POLYMYALGIA RHEUMATICA
TREATMENT INFORMATION FOR PATIENTS
What is Polymyalgia Rheumatica (PMR)?
Polymyalgia Rheumatica is a condition that causes pain and stiffness around the
shoulders and hips, particularly in the morning. The exact cause is unknown.
Diagnosis can be difficult and is usually based on your symptoms rather than a
specific blood test.
Treatment
The only successful treatment is with steroids (prednisolone). These tablets are
taken by mouth each morning with your breakfast. Different strength tablets are as
follows:
One red tablet = 5mg,
One brown tablet = 2.5mg,
One white tablet = 1mg
You will need about 2 years of treatment. The dose should be reduced slowly and the
table below shows how you can do this. Sometimes it is not possible to follow the
table exactly but you can work with your GP to decide how much steroid you require.
If you cannot get below 10mg (2 red tablets) after 4 months of treatment then there
may be a different diagnosis and you should see your GP again.
It is usually best to go by your symptoms rather than by monitoring any blood tests.
Try and get onto the lowest dose possible without your symptoms coming back. This
dose will gradually go down as the months go by. If there is a recurrence of
symptoms, try going up by 1 – 2mg rather than by 5mg.
What about side effects?
There are many possible side effects with steroid treatment. We try and reduce the
risk of side effects by using the lowest dose possible to control your symptoms. An
information leaflet on steroids is available for you.
One side effect we can protect against is loss of bone. If you are over 65 years old
you should have a weekly tablet to protect your bones along with a daily calcium and
vitamin D tablet taken either once or twice a day. If you are under 65 years old, you
should have a bone density scan to decide on the best treatment. Your GP will get
the result of the scan.
TREATMENT SCHEDULE
Dose
Treatment period
15mg
12.5mg
10mg
9mg
8mg
7mg
4 weeks
4 weeks
4 weeks
4 weeks
4 weeks
4 weeks
Continue to decrease by 1mg monthly to lowest possible dose then leave for
several months before trying to lower further
If you have any questions regarding your condition or your treatment, contact:

Your GP

The Rheumatology Department (01592 648193 – and leave a message,
someone will return your call within 2 working days).
Updated April 2010 Version 1 due for review April 2011