Taper from 12.5 to........

[DianeA1]

Hi,

Dx'd with PMR in Jan 2018 and put on 15 mg which was wonderful.

2/17/18 reduced from 15 mg to 12.5 mg. Drs instructions are to reduce to 10mg on 3/19/18. I wonder if that is too big an amount to reduce. Should I instead reduce 10% to 11.25mg?

Thank you in advance!

Diane

[Soraya_PMR]

Impossible to predict DianeA1

My rheum wanted me to drop from alternate 14/15 doses to 12.5 and I tried. Had nasty steroid withdrawal pains early and then from day 7 it went pear shaped, until day 9 when I got stuck on stairs. Back to 15 to control it, then down 1mg at a time.

I think smaller drops are better as you can tell exactly where your symptoms are ok. If you drop from 12.5 to 10 and it doesn’t work, then you don’t know if your ideal dose is 12, 11.5, 11, or 10.5, and you’d have to go back to 12.5 to find out, ultimately taking a higher dose than might be necessary.

Maybe a drop to 11 initially, then pause and reassess?

[DianeA1 in reply to Soraya_PMR]

Hi Soraya, thank you for sharing. I concur and want to avoid the yo-yo you describe.

[DianeA1]

I need to add that I am having no 'issues' at 12.5 as long as I pace. Just had a niggle once. Is this the time to start the DS method?

[DorsetLady PMRGCAuk volunteer]

Hi Diane

Guess you only have 2.5mg tablets, hence the 11.25mg drop. I would be inclined to try that rather than the full 2.5mg but ask your doctor for 1mg tablets as well - you will need them.

It entirely up to you when you introduce a slow taper. But whatever way you go, you must give yourself time to know the current dose is okay before you consider another taper.

Most people seem to get problems because they are advised to reduce before they are sure the current dose is enough. Two weeks on an overnight drop is not enough, 4 weeks much better.

A slow taper is designed to stop steroid withdrawal and to help the tapering process. Some need to use it on bigger doses than others.

[Hindags]

I think it makes sense to follow a taper that is consistent with what you believe of know about yourself. I just knew I needed a slower taper because I'd had a hard time coming off of a blood pressure meds...

Reading this forum, I just decided that it didn't make a lot of sense to rush the treatment. It would take what time it would take. (I started Pred in 12/2016)

I started at 1mg a month the second time I was at 14. The first time I had some kind of flare. When I was at 8 I started PMRpro's 26 day taper to 7. Then her 38 day taper to 6. I've just started a 38 day taper to 5. I suspect I'll be at 5 for a while once I get there.

[DianeA1]

Based on my shoulders and what you have said I am going to delay my taper for a week and only drop to 11.5.

PMRpro's bucket analogy is so clear, too.

All of the voices on this forum are in my head!!! (Just Joking: I am not hearing voices...)

Happy St. Patrick's Day!!

Thanks to all, Diane

[Joydeck]

Diagnosed late in October, I'm on 12 mg and now tapering at 0.5 mg a week. So far, so good. (I use a scale weighing down to 1 mg)