Do I taper if I’m coming down with a cold?

[GratefulBailey]

I started the “Dead slow” method of prednisone tapering - went down to 7.5 (for 1 day) from 8; the first 2 days were OK, some nausea, but by mid week was fine. I’m to take 7.5 again tomorrow but am struggling with the start of a cold. (I’m also on Actemra.) Any thoughts as to taking 7.5 tomorrow or stay on 8 until I feel better?

[Yellowbluebell]

We dont usually reccomend tapering whilst ill. I personally would stay on my present dose until the cold clears up. Its a fairly low dose of pred anyway and a few extra days shouldn't hurt. Take it easy. YBB

[GratefulBailey in reply to Yellowbluebell]

Thanks...I was leaning toward staying on 8 for a few more days...

[Yellowbluebell in reply to GratefulBailey]

Sounds good.x

[Hidden in reply to GratefulBailey]

I always think if something beyond "normal" life happens then the taper should be postponed until it resolves. Best wishes.

[GratefulBailey in reply to Hidden]

Thank you...a good way to monitor the taper. I guess I (like everyone) just want to be done with prednisone!

[SheffieldJane]

I wouldn’t risk it. Give it another week. You’ve nothing to lose.

[GratefulBailey in reply to SheffieldJane]

Yes, now that I’ve read your reply-and the other replies- I realize another few days (or weeks) isn’t the worst thing - feeling better and being able to handle the taper has to be a priority rather than getting off prednisone quickly!

Thank you for taking the time to reply.

[PMRpro Ambassador]

I'd probably stop where I was in the middle of the taper until the cold is better if it was bad enough although mostly I just continued since the periods between new dose days were quite long for me at the start of a taper step.

More to the point - what is the recommendation about colds when on Actemra?

[GratefulBailey in reply to PMRpro]

I was told to monitor my symptoms and see my doctor if there are any signs of infection. Day 3 today and holding steady with congestion, sore throat, headache (the cold kind, not the GCA kind!) ...will see how I am tomorrow and call my doctor if necessary. Lots of cold self care! I think I’ll stay on 8 for a few more days because tomorrow is Actemra injection day and the day after is rough, so that, plus the taper and the cold....just too much!

Thank you!

[HeronNS]

Just to throw another thought into the ring. As pred is an immune suppressant I have no idea why we are recommended not to taper when we're ill unless, and I think this is important here, you need the cortisol and your adrenals are not at the stage where they can step up and produce more if needed when you're ill. So I wouldn't make a blanket statement not to reduce when ill. Only when you are, as indeed you are, at the point where your adrenals are having to up the ante. (As an aside I had a tummy bug when I was at about 6 mg and didn't take pred for a couple of days, once because I'm sure I didn't absorb it and the second day because I forgot. No evil consequences, but the reason I remembered finally was the development of a headache, I think an adrenal issue, not because of return of PMR symptoms which vanished while I was sick.)

[GratefulBailey in reply to HeronNS]

Thank you...I decided to step down today now that I’m feeling better! So tired of feeling “sick and tired” ...I decided to pay it safe and not risk feeling worse.