If you are on prednisone/olone full time, what is the typical daily dose?

[runcyclexcski]

My consultant proscribed a taper from 20 mg per day for a week, then 10 mg per day for a week, then 5 mg per day, while I am waiting for xolair (allergic asthma). He stated that 5 mg will minimize any side effects. To me, the "side effect" of not being able to work and having to stay at home in a pressurized HEPA chamber 24-7 feels worse than potential side effects. Well, I did not convince him this time to let me have more than 5 mg per day. I am lucky to have him as my consultant, but I wonder how high one can do on prednisolone if staying on it for months/years?

Thank you all in advance!

[SpireAnt]

Hi runcyclexcski , I was on 20mg for a long time many years ago, but I was told that this would affect me in older life, so they brought it down to 10mg per day. I've been on 10mg per day for the past 15 years. Having said that, I've had cataracts and I now have osteopenia (not osteoperosis), and my consultant has asked me to try lowering my prednisolone dose down to 7.5mg if I can. I have been told that 7.5mg or even 5mg is a typical daily dose.

[runcyclexcski in reply to SpireAnt]

Many thanks, SpireAnt! 10 mg per day for 15 years, with a chance of cataracts, sounds better to me than no cataracts, but a 100% chance of daily asthma attacks.

[Js706]

Honestly I would say to avoid long term prednisolone over 5mg if at all possible.

I’ve been on 20-35mg daily for just over 3 years. But I now have severe osteoporosis in my spine, osteopenia in my hips and 4 vertebral fractures. I also have a potential primary immune deficiency (just sent off gene testing) but the steroids made my immune issues significantly worse and I was ending up in hospital monthly with pneumonia at my worst point.

I know the waiting times suck but just wanted to add in my experience as I’ve not really been on prednisolone that long compared to others but it has already started to totally wreck my body!

[twinkly29 in reply to Js706]

Yes agree. My issues are nowhere near the level of yours, Js706, (sorry!) but I've had immune levels diagnosed as low (borderline needing IV infusions), cataracts which needed surgery in my 30s (which caused a huge impact on my life) and all sorts of other issues too all because of lomg term high dose pred.

[Js706 in reply to twinkly29]

I’m just special 😉😂 but yes, I think pred has disabled me much more than my asthma, despite all the admissions! (Although I appreciate the pred has been entirely necessary)

[runcyclexcski in reply to Js706]

Thank you, Js706. Are they planning to keep you on the steroid?

I have a friend who has been on prednisone for 20+ years. He is ~20 older than me (I am 45) and appears to do well (cycling, walking, intense job etc). So my cavalier ideas about bumping up the prednisone are probably based on his positive experience (N=1), not a statistically large sample size, for sure.

[Js706 in reply to runcyclexcski]

Currently they said they have no other options. I’m on all the licensed medication for asthma and xolair and still have regular admissions (although far better than I used to be!!) and we tried reducing my pred on a planned admission before and it didn’t quite go to plan 😅

To be honest I think a lot of people won’t have the same issues I have but just thought I’d mention them as I also wasn’t expecting them!