Taper 0.5 mg by alternating dose

[Lovebikes]

I feel a bit cheeky asking this when I know the DSNS taper is such a favourite on here. However, if I can manage without it, it will definitely save me getting in a twist over which dose I am taking which day.

I am at 7mg and have so far got away with reducing a mg at a time. However, last time I was worried for a couple of weeks that various pains could be the PMR coming back, before it all settled down again. So this time it will be no more than 0.5mg.

Now I think the usual way to do 6.5mg is to alternate 6mg and 7mg and, in discussion with my very helpful Registrar GP, I was going to go with 4 weeks of alternating then 4 weeks of 6mg etc. I was just interested if anyone had any first hand experience of using alternating doses or any comments on whether it was as bad as yo-yoing with your adrenals having no idea what they were going to get any one day for 4 weeks.

[Robinsnest72]

Hi Lovebikes

I am going from 5mg to 41/2mg as my Rhuemy said 1/2mg monthly now. I am using DLs Simple taper and it seems to work.

Start on a Sunday

Wk 1 Sunday and Thursday new dose

Wk 2 Sunday, Tuesday and Thursday new dose

Wk 3 Sunday, Tues. Wed. Thur. New dose

Wk 4 Sunday Tues. Wed. Thur. Sat. New dose

Wk 5 every day new dose

I know by the end of wk 4 if all is well so I have started again on Wk 5

Get a pill dispenser and fill the doses a wk at a time. I just find this one seems to be a bit quicker as I am only doing 1/2mg at a time. I do not want to have to go back up so am being very cautious.

[Lovebikes in reply to Robinsnest72]

Thank you for replying. So when you say new dose you are talking 0.5mg less? How are you getting the half mgs? Are you cutting the pills?

[PMRpro Ambassador]

That is a fairly standard way of reducing - and if it works, that's fine. But the slower you go from one dose to another the less your body will react to the change. You have to try it to know it works. Or not ...

[DorsetLady PMRGCAuk volunteer]

Robinsnest72 beat me to it - but this is full link - straightforward tapering -

healthunlocked.com/pmrgcauk...

And I think either this or DSNS is a better way than alternating days - easier on body.

[Lovebikes in reply to DorsetLady]

Totally makes sense that alternating days is not great on the body. Same question as to Robinsnest72, am I understanding it right that you are only dropping 0.5 mg over the month and so you are getting new dose using pills cut in half? Or are you using 2.5mg and 1mg pills to make it up but then what do you do when you get below 2mg? Feeling dumb

[Robinsnest72 in reply to Lovebikes]

I have to cut the 1mg in half to get that dose so at 4&1/2 I am using 4 one mg tabs and 1/2 a mg tab. I live in Canada and the tabs are not coated so easy to break. Being a retired pharmacy tech I find it easier to break the tabs as using a pill splitter which I do have. This is what I call the new dose and on other days I take the 5mg tab

[Lovebikes in reply to Robinsnest72]

Ah right! My (mis)understanding had always been that the only way you could get a half mg was by alternating. My 1mg tablets aren't coated but there is no splitting line. I might have to experiment! Thank you for clarifying

[Robinsnest72 in reply to Lovebikes]

I have no problem splitting them with my fingers. I do up a bunch so I can fill my doscette

[DorsetLady PMRGCAuk volunteer in reply to Lovebikes]

Personally I used 1mg tabs and cut as necessary - now off the Pred completely - GCA in remission 3years. But you can mix and match - but as you say that only works until you get to 2mg - and then you need to split the 1mg tablets. Although they are quite small it’s easy enough to do with a pill cutter - available in all pharmacies or through that well know online retailer.

[Lovebikes in reply to DorsetLady]

Great to hear from someone in remission. Thanks for still being here to help us all through