Pred problems

[Angelgoth]

So I taper when I take pred, 40mg then taper by 5mg every 3 days, however i am struggling to reduce to 20mg and went back up to 25mg today for another few days I will speak to gp on monday.

Was also thinking a maintinence dose would be better then all this tapering, my cons at rbh is happy for me to do this but it wasn't something we discussed, she just assumed I already was (I am new to rbh)

was hoping some of you guys could share your opinions on this, I will be speaking to cons about this at my next appointment.

Lejaya

[johnsmith]

Speak to a pharmacist. They have done a degree on drugs. A GP probably had a week of lectures on drugs at the most.

Have a look at

april.org.uk/

This is what I have read at lagunatreatment.com/medical...

"The initial dosage reduction is typically around 10 percent of the starting dosage of the medication. Again, depending on the reaction of the individual, this dosage can be adjusted to account for any withdrawal symptoms. Typically, the initial dose reduction will occur within a week or two after the start of the program, but again, there are different protocols for different withdrawal management programs, and the process can be adjusted based on how different individuals react.

Subsequent dosage reductions will occur 1-2 weeks apart. Again, as a general guideline, the reduction will commonly be about 10 percent of the starting dose.

When the patient is getting a dosage that is 80-90 percent less than the initial starting dosage, smaller dose reductions may be required (e.g., such as a 5 percent reduction) in order to ensure that no significant withdrawal symptoms are experienced.

Eventually, when the patient is only getting about 5 percent of the initial starting dosage, they may be discontinued from the drug entirely."

Discuss this with the pharmacist.

[EmmaF91 Community Ambassador]

Hi

I would suggest either speaking to your GP about a slower wean. Personally I wean 5mg every 5-7 days (sometimes longer like 2-4 weeks).

You should have a contact number for the asthma nurses at RBH (or email) so may be worth contacting them to ask about what maintenance level they would put you at. They have experience with weans/maintenance pred.

I hope that helps.

[warmlight in reply to EmmaF91]

Hi

I’ve had the same thing recently.

I was never given any advice about weaning from steroids until I had a total of 8 course in the space of 12 months last year. I was told after my 4 th course I should be weaning. The difficult asthma consultant advised 7 days of 40mg then reduce by 5mg every 3 days. I would often have to take 10 days o 40mg and hope was ok when I stopped. Like I say I was never given any formal advice u til last summer. Since then I’ve followed the weaning regime which has worked to stabilise asthma symptoms but I now have adrenal insufficiency and see a specialist soon after. 6 months of waiting to be seen.

I’ve just had another flare up where the peak flow just is t shifting. My gp decides to criticise the steroid reduction and says I cane down too soon! I still feel more likely to trust the difficult asthma consultant though. Anyway like you at 20mg I was still symptomtic with peak flow stubbornly not increasing despite 2 courses antibiotics. They gave me 2 choices. Steroids back to 40mg and back to gp tomorrow for a review or go to Ae. Am back at 40mg and very annoyed that the high dose has helped a little because of how rude and critical she was - hate it when they are right!

If you have to keep boosting and then weaning it may be better to stay on small maintenance dose continuously. I am for both asthma and adrenal insufficiency bit don’t seem to stay low very long due to the number of flare ups I keep having... so round and round we go! 🤦🏼‍♀️

[lejaya in reply to warmlight]

Hi

thanks for your reply, what dose of pred to u take for asthma? do u find it helps being on a maintenance dose? I take pred as and when needed but seem to be on it more often then not these days as keep getting nasty chesty infections

and it's good your doc was happy for you to have more pred, but not so good she was rude about your taper, as you are only going what your cons recommended.

hope you feel better soon

[warmlight in reply to lejaya]

40mg for 7-10 days when I have to boost the steroids. Then wean by 5mg every 3 days until I get to 7.5mg. Once I reach 10 mg I alternate between 10mg and 7.5mg for a week. The theory is if you stay on a small dose regularly you will have less steroid overall than if you are having to regularly boost your dose. Regular steroids do make you less resistant to infection unfortunately 😔 which seems proven for us both xx

Good luck

[Artforever]

My husband has been on and off steroids for other reasons not asthma for many yeaes. He has struggled coming off them too. However at his last cons appointment he was told to reduce his 10mg dose by 1mg a month, it takes a long time for your body to readjust to living without steroids again. It's going to take 10 months to be free. Think of it as a balancing act, your body is relearning how it has to behave. Check out with the cons and pharmacists. Good luck