Tapering prednisone with methotrexate

[arvine]

took my first methotrexate injection 15 mgs today, been on 4 mgs pred since May, whst sre opinions of starting taper to 3 1/2 mgs now?

[ftorres18]

Advice on your situation:

1. Give methotrexate time:

Methotrexate does not work immediately. It takes between 6 and 12 weeks to start effectively controlling inflammation. In the meantime, prednisone is still key to keeping your symptoms under control.

Do not reduce your prednisone dose too quickly until methotrexate has had time to take effect.

2. Taper prednisone slowly:

You’re already on a low dose of 4 mg, which is a good sign. However, reducing below 5 mg requires caution because the adrenal glands (which produce cortisol) may still be "asleep" due to prolonged prednisone use.

How to reduce: Lower the dose by just 0.5 mg at a time, and stay on the new dose for at least 2 to 4 weeks before reducing further. This allows your body to adjust safely.

3. Pay attention to your body:

If you decide to reduce to 3.5 mg, monitor yourself for any signs that your condition is flaring, such as pain, stiffness, or fatigue. If these occur, stop the taper and consult your doctor.

Watch out for other symptoms like weakness, dizziness, or nausea, which could indicate your body is struggling to adjust (adrenal insufficiency).

4. Always consult your doctor:

Even if you feel ready to reduce your dose, your doctor is the best person to advise you. They can confirm whether this is the right time to taper or if it’s better to wait until methotrexate has been in your system for longer.

5. Be patient with the process:

Tapering prednisone is a slow process, especially at low doses. This is normal and helps avoid relapses or side effects. Your long-term health is the priority.

Simple summary:

Can you reduce to 3.5 mg? Yes, but do it gradually and pay attention to how you feel.

Wait: At least 2–4 weeks before making further adjustments.

Consult: Always discuss your plan with your specialist before making changes.

Remember, the goal is to maintain control of your condition without rushing. You’re on the right track!

Good luck 👍🙏