~Dead slow reduction of my Hydrocortisone~

[Megams]

Hi team

My brain is not always remembering as well these days since my steroid intake, so forgive me if I haven't absorbed the dead slow method correctly.

Have started following the dead slow method of the hydrocortisone (acid resistant capsules) with my usual dose is 15mg x 2 daily. Not a high dose anyway and hugely grateful that this has been the case when I read of others on this site.

Have had 5mg capsules made up for my slow reduction.

When I come to the day of the "NEW DOSE" - am I taking new dose of 10mg x 2 daily or is it 10mg "NEW DOSE" morning or evening and the usual 15 mg morning or evening?

I have no pain upon waking in morning so opted recently when starting this plan to take 15mg at night.

I am pretty well at present and spring is supposedly 2 days away - we are in for another nasty cold snap having said that, according to weather forecast

Anyway am I confused with how much I take with "NEW DOSE"?

Want to follow by the plan but need to make sure I fully understand.

Hugs to you all as usual.

[PMRpro Ambassador]

Um - not sure here Megams. 5mg is still a big drop but of course it is hydrocortisone you are using. And I was thinking prednisolone when I worked it out plus people rarely have to take 2 doses a day with pred, that is the exception for most of us.

However - I would start by trying stopping 1x5mg per day at night so that you are taking 15mg in the morning and 10mg at night at first and see how that goes.

What would your doctor suggest for reducing under their normal system (or don't they have a normal system here)? Is capsules with 2.5mg in them possible or is that complicated and expensive to get them made?

[Megams in reply to PMRpro]

Hi there PMR pro - great to hear from you and I thought possibly my question might be a little different being as I am taking hydrocortisone capsules which I can not cut in half of course.

Interestingly enough I started my tapering last month for the first time using your dead slow and stop plan and felt absolutely dreadful the next day.

Figured that highly likely the 5mg drop was the culprit (took 10 mg morning and then usual 15mg in evening).

Went back to my usual 15 mg x 15mg twice a day the following day and have continued thus until yesterday.

As mentioned have started to feel well, apart from lower back, neck shoulder and elbow discomfort, from either sitting on computer too long or lifting anything a little too heavy - can deal to this OK and pace myself accordingly.

Digressing, a 9 year history of Cipflox for pneumonia's has not helped my tendons/ligaments one little bit - your comments on this site shocked me recently on Cipflox and answered so many questions.

Anyway, decided yesterday to start again with the NEW DOSE and today not too bad but not as bad as last month's first attempt.

I am due to see the Rheumy next week for my monthly check and I think to err on the side of caution I will ask for a script to make up 2.5mg as you suggest.

I will ask him what his system his reduction might be - he was stressed and snappy last month so will prepare with notes next week ( I usually do) making sure I am not put off my stroke like last visit - I pay well for his advice, so not as if I am in our public health system.

From memory on this site the potency of my daily hydrocortisone intake 15mg x 15mg = 30mg is equivalent to a daily intake of 10mg prednisone?

Have I got this right?

I will check in after next week's visit, I will be interested to know any thoughts.

Kind regards once more.

[PMRpro Ambassador in reply to Megams]

I find that the first few times I try the new dose I feel quite strange - not exactly ill but strange. The next day on the old dose I'm fine. Then my body seems to say "Give up, you're just teasing" and I feel less and less strange. And that is only ever 1mg! If there is any chance of 1mg capsules so you can do 2mg at a time, 1mg morning and one evening that would be far better. Sorry I didn't think of that yesterday.

[Megams in reply to PMRpro]

Thank you once more, that seems a great idea - will report back end of next week.

Kind regards as always