Hi DMsucksss, Excellent question on Prednisone dose for flares. If you are at the beginning of DM, the doctor will place you on a high dosage that fits with your body weight for the first DM flare. You would stay on the high dosage until your CPK & blood work gets under control and goes down to a more controlled range. I had to stay on the high dosages for three months until my CPK lowered and was under control.

Today, four years later, I take 5mg of Prednisone daily and 750mg Cellcept daily. If I flare, then I would go up to a higher dose of Prednisone depending on the intensity of the flare. I would never decide on my own how much to raise the Prednisone. The doctor determines steroid dosage amount based on the intensity of the flare, also issues like the operational status/health of my liver & kidneys when considering dosage amounts.

Our medications are serious medications that require doctor supervision. I make an appointment ASAP when flaring to go in for blood work immediately. Flares involve the liver & kidneys so it is very important that correct and careful doctor supervision is involved.

In blood work, a DM flare will often include a rise in liver enzymes of ALT, AST, aldolace, and other scores might rise too. CPK does not always rise in a DM flare for all patients. At the beginning of DM, CPK is usually a rise for most of us and that will be above normal range or very high like in my case. There are some patients like with PM that do not always have a CPK that will return to normal range for a long time. DM often does return to normal CPK ranges. My CPK went high in my first flare. My flares today would usually just be screaming liver enzymes of ALT, AST, aldolace, increased sed rate, etc.. but usually not a CPK rise. In a flare, I will feel big weakness in both arms & legs. My legs will feel like bags of cement when walking across the room. My chest is heavy during a flare too.

Do see the doctor if you suspect a flare. You could discuss with the doctor your best procedures that are right for you in case of flare. Best Wishes.

Hi DMSucksss. I asked my Rheumatologist what I should do if I had a flare on holiday. If on no Prednisone then go straight to 15mgs daily and remain there until I returned from holiday and saw him. It's a bit different if you are already on steriods then he told me to go to the last dose I was on before the flare and to see him s soon as possible. I don't know how quickly you can see your Rheumatologist. Here in London if you have a flare you call the Rheumatology Secretary and the Rheumatologist fits you into the clinic on the day. What other Meds are you on to help you taper the prednisone. Let us know how you are doing.best wishes. Autumm

Hi DMSucksss. I forgot to add that it's how you feel that matters, you can have a flare three weeks before it shows in your blood work. Contact your Rheumatologist and ask his advice. We are all different and what works for me may not be right for you. Autumm

Thanks a lot!

We are thinking of you. You will get through this. Autumm

Hi DMsucksss, Autumn made an important point about establishing a procedure with the rheumy in case of flare, and especially during a holiday. I will also see the eye doctor ASAP when going up on Prednisone. I have glaucoma which is high pressure in the eyes caused by Prednisone increase. I will see my eye doctor for a fast five minute pressure check in the event of increasing my Prednisone dosage. High pressure may require daily eye drops if it goes too high to avoid blindness.

Remember that high doses of steroid causes high blood sugar. I watch my blood sugars and I had to eat a lot of leafy green veggies for a while until I was able to taper much lower. I avoid any starches like corn, spaghetti, breads, candy etc.. on high prednisone. Do discuss diet with the doctor for high Prednisone.

Our bodies are all different and some people will increase the steroid to 15mg for three days. I only increase to 8mg and that usually does the job for me. I hope you will get your flare procedures worked out well very soon. Keep us posted.

Best Wishes.

Thank you everyone!
I came back from the Doctor's appointment and he sent me to an EMG test, and said to increase the prednisone's dosage.
I also wrote about it in a new discussion.