Average time for Prednisone to start working?

my neurologist told me to give the prednisone 2 months to see if it would work. on the 4th dose/day my leg muscles became weaker even though internally my energy increased??? I did give it 2 months at 50 mg (i weigh 140) so this was high dose for me. It did not work for me—-my neurologist felt that by giving it a whole 2 months we at least determined that it was not going to work and would not attempt that route again. Lori

I’ll weigh in. But not about my personal experience on time to results for Prednisone.

If I read your post correctly, and the dates are correct, then my position would be that you have had too many different treatments too fast.

From a diagnosis in Jan 2011 to determining that IVIG, PE & Prednisone are all not working as of March 15 seems a big deal.

For example, from a 1999 Clinical Trial to evaluate the effectiveness of IVIG for CIDP. “…The study will take 60 patients with CIDP and divide them into two groups. Group one will receive 2 injections of IVIg once a month for three months….”

And, for more on CIDP, from a link given to us by Emily’s Mom, Dr. Lewis (an expert) says regarding CIDP: “…On average, improvement seen by day 10 and continues through day 42.”

Another important factor for the success of IVIG is How much and How often. In my case it was twice a week for 3 months.

From the Muscular Dystrophy website: “…An average course of plasma exchanges is six to 10 treatments over two to 10 weeks. In some centers, treatments are performed once a week, while in others, more than one weekly treatment is done…”

After all, MDA should have some credibility since both GBS and CIDP are included in diseases they cover.

Dr Lewis says this about PE, “…Adult Based on body weight and size to determine plasma volume; commonly, patients undergo 3 plasma exchanges per wk for first 2 wk; after that, number and frequency of treatments determined by clinical response; response tends to last for 2-4 wk and must be repeated to sustain improvement; some patients require more frequent treatment; remission is uncommon if plasmapheresis is sole therapy…

As for prednisone- Again, from Dr. Lewis, “…Adult Doses vary; most patients are started on prednisone at 1 mg/kg/d PO initially (60-80 mg/d) Improvement can be anticipated within next 2 mo…”

The Dr. Lewis website I’ve quoted from is here:

[url]http://emedicine.medscape.com/article/1172965-treatment[/url]

Please note that there are 5 tabs, one each for
* Overview
* Differential Diagnoses & Workup
* Treatment & Medication
* Follow-up
* Multimedia

Cory,
I have had success with Prednisone. Have been on and off of it for about 15 years. First, remember that all CIDP patients do not respond the same to the various treatments.

Usually see positive a reaction from the high dose (500mg) iv prednisone within 24-48 hours. Get a real energy surge that lasts up to several weeks. The oral I took, 60mg/day, took several weeks to give me any relief, but the side effects were not so hot(gained over 40 pounds and puffed up like a toad). Side effects are also a concern with daily steroid use over long term. Liver and kidney.

After about a year and a half I went off oral prednison and began PE with IV solumedrol infusion which worked for me many years. Frequency varied from 5 days in a row, to 3 times a week, then weekly, monthly and at one point was able to go 4-6 months between treatments. When PE alone failed to stop the progression, doctor switched me to Gamunex, PE and IV solumedrol. After nearly two years of Gamunex, PE amd IV prednisone every three weeks, my condition stablized and my neuro decided to try maintain with just IV prednisone. Since December, I take 500mg IV solumedrol three days in a row, every three weeks. So far, so good. Am still
able to function as well as I did with the combination of treatments, at a fraction of the cost. Again, this is how I react to steroids and I hope they do the same for you.

While IVIG works for many, my experience was not very successful. That said, I did get some help from Gamunex as stated above. We tried this brand because it is amino acid processing vs other brands which use glucose base.

The post about the quick changes of treatments seems spot on. Usually PE is done 3-5 days in a row, then, depending on the response, weekly, bi-weekly or other time frames. My response to PE a couple of weeks. IVIG also takes some time to see results and usually has a high dose load at the beginning of the therapy.

Pulse steroids do not pose the same risks a daily oral use, but side effects still have to be monitored. Ask your doctor about high pulse doses of Prednisone IV as an option to oral. Your response should be much quicker and you will know fairly quickly if steroids are going to help you. Hope this helps.

Cjsmo,

If you read my posts under ‘prednisone hell” you can see what my experience has been. I have never responded well to IVIG.

I started on 60mg/day prednisone on Jan 11th (2011) within about 2 weeks I started noticing subtle improvement. By about the 4-5th week i had noticeable improvement. I am now a little over 2 months and i have very significant improvement. I would say my numbness and pain are about half of what they were and my motor functions, walking, balance and strength is about 75% of where I was prior to this relapse.

I would definitely give it more time before you get too discouraged.

Hi, I am about to start prednisolone on Thursday after my lumbar punch. She started me at 40 mg twice daily for 14 days. Then she did not put anything else on the bottle. Just stops after 14 days. Isn’t that a problem to stop prednisolone cold turkey? Shouldn’t you wean off the stuff? Did anyone have the insomnia from taking prednisolone? I am already an insomnimac and am worried that once I start taking the pred that i will never sleep.

You are correct about weaning down the dosage of Prednisone and not going cold turkey. Absolutely insist on a weaning schedule as abrupt withdrawal can precipitate diabetes. I was on it for my MS and it made me hyper and sleepless. And I got the moon face –yuck!
Laurel

I am a prednisone veteran. 40mg twice daily (80/day?) is a fairly high dose . I had a 100mg dose with my 1rst attack (1989) , and a 80mg at my second relapse (2001) and I am currently relapsing but I started early so right now I’m on 60/mg.
The stuff is nasty, at least for me. Your Doc should have instructed you about the uptake and tapering process with prednisone. If you our starting with 80mg/day x14 days you will need to first see how it might be improving your CIDP. Most protocols call for at least a 2 month treatment and when and nif you respond most Docs will tell you they want you to have a least a 1 month “maximum platuae” for your symptoms before tapering you down.

One of the many serious complications with abrupt and discontinuance with prednisone is the effect on the adrenal glands. You should ‘google’ prednisone side effects and you should educate yourself and be prepared to confront your doc about your prednisone treatment. read some more on this site, lots of good advise hear.

Hope i can help you now and with your upcoming treatment.Been there, done nthat, doing that!

Hang on and hang in there!

Mongo