Tapering Approach

[Themidget]

Diagnosed with PMR Nov18.Started on 15mg Pred and began tapering down to 10mg 6wks later. Have been reducing by 1mg every month till hit 7mg(March) and then noticed claw left hand begin to re-appear again in mornings plus a mild overall headache. Alerted to the impact of tapering strategy thru the postings here, I increased to 8mg and all seems to be fine. Should I have increased by more than 1mg?and are point-five.5mg tablets available?

[SheffieldJane]

The hand sounds like a separate and possibly related condition that needs particular attention. I think Margaret Thatcher had this, I can’t remember what it was called.

You need to invest in a good sharp pill cutter from the pharmacist. You cannot get 5.5 mgs unfortunately.

If a 1 mg increase hasn’t mopped up the inflammation you may have to go a bit higher. You are right 0.5 can make all the difference.

[SnazzyD]

Hello. The PMR people will be along soon, but it sounds like 8mg is ok if all is well. Definitely worth 0.5mg drops now (I did 0.5mg every 6-8 weeks) as these lower doses can get a bit tricky with low or no adrenal function to add to it. You ask about tablets - If you are on non coated Pred you can cut 1mgs in half and some use a pill cutter. I’m on coated Pred which you can’t cut and so far I’ve been cobbling together my doses using 1mg and 2.5mg tablets. When I get to 1.5mg it’ll be impossible so I may have to try uncoated Pred and hope it doesn’t upset me as it’s such a low dose.

[Themidget in reply to SnazzyD]

Many thanks. This is helpful. Have a good weekend.

[Rosbud]

I don't think .5 mg are available but I manage by using 2.5 mg mixed with 1mg x

[Themidget in reply to Rosbud]

Many thanks.

[PMRpro Ambassador]

No, 1/2mg doses require a pill cutter and a bit of practice! Although 2.5mg pred tablets are available in both plain and enteric coated forms (in the UK only) and can then be combined to give 1/2mg doses.

If 8mg is doing the job - why go further up?

[Themidget in reply to PMRpro]

Yea. Think 8 is doing the job but do you ever really know?

[PMRpro Ambassador in reply to Themidget]

If it weren't - you will develop symptoms eventually,

[Rosbud in reply to PMRpro]

As I found out to my cost , got myself down to 8.5 although at 9 is felt ever so slightly off , by the end of week 2 was back to crawling out of bed in the morning , put myself back to 10 and am so much better, will listen to my body in future !

[Themidget in reply to Rosbud]

Thanks. It's so sensitive to 1 or .5 mil. Think I need to listen to body regardless of "pressure" to reduce.

[PMRpro Ambassador in reply to Themidget]

YOUR version of PMR and YOUR body will always win!!

[Telian]

No 5.5mg pred (if that's what you meant) but there are 2.5mg when you get that bit lower. Remember to let your GP/rheumie know your symptoms.