Time to start reducing Pred?

[PatB1948]

Hi everyone,

I am now at end of fourth week of 15mg Pred and due to start reducing to 12.5mg at my next dose. I have been feeling much better with just a little pain. I had a very busy weekend helping with a charity event and did a lot of baking for it in the few days beforehand. However, I have wakened up this morning not feeling well at all, shoulders very sore and feel exhausted. I think I may have overdone it as I was feeling so well. What I wanted your opinion on is, should I go ahead with the reduction tonight or leave it a few days, I am due to see GP next Monday and then going down south (we're in Scotland) to see our son and family on Wednesday. Should I wait until I get back before I start reducing? Yours thoughts would be much appreciated. Pat

[Patricia157]

Personally I would leave any reduction until you return from your visit to your family. It sounds as though your body is not quite ready for starting to reduce.

I found that reducing from 15 to 12.5 was too much and had to go back to 15. 10% reduction is as much as the Pmr Pro's recommend. I then went down by only one mg until 10 and then by halves.

I have had a few hiccups along the way but with the slow method I am now at almost three and I am now able to lead a reasonably good life allowing for my age and caring for my husband.

Enjoy your break and have some recovery time when you get back before starting your Pred journey.

Best wishes

[PatB1948 in reply to Patricia157]

Thanks, Patricia, I was thinking along those lines, good advice from you. Pat

[SheffieldJane]

If it was me Pat I would wait until my visit was over and I was feeling well and rested. Tapering tends to fail if you push it when there are other demands on your body and mind. Then you are back to square one. It is tempting to try and be your former energetic self when you feel good, but remember Pred. Is essentially a painkiller. You still have the disease.

[PatB1948 in reply to SheffieldJane]

Thanks, Jane, that's what I'll do. I think I should take the advice from all of you that PMR is a serious illness, I find it hard to slow down as I have always been a "get things done" person but I shall try to rest more. Pat

[DorsetLady PMRGCAuk volunteer]

Hi,

As others have said, don't reduce at moment, and yes you probably did too much.

Get yourself back on an even keel, enjoy your trip, and then think about reducing.

If you haven't already considered a slower taper over a few weeks rather than an overnight drop it might be easier, and as Patricia says sometimes the drop from 15mg to 12.5mg is too much. If you feel any return of symptoms, which hopefully you shouldn't with the slower taper, then rethink the amount you drop.

FYI My slow taper as follows:

1st week - Sun & Thurs new dose

2nd week - Sun, Tues & Thurs new dose

3rd week - Sun, Tues, Wed, Thurs new dose

4th week - Sun, Tues, Wed, Thurs & Sat new dose

5th week - all week new

[Hidden in reply to DorsetLady]

Love reading your posts as you are so knowedgable and wise. Have written this taper down to help me. Have stayed on the 20mg as suggested as still having shoulder and neckpain as well as sore muscles. Thank you.

[PatB1948]

Thank you, DL, yes I think I'll try this slower taper when I get back from my trip, you are so knowledgeable and give lots of good advice. Pat

[PMRpro Ambassador]

If you DO decide to go ahead with a reduction - and I wouldn't - then I certainly wouldn't try 2.5mg at one go. 1mg is more than enough at this stage - no reduction in the taper should be more than 10% of the current dose.

And this is another slow taper that a lot of people on the 3 forums have used:

healthunlocked.com/pmrgcauk...

It is being used by a group in Leeds who are doing a clinical study on pred and PMR so is approved by doctors. You can adjust it to fit your needs.

Doing a small reduction that works is often faster than trying a bigger one that doesn't!

[PatB1948]

Thanks, PMRpro, it was GP who said to start reducing after 4 weeks but since seeing all the posts regarding this on the forum, I think you're right and I'll do as you say and also wait until after my trip to start taper. I'll ask doc on Mon for the 1mg enteric coated tablets as my stomach and reflux are much improved with the GR Pred. The only thing is that the 1mg tabs cannot be halved so I'll either have to reduce by 1mg or 2mg. Pat

[JanetRosslyn in reply to PatB1948]

You can get 2.5mg coated pred too. My gp has given me 1, 2.5 and 5s to work with, which will work right down to 2mg, at which point if I need 1.5 I'll add half an uncoated 1mg to the mix. That's a loooooooong way off for me though as I'm just in the process of dropping from 9 to 8.

[PMRpro Ambassador in reply to PatB1948]

rcpe.ac.uk/sites/default/fi...

This lot keep patients at the starting dose for 6 weeks - or longer if need be to get symptoms well under control.

As Janet says - enteric coated come as 2.5mg too.

If you combine things correctly using a 2.5mg tablet you can do 1/2mg at a time:

2.5 + 5 +5 +1 +1 = 14.5 etcetera...

And you do have a note of this don't you:

medicines.org.uk/emc/medici...

because your average doctor will tell you that 1mg enteric coated doesn't exist. It does now! Since last August

[PatB1948 in reply to PMRpro]

Thank you for your input, I'll ask doc to prescribe the 1mg coated, I actually have the 2.5.

[PMRpro Ambassador in reply to PatB1948]

And remember - don't cut enteric coated tablets!

[DorsetLady PMRGCAuk volunteer in reply to PatB1948]

As others have said, there are many ways of getting around the 0.5mg dose. Even if you take the majority of your dose with enteric pills, the 0.5mg uncoated pill is unlikely to cause much problem.

Not only do you have to be patient with this illness, you need to have a degree in Maths as well!

Good luck.