prednisone Tapering

[TaylorPlayer]

Hi All. I am a newbie and trying to learn as much as I can about RA

1st flare was in October 2022

Diagnosed RA January 2023

1st Rheumy visit Feb 2023. Was given hydroxy

2nd visit for pain was Feb 28, 2023. Given Prednisone 25-50mg. It only took a week before I was taking 37.5 and pain managed

Next rheumy visit June

I would like to taper off Prednisone beginning now. Is that a good idea. I would like to see if Hydroxy is working

I doubt I can get an app to ask rheumy but may get a msg to him via nurse?

Or Can I safely taper? What would be an appropriate schedule for 30 days use

Or should I just stay on Prednisone until June

Much appreciated. There is such knowledge in this group. Cheers 🌹

[Dolindocurmi]

Hi there l have had rheumatoid for 17 years. I was never given that much of a dose. Last couple of months I have had a flare ups and I was given 15 mg for 10 days and cuts me down 10 mg for five days and then 1 mg for five days and I am also on.4 mg Baricitinib every day. I was taken Baricitinib every second day for a few years but it didn’t help, and thought maybe l was having flare ups because of that. But l seem to be feeling better and it’s only been 10 days. But l have to say that when l was diagnosed with rheumatoid arthritis many years ago, he did put me on methotrexate, and I was in remission for 10 years.You need to have good communication with your doctor and let him know your concerns about staying on prednisone. I’m just on it for short term and then he will reaccess. Hope this helps.

[KittyJ]

Please don’t mess about with your meds, do you really want to risk flaring and not having your RA under control again? There’s a reason you‘ve been given an appointment in June and that’s because by then the hydroxy should be working and then the consultant will tell you how to reduce your steroids so it’s best to wait until then. Many of us have taken a short course of steroids when starting a new med, your rheumy knows what they are doing. 🤞🏻 it all works out how you want.

[TaylorPlayer in reply to KittyJ]

thanks Kitty. Thats probably wise advice. I guess I am just anxious and a bit confused and jumping the gun. I will go the course, as much as I would like to be off it. My flares were pretty awful. I think I was still stunned of the diagnosis. Cheers 🌹

[Mmrr]

Are you taking 37.5 mgs prednisolone per day ? That is a big dose.If you feel that you can manage with less you would need to discuss it with your rheumatologist. We can't give medical advice on the forum, and it probably isn't wise to start altering medication so soon into your treatment plan.

Some of us do change prednisolone dosages but work within parameters agreed with our rheumatology team.

Hopefully things work out for you.

[nomoreheels]

I support what Kitty says, best not to mess about with your meds, not without the ok from your Rheumy. He has has prescribed as he did, including the length of the course, with good intent, to bring down inflammation (& pain) quickly. In doing this it makes you more comfortable (as you've found) & potentially dimish the risk of damage caused by the inflammation.

It's common for prednisolone to be used as a bridging med to help whilst a DMARD (hydroxychloroquine in your case) is given time to build up to be it's most effective. As you've only been on HCQ a matter of weeks it's unlikely to be there yet, although it could have to a degree, but it won't have taken control of disease activity. Your period of time to your follow up appointment in June is that should be time enough to see if the HCQ is working or not & so he can base his next course of action to continue treatment or look at trying or adding another DMARD. I appreciate why you’d want to see if it is but that's better under the direction of your Rheumy.

If the letter to your GP (which you should also have sent a copy of) says repeat script pred then your Rheumy will expect you to remain on pred until your clinic appointment so please do, for all the reasons above. If that is the case your GP should be able to issue a repeat script if he's signed a Shared Cared agreement. If it was only a 30 day supply then a taper plan would have been supplied as it's a reasonably high dose to just stop at the end of the course, this is working off a 3 week or longer supply at 20 mg dose would generally be tapered.

I hope this is of some help. Let us know how it goes.

[TaylorPlayer in reply to nomoreheels]

that makes total sense now. Thank you both for the support. I do have 3 repeats that should take me to my appt. I shouldnt second guess my specialist lol……… I feel much calmer having read your and Mmrr’s replies

All the best and May You Know Painfree Days Filled With Joy🌹

[nomoreheels in reply to TaylorPlayer]

You're most welcome. I guess if the pred lasts until your appointment your Rheumy will give you a tapering plan then. If there's anything else we can help with just ask, we’ve all been where you are so can relate, it's an uncertain time! Thank you for your kind thoughts too.

[Deeb1764]

like other replies never for RA been given such high dose I go on that for my breathing issues. However I have a set system with my GP for tapering and he knows I know to manage it. So either call nurse or speak to GP on tapering and then if all agreed you are sorted.

[Runrig01]

wow that is a big dose, and I can understand your wish to cut down. With that kind of dose, you will quickly gain weight, and risk diabetes and osteoporosis. Whenever I’ve had big doses I’ve been allowed to taper 5mg at a time till I got to 20mg, then 2.5mg till I got to 10mg. You need to disk to either your rheumatologist or gp to get a safe tapering plan in place. Tapering is about nudging the adrenal glands to start producing their own cortisol, so you need to be alert to nausea, lightheadedness, stomach pains as well as other symptoms, that dictate you should stop tapering. Only a medical professional can advise the raise safe for you. I unfortunately live with adrenal insufficiency as a result of long term steroids. Any stress hood or bad makes me very ill, and needing to take more steroids. Normally a healthy body produces these steroids in seconds, however I can be 1-2 hrs before I feel normal again, and have to administer an emergency intramuscular injection if I’m sick or seriously ill, or risk death. Family havd had to be trained also. It really is imperative you seek medical advice to taper safely