Rapid tapering?

[Navion]

My rheumatologist is recommending that I drop my prednisone dosage from 10 to 7.5 and then in a month drop from 7.5 to 5 mg. Her thinking is that I was did as well at 5 mg as I did at 15 so I may as well get down to a lower dose as soon as possible. She believes that the remaining pain in between my shoulder blades is not PMR.

I'm wondering if it would be fool hardy to follow her advice? I agree with her reasoning and think I'll do okay at 5 mg, but I'm worried about the big jumps. I was thinking of at least following PMRPro's schedule. so I would do 7.5 for a day, 6 days at 10, 7.5 for a day, 5 days at 10, etc.

[DorsetLady PMRGCAuk volunteer]

Sorry.. but confused. Have I missed a post? Why were you only started at 5mg?

Presumably that was not enough if you've gone up to 15mg - so why do you and your Rheumy think 5mg is now enough? .

If it was a flare once it’s controlled you can go back down fairly quickly to your previous post you were last okay at (but do you know that) - your post doesn’t really make that clear.

If it’s a “normal” taper, then it is foolhardy to follow. Why doesn’t she think shoulder pains are PMR?

[Navion in reply to DorsetLady]

My rheumatologist started me out at 5 mg. It controlled all my leg and hip issues and allowed me to move my neck better and got rid of my collarbone pain but only helped minimally with the pain in between my shoulder blades and in my trapezius muscles. She upped it to 10 for a month, then 15 for a month. I got no further decrease in symptoms. So I went do went down to 12.5 for a month with no increase in symptoms and am now on 10. She believes the remaining pain is something like myofacial pain syndrome and had referred me to an osteopath. Since the increase up to 15 didn't help, she wants me back to 5 as quickly as possible.

[DorsetLady PMRGCAuk volunteer in reply to Navion]

Ok, but not sure that is very wise.

But I guess you can only try it her way, and see what happens.

Please keep us informed. And good luck.

PS - forgot to say MPS is very often linked with PMR, so she might be partially correct - linked, not necessarily completely separate.

Plus as you’ve been at higher doses for longer than a couple of weeks you still need to be careful about reducing too quickly - adrenals will have been affected.

[PMRpro Ambassador]

I'm sure she is right - but she has had you at a dose above physiological levels (about 7.5mg) for a few months now so reducing might be a bit more uncomfortable/not so simple. The drop to 7.5mg using a short version of my taper would probably be fine - starting with one day new dose, 4 days old dose and so on would maybe be a good place to start. If that goes OK you could try a bit longer for the drop to 5mg.

[Navion in reply to PMRpro]

Thanks. That makes sense.