Prednisone taper maybe Thursday

[Nanna71]

So I'm on 20 mgs prednisone - back up yet again - and from all the information I've read on this forum I am going to try to reduce, but much more slowly now. My tablets are 5 mgs so I was thinking to cut them in half and go down to 17.5 mgs. In anyone's opinion is that too big a taper? I don't have any 1's to use, although I could likely get some, but not too soon.

The high level of pain has adjusted down. It took almost 2 weeks to control when I went back up from 15 to 20. Is 2 weeks good enough at 20 mgs if the pain seems gone? Or should I go ahead and try the smaller reduction? I wonder if I could quarter them?

I have RA and overlapping PMR so am also on 2 Dmards as well as pred. The PMR showed up in my doctor's mind when he realized the pred. was doing all the work. Plus I have the specific pain for it, as well as RA.

Additional information - been on pred. for 6 months, MTX and sulfasalazine for almost the same.

Thank you for your patience and wisdom.😮🙂

[DorsetLady PMRGCAuk volunteer]

It sounds as if you’re not 100% right -so why not stay on 20mg for another week just to make sure. One week is nothing in the great scheme of things.

Then reduce by 2.5mg - should be okay, but the trouble is once you’ve had flare it does seem to make reducing more difficult. It probably will be too difficult to try and quarter the 5mg tablets even with a pill cutter - can’t you ring the surgery and ask for 1mg tablets. Or does your Rheumy prescribe them?

If this taper works, then in future stay on each new dose for a month to make sure everything is okay before you try and reduce again.

Good luck.

[Nanna71 in reply to DorsetLady]

To get the 1's I have to phone and then plan a trip to town to pick them up. Actually, waiting another week on 20 means I could possibly get them by then. Perfect!😊

[DorsetLady PMRGCAuk volunteer in reply to Nanna71]

Good. Then just reduce by 2mg and see how things go.

PMRpro has given link to one slow taper - here’s another one -

healthunlocked.com/pmrgcauk...

[Louisepenygraig]

What I've read on here is to reduce by 10% which would be 2mg so 2.5 may not be too big a jump. In the meantime you could order some 1mg tablets to use once you've got to 17.5 or 15 I was only on 20 for a week and got too hyperactive so dropped to 15 without any problems. Now I'm very cautious about tapering. (Currently on 9.5 a bit after two years)

[PMRpro Ambassador]

Using one of the slow approaches also works well when you have to use a bigger % drop:

healthunlocked.com/pmrgcauk...

was devised to do just that.

But you do need to be sure you feel pretty well at the current dose before you start the downward path.

[Nanna71 in reply to PMRpro]

Thank you for the response and the link. Going to read it now.

[Soraya_PMR]

If it’s taken nearly 2 weeks to get the pain under control, and you’re at 2 weeks now, it’s too early IMO.

Take another pain free week, stack the dice in your favour, then you’ll be better equipped to distinguish between steroid withdrawal pains or resurgence of PMR.

[Yellowbluebell]

I only had 5mg tablets but used a sharp knife and actually quartered some of them. It was fiddly but worked for me. It meant I could taper slowly from 15mg to 13.75mg and then to 12.5mg.

[Waterfeature in reply to Yellowbluebell]

For anyone struggling to cut tablets you can buy a pill cutter on line but I use a pair of nail clippers and it works fine

[Hidden in reply to Waterfeature]

I like my pill cutter because it catches the pills. I was always scrambling about the floor trying to find the bits that got away. Wouldn't hurt my dog as she has had pred herself, but wouldn't want her taking it unnecessarily.

[Nanna71 in reply to Yellowbluebell]

Okay, this is doable for me. My filleting knife has a very thin blade and maybe with that I can cut them two ways. Also, I think I will wait one more week as was suggested to get solid in my pred. before reducing. Thank you.🙂

[PMRpro Ambassador in reply to Nanna71]

It really doesn't matter how accurate it is - as long as it is less than the uncut version ...

[katiemills]

My surgery gives me 5mg , 2.5 mg and 1 mg tablets , so maybe you could ask for a selection ?