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[Bonnig]

I've been on 20mg of prednisone for one month. My latest blood work (CRP and Sed rate) are both in the normal range. Is going down to 17.5mg for four weeks the right thing to do? And then take another blood test?

[PMRpro Ambassador]

Yes, if you have no symptoms then it is about time to start reducing. The blood tests probably don't mean a lot - other than the current dose of pred is enough to deal with all the inflammation. In some people they don't rise again while they are taking pred so symptoms are always more important than bloods.

You should be OK with a 2.5mg drop down to 15mg but just be aware: if it is going to happen, pred withdrawal discomfort starts immediately you drop the dose, same day even, and then improves over the following week or so. If you are fine for a few days and then symptoms reappear it is a sign the dose isn't quite enough to clear out all the inflammation and it is mounting up again so you may need to go back, wait a week and then try again. Or perhaps get some 1mg tablets and try a smaller step-down.

[Bonnig in reply to PMRpro]

just to be clear..do you mean down to 15 or 17.5? I was tinkning 17.5..which is a12.5% drop or should I just go to 18..which is 10%?

[PMRpro Ambassador in reply to Bonnig]

Sorry, yes, that wasn't very clear was it! I should have said 2.5mg drops, 20 to 17.5 to 15. Try the 2.5mg first - if it doesn't work you can always try again.

What sort of tablets do you have?

[Bonnig in reply to PMRpro]

uncoated 5mg (which can eaasily be split). But I can ask the doc for 1mg so I can go to 18 instead of 17.5.

[DorsetLady PMRGCAuk volunteer]

Hi,

If you read the so called professionally designed plans, the normal reduction is in 2.5mg steps from 20mg down to 10mg. Some people manage that, but many don't which is why there is so much talk about them on this forum!

I managed from 25mg down to 12.5mg in 2.5mg steps, but I had been on much higher doses, and for a lot longer than you - not that I'm sure that means much as we're all different in our reaction to/absorption of Pred.

As PMRpro says you should be okay to drop down in 2.5mg steps, to 17.5mg then 15mg. Depending upon how you feel each time, you are the best one to decide what to do after that.

That's the important thing - how YOU fell, not what the doctor thinks you should do, or feel!

[Bonnig]

OK, THANK YOU BOTH!!