Tapering

[Sailormo]

Hi I'm trying to taper from 12/11 before Christmas I had a bad flare I was down to 9mg but had to go up to 12mg, this is going into my third week I'm so tired and having alot of pain especially early morning. I'm seeing my rheumy in to weeks, I feel really disappointed things aren't getting any better, I've had this pmg over three years now, and a few flare ups from infections, I seem to be giving up more than I'm achieving. could you help with any advice.

[DorsetLady PMRGCAuk volunteer]

How are you tapering - an overnight drop or a slow taper such as DSNS or this -

healthunlocked.com/pmrgcauk...

You might also find that reducing only 0.5mg at a time helps. Plain tablets can be cut to get the 0.5mg or a mixture of different doses can give you the dose you need.

If you are having pain in morning splitting your dose 2/3rd am 1/3rd pm might stop that.

Some options to think about and discuss with Rheumy. But don't be pressurised to reduce quicker than you want to... and 3 years is about half way through for many.

Let us know what happens following appointment please

[Sailormo in reply to DorsetLady]

Thank you for your help I mention this some time back to one doctor, and she told me Iwouldn't be getting a correct dose but I'm going to try what you suggested .

[Hidden in reply to Sailormo]

If it works it's the correct dose!

[DorsetLady PMRGCAuk volunteer in reply to Sailormo]

The split dose doesn’t seem to be such a problem with PMR as GCA - and as Poopadoopy says if it works - it works!

[PMRpro Ambassador in reply to Sailormo]

Silly woman (not you) - you are tapering to find the correct lower dose. Whether it comes in 1 dollop or 2 you will get the amount you require BECAUSE you are titrating the dose.

[PMRpro Ambassador]

Have you tried splitting your dose? The early morning pain is because the antiinflammatory effect of the pred doesn't last the full 24 hours for you - it isn't uncommon. Often taking about 2/3 of the dose in the morning and the rest later in the day is enough to make morning better - and sometimes makes getting to a lower dose easier.

[Sailormo in reply to PMRpro]

I did try this and it did work,a couple of times I forgot to take my meds and woke up at 2am and took them so I went back to taking them in the morning if I took the second dose at night what would be the best time to take it.?

[DorsetLady PMRGCAuk volunteer in reply to Sailormo]

If you wake regularly for a comfort break during the night - then take them.

2am is a good time - then they are ready for the 4am release of inflammation.

If you do not normally wake then as late as possible before bed - with a spoon of yogurt or something.

[PMRpro Ambassador in reply to Sailormo]

What time would you expect the pain to return? If it is during the day then you would take the second dose a couple of hours before that. If it is not until the next morning then try various times to find an ideal one for you - so it manages the pain AND doesn't disturb your sleep.