Polymyositis & Dermatomyositis Support Group

Polymyositis (PM) is a type of chronic inflammation of the muscles (inflammatory myopathy) related to dermatomyositis and inclusion body myositis. The inflammation is predominantly of the endomysium in polymyositis, whereas dermatomyositis is characterized by primarily perimysial inflammation.

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joyforalifetime 03/07/2012

i searched through past discussions and was reading some previous posts about Prednisone Tapering but still wanted to ask and see if anyone had feedback or advice about my situation:) I was on 80 for 2.5 months, 40 for 1.5 months, and have been on 30 for a few days. I've been on the liquid prednisone since it was going in my stomach tube, and as soon as I'm out of that (probably another day or two) I'll switch to 15mg of pills.
i don't really understand the difference in dose amount between liquid and pills...would 40ml of liquid equal 40ml of pills? so, am I jumping from 40 to 15? sounds like a pretty big jump!
I've been achey and pretty tired going from 40 to 30 as my body adjusts (however, i have been getting a little less sleep and am at my 2nd day back at work, so tiredness is understandable!) I assume I can expect the same when I switch to 15mg pills. just trying to get an idea of what to expect in the next tapering step! am I to the point where side effects should start going away? not sure which side effects come from prednisone and which come from MTX, but i have the extra hair and the acne.
thanks for any responses!! always encouraging to hear from you all :)

trpt1 03/07/2012

Be extreamly careful with prednisone tapering. I do not know about the difference between the liquid & the pills. Do talk to your doctor on this subject for you. I can tell you that with my situation, the doctor told me to go from 40mg to 30mg after fourteen days. Then 30mg to 20 mg after fourteen days. When I get to 20mg then I taper down by one milligram every fourteen days.Ex: 19mg, then 18mg, 17mg etc...I was having lots of bad feelings once I hit 15mg. I decided to taper down by a half milligram like 14.5mg for fourteen days, then 14mg, then 13.5 mg etc... The main thing is to go slowly and if you need to stay on an amount for longer than fourteen days that is o.k. I am currently on 5mg for 26 days and I will probably taper to 4.5 mg tomorrow. Do not be in a hurry. Do not make big jumps below 20mg but go in small amounts slowly. You must talk to your doctor about anything where you are not clear because prednisone is dangerous. My tapering may not be right for your situation. Everything depends on your issues. I know I feel great weakness as I taper. Please keep in mind you will experience the same so be very careful. I have increased the MTX as I taper down on the prednisone. Your doctor will have you increase another medication as you taper down too. Good Luck

nanny1611 03/07/2012

Liters and Grams are metric forms of measure. Normally "liter" measures the volume of liquid, while "gram" measures the weight of solids. The prefix "milli-" means 1/1000 of a "liter" or "gram." That's the extent of my knowledge on the subject, so I found the following website that is supposed to help you convert liters to grams. Just remember that 40 ml would be 40/100, or .04 liters (I think). And 15 mg would be 15/100, or .015 grams (again, I think). Hope this helps. And best wishes on your reduction and changeover. Let us know how you get along.

http://www.convertunits.com/from/liters/to/grams

nanny1611 03/07/2012

Oops. Make that 40/1000, not 40/100, and 15/1000, not 15/100. Sorry about that.

PrayPerseverance 03/08/2012

I strongly agree with trpt1 and if I were you I would let the doctors and pharmacist figure out amount of liquid or pills. You don't know the concentration of the drug per ml or gram. If however, you do know the concentration of the prednisone per unit, you could do the conversion.

The web link that nanny has given for converting liquid to grams (mass) is only applicable for pure water at 4 degrees Celcius. It is not applicable for liquid prednisone or any other substance.

http://www.simetric.co.uk/si_water.htm

And just so you know, a "gram" and similarily a kilogram is a unit measure of the mass not the weight.

Just be careful! Let the pharmacist do it!

PrayPerseverance 03/08/2012

I suppose that didn't help in trying to answer your questions. 1ml of liquid could equal 100000 mg of pills or vise versa. It all depends on the concentration of the drug in its medium. As far as side effects go, everybody is different but I know how you feel.
When you taper there is a good chance that you will start feeling worse. At least that what happens to me and many others. The problem is that the long term side effects of high doses of steroids are terrible. If only a steroid could be made without the long term side effects. I sure hope someone is working on it.

I feel your pain. Literally.
The saying " be strong " has a whole new meaning.

joyforalifetime 03/08/2012

thanks for your help!! I think maybe I wasn't clear ha, I'm not trying to taper on my own or anything. Doing exactly what the doctor ordered, and the pharmacist gave me what I needed according to his orders. I was just curious as to how much I was stepping down, if there was a difference between the liquid and pills (if I put liquid up to the "15" to go down the tube, is it the same as 15mg of pills). sorry if I'm being confusing haha. trpt, my doc is going to do the same...increasing my MTX as I decrease pred, but he hasn't told me to do that yet. i really hope i do okay with the tapering and don't backtrack at all. we'll see! I've responded well to treatment so far, hope my body adjusts well. Pray, i agree...really wish steroids did all good and no harm! so thankful for them, still.

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