They did plasmapherisis and then 60 of predisone for me when I had a crisis. That is all I know.
Ann

I do not know of dosages, but that seems high. I know my doctor and I discussed IV steroids to start my treatment out but we decided against them because of other health issues.

Chuckie -

200mg is a stiff dose but in a crisis, it may be considered worthwhile. When I was in a coma, my dose was 100mg EVERY day. I'm not sure there is a direct translation here between my dosing/schedule and the one your doc is suggesting, but every other day dosing is not uncommon. It allows the adrenals to come back to life on the "off day."

Crisis implies a severe spike in antibodies and that requires serious medication. Many folks in this group and their docs seem reluctant to use prednisone, let alone use it in high doses. I definitely don't agree with that position and since there's so much "witchcraft" used in the treatment of MG, this advice must come as a shock to those accustomed to the alternative therapies so many use.

Curt

My daughter has MG and possible normal tension glaucoma. I was told that if a glaucoma patient is given prednisone it can cause vision loss. But the docs say it's still "on the table" in the event of a severe crisis.

They were giving me 240 ml of solumedrol per day through my IV when I was hospitalized in August. I later figured out that was the equivilant of 300 mg of prednisone per day.

Be very careful about how they taper you off a high dose of prednisone. I was sent home and told to go back to my 20 mg per day. Two days later I was really in crisis.

It was back to the hospital and back on the solumedrol. Four days later they started me on a taper. The first 3 days was at 60 mg of prednisone per day. Then 3 days at 40, 3 days at 30 and then back to the 20 mg.

Yes, solumedrol is what they gave me when I was in a coma. 100mg per day IV. I don't know why my dose was so low compared to what everyone's talking about here, but it did the trick.

Curt

While still in the "waking" stages of my thymectomy, my blood pressure and pulse went down. They said it happened due to a vegus nerve stimulation. (a vegul drop???). They told me it was probably due to the fact that I was on 40mg prednisone a day at that time. I was given at least 2 additional doses of 40mg by mouth and solumedrol in my IV (but I don't know how much). But it is all a bit blurry because of the state I was in, thank goodness I had Sherry there to write it down for me while I was busy making people fan me (I had become very hot) and telling my poor daughter that her breath smelled like a fish tank.
I believe my total prednisone for that incident and that day combined was either 120mg prednisone or 160mg prednisone plus the IV steroid. I continued to take 40 mg daily after that and am now tapering.

I have been up to 100mg a day for an extended period like you Curt but mine were oral doses. Just to say that I recently learned when having IV cortisone for my asthma that the IV doses don't equate to the same dose orally though which I found interesting. I was on 50mg of solcortef 6 hourly and found the whole weaning back to oral doses quite drastic until my specialist told me that those IV doses actually only equated to 50mg of the oral prednisone and not the 200mg it sounded like.

I am now on more moderate doses because they don't really seem to help any less and I have suffered many of the more serious side effects of pred.My disease is one of the rare cases that is pretty steroid resistant though unfortunately so the high dose regiment may be different for others.

Ange

Started with 40 every day, taper down and then develop crisis. Then they bumped up prednisone . sometimes 60 per day or 80mg via IV and last February 100mg every other day. Be aware of developing Diabetes with high dose of prednisone. I was feeling awful-until I saw an Endocrinologist who put sugars to right. Predinsone diabetes differers from the usual as your bloodsugars will be high in the AFTERNOON, so it's not always picked up if your dr. test in the morning. Every other day prednisone did not work for me due to spiking sugars.

I am finally at 10 mg every day and we're tapering very very slowly by 1mg per month. If you get off prednisone too fast, you might relapse if other meds have not kicked in yet. Prednisone does work to keep you going! Take Care of yourself.

Hi BB, I am tapering at the moment and having read your comments I am concerned I may be going too fast. Do you get any warning if you about to relaps? At the moment I am on 17.5mgs on alternate days and reducing by 0.5 every other day. Do you think reducing by 0.5mgs a week or even every two weeks is wiser?
Gwyn

Here is a link that I found useful when I was reducing my dosage of prednisone. It was written for another illness, but much of it applies to us.

http://www.sarcinfo.com/weaning.htm

Thanks for the link on weaning off prednisone. It was very helpful.