Remicade, Prednisone as pre-medication

I haven't heard of Pred use as you describe. Generally only a pre-med when you've had previous infusion reactions.

Yes, 5mgs per kilogram is the standard starting dose.

Thanks iPoop and Sara. I have an IBD doctor at a respected teaching hospital too distant for regular in-person visits and a local older sweet generalist GI who keeps up to date. The local guy is affiliated with the the teaching hospital, even referred me, but they don't seem to communicate.
I wrote to the PA/specialist and 5mg is highly recommended to get the best response and avoid antibodies. My next task is to urge the local office to up the dose at the infusion center. I didn't know orders like dosage (and lab orders, another story) were supposed to originate with the patient. I feel like I'm stepping on egg shells trying to negotiate the rules of medical etiquette and pecking order.
I got an accidental look at the written infusion orders and there is a printed check list with two choices: 3 or 5mg. Maybe 3mg has a role in some cases.

I agree Sara. You have motivated me to call, write, message and email a few providers (in a nice way).

The wrong dose sounds like a serious error and violation of the medical oath of "first do no harm".

The odd Prednisone pre-medication taper comes from the specialist; the dosage originates with the local doctor, or maybe the hospital pharmacy. You can't trust anyone.

It's exhausting to coordinate my own care but I will be a strong self advocate. Wish I had caught this sooner; it was in the back of my mind that 5mg was standard.