Next reducing level

Diagnosed with PMR end of Nov 2019. Been in pred 20,17 1/2, 15, and now on 10 doing the slow Dorset Lady’s plan. Have been fortunate pain disappeared completely and hasn’t returned. My question is what do I drop down to now. Doctor has prescribed 5mg and 1mg .

[DorsetLady PMRGCAuk volunteer]

I would try going down by 1mg per taper until around 7-6mg and then 0.5mg taper. That’s of course everything remains as it is.

Some people find around 7mg things become more difficult - so just gauge things as you go.

As we always say - it’s only a plan - which can be amended as you go. If you feel the 1mg drops initially are too much, then go to 0.5mg.

If you’ve dropped from 15mg to 10mg in one go - Just make sure that that 10mg is enough - maybe staying on that a month before you consider any taper. It’s a big drop - so you need to ensure it’s still controlling everything.

[Maisiek in reply to DorsetLady]

Thank you- ive been sailing along with the DSNS method , but now at 6, the symptoms are all coming back : maybe I will try 0.5 mg reductions now. X

[DorsetLady PMRGCAuk volunteer in reply to Maisiek]

Yes do. It very often becomes more difficult to reduce as you get lower - you have less leeway between plenty of Pred, just enough and not enough!

So smaller and slower steps are the key.

But if your symptoms have returned maybe a week at 10mg will sort things out - and then drop back down to 7mg or 6.5mg - as 6mg is not quite enough!

Make sure things have settled before you continue tapering...and don’t reduce any-when if you’re in pain.

You are always trying to find the LOWEST dose that gives you relief - no point in going below it.

[Maisiek in reply to DorsetLady]

Thank you so much - I would be able to reduce straight from 10 to 7?

[DorsetLady PMRGCAuk volunteer in reply to Maisiek]

Yes, so long as you’re only on the higher dose for a short time. It’s one of the recommendations to get a flare - or maybe the beginnings of a flare - under control.

[Maisiek in reply to DorsetLady]

Thank you- what would we do without you! X

[PMRpro Ambassador in reply to Maisiek]

But don't forget that you aren't tapering relentlessly to zero - you are looking for the lowest dose that works as well as the starting dose did. If the symptoms are returning then that is the sign you have got there, and probably have passed it. It doesn't mean you won't get lower, just not yet. However slowly or small steps you try, eventually it will catch up with you.

[Maisiek in reply to PMRpro]

👍

[Thelmarina in reply to Maisiek]

Also for my part I have learned to differentiate between polymyalgia symptoms and a bit of arthritis now showing up with reduced steroid dosage, and muscular response to gardening or unexpected exercise!

[Hidden in reply to DorsetLady]

Missed one out should read dropped from 12 .5 now on 10, the old brain is addled! Will start only dropping 1mg from now on, thank you

[DorsetLady PMRGCAuk volunteer in reply to Hidden]

Did wonder, Thats why I said if! But rest applies.

continued good luck.

[Hidden in reply to DorsetLady]

When I read the word If from you, I thought I know I’ve typed something wrong.

[DorsetLady PMRGCAuk volunteer in reply to Hidden]

I never was a schoolteacher - but I was a head girl - sorry it’s showing! 😂😂😂

[sara44 in reply to DorsetLady]

Sorry what is a head girl

[DorsetLady PMRGCAuk volunteer in reply to sara44]

Head boy and head girl are roles of prominent representative student responsibility. The terms are commonly used in the British education system and in private schools throughout the Commonwealth organisations.

My school was single sex and I had 12 prefects who helped me to look after the younger students etc

Equivalent terms

Class president is a similar position; these are commonly found in high school and secondary schools in the United States and Canada and may or may not necessarily be gender-specific.

[sara44 in reply to DorsetLady]

I was correct in my thinking as you seem to represent a very knowledgeable and respected individual love your comments and I’m so glad I found you on

[PMRpro Ambassador]

Not more than 1mg at a time from here on.

[Gary1310]

I was diagnosed PMR about the same time. Flared in Dec. 2019. My Rheumatologist at Marshfield Clinic, started me on 20 mg. Gradual reduction till 1 mg p m till Feb 1. this year. Then STOP. I feel well since. I am not 100% well but maybe 90%. No pain just weak muscles. I think the most important advice I learned here was to pace myself. Fatigue was a big problem for me. I still know my limits, rest a lot. It is a priority. I learned to say NO to all unnecessary things.

[Hidden]

I agree when I feel a bit weary, I give in now, being retired nothing is that important anyway. Glad to hear you are doing well.

[Kulots]

What is the Dorset Lady' Plan?

[PMRpro Ambassador in reply to Kulots]

There are links to all the relevant taper approaches here

healthunlocked.com/pmrgcauk...

[Bcol]

DL has some tapering plans for reducing your Pred doses either over over 5 or 7 weeks, you can either use them as they are or adapt them them to your own requirements. They are also pinned to the site. Peter

[Hidden]

It is working so far down from 20 to 8 with Dorset Lady’s plan, long may it last!