Polymyalgia Rheumatica (PMR) Steroid Regimen

Bone protection while taking prednisolone: To prevent osteoporosis you will be prescribed a medication to protect your bones alongside a daily vitamin D supplement. You can check if you need a calcium supplement too by completing an online assessment of calcium intake:

Calcium Calculator

Monitoring

Please arrange these appointments while you are taking prednisolone:

• A diabetic blood test every 3 months.
• A blood test to check your kidneys and cholesterol levels every 6-12 months
• An eye examination with the optician every 6-12 months 
• Monitor your blood pressure and weight. Review with GP if increasing

Seek Medical Advice Urgently if: 

• You develop any headaches next to your eyes, tenderness to your scalp, pain in your jaw on chewing, loss of vision
• You develop any heart burn or indigestion symptoms

Please ensure you carry your Steroid Emergency Card with you.

Polymyalgia Rheumatica (PMR) Treatment Sheet

Dose of Prednisolone by week:

• Week 1: 15mg (3 x 5mg tabs) 
• Week 2: 15mg 
• Week 3: 15mg 
• Week 4: 12.5mg (2 x 5mg tabs, 1 x 2.5mg tabs) 
• Week 5: 12.5mg  
• Week 6: 12.5mg 
• Week 7: 10mg (2 x 5mg tabs) 
• Week 8: 10mg 
• Week 9: 10mg
• Week 10: 10mg
• Week 11: 10mg
• Week 12: 10mg

After this reduce by 1mg every 4-8 week (dependent on symptoms see below)

• Week 13 onwards: 9mg (1 x 5mg tab, 4 x 1mg tab) 
• After 4-8 weeks: 8mg (1 x 5mg tab, 3 x 1mg tab)  
• After 4-8 weeks: 7mg (1 x 5mg tab, 2 x 1mg tab) 
• After 4-8 weeks: 6mg (1 x 5mg tab, 1 x 1mg tab) 
• After 4-8 weeks: 5mg (1 x 5mg tab) 
• After 4-8 weeks: 4mg  (4 x 1mg tab) 
• After 4-8 weeks: 3mg  (3 x 1mg tab)
• After 4-8 weeks: 2mg  (2 x 1mg tab) 
• After 4-8 weeks: 1mg  (1x 1mg tab) 
• After 4-8 weeks: Stop

If at any of these stages your symptoms return, please increase oral prednisone to the pre-relapse dose and decrease it gradually (within 4–8 weeks) to the dose at which the relapse occurred.