Adrenal Insufficiency Support Group

I'm not sure whether to be mad at the pharmacy or embarrassed that I totally missed this.

The doctor had me taking 2 mg of prednisone in the morning and 1 mg at lunch. However, due to some highly stressful situations lately, I had been updosing to 3 in the morning and 2-3 at lunch. Because the insurance would not fill my Rx early and I needed them sooner than normal due to the updosing, the pharmacy called the doctor for another script. Well, I picked it up and started taking it the same way for the next month: 3 in the morning and 2 at lunch. Yesterday I got my refill and for some reason noticed that they had changed me to 5 mg tablets instead of 1 mg but the instructions still said take 3-am and 2-pm. I pulled out the bottle that I was almost done with and noticed that it was the same way. Therefore, I have been taking 15 mg in the morning and 10 mg at lunch for the last month. WOW! If I calculate right, that's the same as 125 mg of cortef daily, right? So now I'm wondering if I need to wean down after a month of that high a dose or just go back to 3 and 2. I'm thinking I need to wean, but still in shock that I missed it and the pharmacy made that big a mistake. Any suggestions?

Firstly check that the pills in the bottle really are 5mg..

And how did you feel?

I'm pretty sure they are bigger than the 1 mg tablets I had, but I don't have any to compare them to. And unfortunately, the markings on the pills themselves do not say.

As far as how I feel, I have felt tired, but not more so than usual, and especially considering I have rushed my mother to the ER twice in the last three weeks and spent several nights there with her. Currently, I am spending the night with her in the hospital now as she has been diagnosed with myelodisplastic syndrom.

Do you have any symptoms of OD? Any signs of cushings? My face gets round and my collar bones get puffy. It would calculate to 100 mg cortef BUT - people take that much prednisone for auto immune stuff so.....I'd call the pharmacy first and see if they have a record of what they filled the last rx with. Then I would ask for a clarification of what the xxxxx is going on, and just what your doctor's order reads. If indeed you had been taking that much, yes you need to taper and you need to talk to your doctor about it.

The pills can be tracked by just their markings on them, they usually don't have the dose. The bottle should have the brand/manufacturer listed. You should be able to do a search either on their web site or on google. For example - brand WKRP prednisone pill identification - or such. I have been able to track dose sizes that way successfully.

Keep us posted! It sounds like you have had a lot of stress going on in your life - hang in there.

Thanks! I'll try tracking and calling the pharmacy. No symptoms of OD or cushings, but my face (& everything) seems puffy. However, I am attributing that to the fact that I have been drowning my sorrows or looking for joy in food. I have acquired an addiction to baked sweet potatoes with all the sweet stuff, so I need to stop that and get back on track, but that's been one way to deal with all this stress.

Don't just assume the everything puffy is from eating. I gained 12 pounds over the course of 2 months from too high prednisone. Yes. Everything very " puffy". Lol. And I want to eat all the time when on high dose. Sometimes we have to connect the dots. That being said, if you have been on high doses, it may have been getting you through the last month. There is a silver lining maybe?

Hypomama,

It makes so much sense when you lay it out in front of me, but I'm just not thinking/functioning well with everything going on. Yes, I have wanted to eat like crazy, but felt like I was just looking for enjoyment in something. I have gained about 5 pounds in the last month. And now that I think about it, I wake up almost every day with my eyes so puffy I can hardly see. Does that sound at all familiar. But I can honestly say that I think there is some silver lining, because I don't think the low dose I was on would have gotten me through everything so far. Nevertheless, I"m sure this is too high of replacement for me. (I'm scheduled to see an endo in January, but am on a waiting list for any earlier cancelations, and hoping that comes through soon.)

I called the pharmacist and the doctor's office, and it looks like they are going to both play the blame game. The pharmacist says that the doctor wrote the script for 5 mg tablets at 3 in am and 2 in pm. The doctor says that what is was supposed to be was 5 mg in am and 2.5 in pm. I have to say that I think the dr office messed up because he has never mentioned those numbers to me at all. And when I asked about weaning, the nurse said just take 5 mg less each day until you get back to the 7.5 daily. I think that's a bit too fast to wean, so now I'd like you guys opinions. I've found that I trust those who have "been there, done that" more than the dr and the pharmacist at this point. Thanks for the help!

Tanya

OK - I would start by going down by 2.5 in the afternoon dose for 3 days and see how you feel. If you are doing OK, then go down by 2.5 in the AM and hold it there for a week. Then repeat the process. Whenever you start feeling achy etc, just hold up and keep it there for a week, it will clear. You may need to take a week at each dose change. Do you have any 1 mg available? If need be you may need to go down by 1 mg at a time. If you don't have any 1 mg, you can quarter you 5 mg pills - been there, still doing that! They break apart pretty easy. Keep us posted and we'll coach you through it - yes the nurse was wrong - 5 mg a day is crazy talk.

That sounds like a plan that makes sense. I have to tell you that I called the pharmacist on the advice of the school nurse. I continue to be amazed at how uneducated these people are who we are supposed to be able to trust. The pharmacist told me to drop a 5mg in the morning and a 5mg in the afternoon! I pointed out that I was taking this for AI and not an infection or some temporary thing, so she decided to look it up on the Internet. She came back and told me it didn't matter, and I could even go more aggressive if I wanted and it would be okay. You would think after the dr and/or pharmacist being a part of the original screw up, they would be especially careful with the advice they give me, but I guess it's just plain ignorance. This is exactly why I am so grateful to you all on this site and your willingness to share your experiences and info with all of us.....Thanks!

My Dr. had told me that since the afternoon was a lower part of the cortisol curve, it was possibly easier on the body to start there. You were on it for a month - right? See how it goes. If you can go faster, fine, bu I think it takes about 3 days for your body to adjust to each dose change. You'll feel Monday's dose change on Wed and Thursday - I learned that one on here - that was an A ha moment!