TAPER: This DSNS seems so perfect and has been... - PMRGCAuk

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This DSNS seems so perfect and has been working well, however - I’m anticipating future tapers and I like splitting the dose so it has gotten very complicated! I don’t know if this is possible. I take Prednisone and I’m looking at 1 milligram pills. Could be challenging :)

3.5 = 1 & 1/2 am 2 of 1 mg pm

3 =1.5 & 1.5

2.5 = 1.25 am & pm.

2= 1 am & 1pm

1.5= 1/2 am & 1 pm

1= 1/2 am & 1/2 pm

1/2= 1/4 am & 1/4 pm

Finish ? Every other day?

[1/2 of 1/2 - this too could be interesting]

8 Replies

This will no doubt be answered by those who've actually done it. But I suspect by the time you're tapering that low PMR is also very quiescent and you don't really need pred for it so much as you need to taper for the sake of the adrenals, and this might mean you'll be able to take a single dose because you won't be getting PMR symptoms, just needing, for a bit longer, a cortisol top up for daily life.

I thot then adrenals kicked in around 7. Do they take this long to adjust?

in reply to ConventCassie

They don't suddenly jump up and do a tango at 7mg no - they have to start slow and build it up. And even after you have got to zero, it is thought it takes up to a year for their function to be really reliable.

Makes sense. At 4 Mg the anesthetist left it alone so I did too following my hernia surgery last week. During the week I was low energy, but watching Wimbledon so didn’t need much. I was tempted to increase a little bit but held out and my energy level has come back. After lounging during the British Open this week, I should be good to go! However I’ll take your advice and not be in any rush.


Part of the reason for the DSNS was to make reduction at the lower doses smoother - so you can just slow it down even further - make the gap between the new lower dose days longer at the start which gives the body more time to accept the new lower dose.

I’m so glad you responded. You’re my coach! Do you mean instead of 6 or 7 days old dose 8 or 9; or do you mean wait longer to start any new taper (like 3 weeks instead of 2)? I’m glad you don’t think these small doses are crazy because I’m using the mind set of the 70% rule. (It was 70 right?)

in reply to ConventCassie

You shouldn't reduce more than 10% (ten) of the current dose - not 70% if that is what you mean.

Although marking time at the new dose for a few weeks extra is also a very good idea, no - I mean start by "1 day new dose, 10 days old dose, 1 day new dose, 9 days old dose" rather than 1 day new dose, 6 days old dose etc.

Got it. Yes, both work. Yes I did mean 10%, that one, math is not my forte :) Or memory apparently.

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