoriatic Arthritis

The fact that your doctor prescribed Prednisolone means that you’re not in the United States. The drug Purin is not in the United States, so I’m just inferring that you are international. Now you’re wondering essentially what dosage of Prednisolone to use while you are having a flare of psoriatic arthritis. That’s a great question.

I have helped a lot of people with psoriatic arthritis too, because I was asked to approve their requests from their insurance company to get expensive biologics. I’m not sure what’s available in your country though. But essentially for this condition, there are a lot of alternatives. I’m not sure why your doctor’s having you go straight to the Prednisolone. 

I see that you’re on Methotrexate and Perlin, but there are lots of injectables and other things that work now too. The last ditch effort is I’ve gotta just get through this really stiff time. 

Advisable Dosage for Psoriatic Arthritis

The question is what dosage to take? There’s not a lot of great information here. I’m just gonna read this from UpToDate online.

This is the most elite, best medical information available. It says;

The use of oral glucocorticoids like Prednisolone in patients with psoriatic arthritis should generally be avoided. They could be prescribed for rare patients with severe flares that aren’t responding to conventional or biologic DMARDs. When they did a review of the studies, it showed that the steroids are associated with a low risk of flare affecting the joints.

But it’s really important to taper them slowly and in close observation with these patients to avoid the development of roderma or pustular psoriasis. 

If you start taking it, don’t just stop taking it. You need to go off slowly. 

They said in patients requiring systemic glucocorticoids such as oral prednisolone, prednisone, or prednisolone, the lowest dose necessary should be employed.

Essentially the lowest dose you can possibly use that is helping you, if you have a 25 milligram and 5 milligram bottle, I would start with 5 milligrams. 

Is one pill of five milligrams going to be enough? Is it going to provide you relief? If not, take 10 milligrams. But again, I’m not your doctor.

Calling your doctor’s office is probably the best option. Based on what this is saying, the lowest dose is the best strategy. And then once you use it, taper off and do not just suddenly stop taking it. Hope that helps. Talk to your doctor to get a more clear answer about your dosage. Signing off is Dr. Megan, your Prednisone Pharmacist.

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Dr. Megan Milne, PharmD, BCACP

Dr. Megan Milne, PharmD, BCACP, is an award-winning clinical pharmacist board certified in the types of conditions people take prednisone for. Dr. Megan had to take prednisone herself for an autoimmune condition so understands what it feels like to suffer prednisone side effects and made it her mission to counteract them as the Prednisone Pharmacist.

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