DSNS TAPER

[Chopin002]

DSNS is my method this time tapering, .my question is , where do the half tablets come in, . ? Everyone talks about half amounts , but on the method to follow it is all whole amounts right down to one, I am almost on six. Don’t want to mess up as I know the consequence well. Thanks.

[Rugger]

Many of us taper in 0.5mg stages - 7.5 to 7mg, then 7 to 6.5mg and so on. It's more gradual that way, especially as we get to the lower doses.

Assuming you have 1mg uncoated tablets, you can cut them in half with a pill cutter from the Pharmacy or a sharp knife - mind your fingers! If the halves aren't exactly equal, it evens out over 2 doses!

I saw my Rheumy yesterday and she wants me on 4.25mg for the next month! So it will be alternate days of 4mg and 4.5mg.

Best wishes with your tapering.

[PMRpro Ambassador]

No - in my original article there is no stipulated dose change, it can be anything, from 5mg at the high doses for GCA, through 2.5mg at moderate doses for PMR down to 1mg. You can use it for any drop you like - it was developed so that patients on gastro-resistant pred could use it to make dropping 2.5mg at a time less awful, at the time there were no 1mg g/r tablets and some couldn't use non-coated at all. Some people find 1mg is too much - and use 1/2mg drops. You can get 2.5mg tablets and if you are really sensitive, with 1mg ones you can easily drop just 1/2mg at a time right down to 2mg.

[Chopin002 in reply to PMRpro]

Thank you both. This makes me realize how sensitive a small amount can be. I will be extremely careful and start cutting if need be. So far so good this time around. Best wishes to all. What a journey.

[HamishPMR]

When you are at your level of prednisolone it is best to drop by 0.5mg at a time. If for example you drop from 5mg to 4 mg, that's a 20% drop but from 5mg to 4.5mg is only 10%. It makes sense. When I get down to 2mg I shall be thinking in quarter tablets. All the best!

[Chopin002 in reply to HamishPMR]

Thank you. That does make it easy to understand. I will do exactly that as I have made mistakes in the past .

[HeronNS in reply to HamishPMR]

I've found the .5 mg still works at low doses, but have had to do each step of the DSNS taper twice so it takes three months to taper .5 mg. Now nearly at 1.

[Chopin002 in reply to HeronNS]

Good for you, that’s wonderful. I will be very patient and slow. Better to get there slowly than to flare again. Thank you.

[HeronNS in reply to Chopin002]

Yes, I learned my lesson two years ago when I was nearly at 1 and my doctor told me to use up the rest of my tablets, stop and see what happened. Several attempts to use those limited tablets to DSNS down ended badly and I was then stuck at about 2.5-2 for the next couple of years.

[Chopin002 in reply to HeronNS]

Good to know.

Not so good for you, but paves the way for the rest of us not to make the same mistake. Thanks again.

[Graememidsussex]

Hi Chopin002

I’m about to start tapering down from 2mgs to 1.5mgs but now you’ve raised the issue I might try 1.75mgs and take longer but maybe safer !

Best of luck with your downward journey .

Graeme from midsussex

[Chopin002 in reply to Graememidsussex]

Best of luck to you too.

I will be taking longer as well. Everyone says not a rush.

We need to maintain quality of life and avoid the flare.

[Suet3942]

My doctor prescribed 2.5mg tablets fir me.

[Moralis]

I have been tapering from 20 mg two years ago, now down to 1.5 per day. Since getting down to 5mg, I have been tapering by .5 per month. As my rheumatologist points out, the lower you get, the greater the percentage by which you are cutting your dose. Slow is best. I just cut the 1mg pills in half.