Tapering Regime

[Crossstitchfanatic]

I am at my wit's end! My G.P. won't supply 2.5mg tablets prednisolone so I can reduce to 27.5mg on Thursday because he says I should reduce by 5mg everytime. I've been reducing by 5mg every 2 weeks since 40mg and it has been successful. I told him that I wasn't happy and he said get another G.P. opinion! I'm beginning to doubt myself but know that he has been of no help and the forum is my only support. Any words of advice ?

[DorsetLady PMRGCAuk volunteer]

Hi,

If you have plain white uncoated tablets, they can be cut - pill cutters very cheap - see reply to this post - healthunlocked.com/pmrgcauk...

However if you are on coloured gastric resistant tabs they cannot be cut.

You GP is incorrect in his thinking - 5 mg reductions can be achieved on higher doses, but the lower you get the smaller the reduction needs to be. General advice is not more than 10% of your current dose - so in this case 3mg not 5mg.

It might be wise to follow his advice - and find another, more sensible, more sympathetic GP!

Can you put your country on profile - helps us answer questions like this.

[SheffieldJane]

I can see no good reason for his intransigence. Having had PMR for 4 years and GCA and knowing from personal experience that the no more than 10% of a dose when tapering advice, really helps, I would be inclined to invest in a pill cutter or indeed a GP who is more interested in my well being than having a power struggle with a patient.

We know that Pred has its side effects and we do want to get off it as soon as is humanly possible but honestly, this kind of pushing leads to flares.

[Marijo1951]

Obviously a suitable candidate for early retirement. Honestly, I thought that sort of rude, overbearing and uncaring doctor - the kind I remember my mother trying to cope with in the 1950s-60s - had died out by now.

I agree that maybe the best thing would be to ask another GP. If necessary, go armed with information from this forum and elsewhere to support your case. Or, is there a chance you could be referred to a rheumatologist who might be more open-minded as well as more knowledgeable? I suppose that's unlikely in the current situation, especially when the NHS evidently believes that PMR on its own should be managed by GPs. In the meantime, a pill cutter would seem to be the ideal tool for you, as long as you're on the plain uncoated tablets. Good luck!

[PMRpro Ambassador]

Get a pill cutter. And a more empathetic GP. Though you might struggle within the same practice - they do tend to stick together. But really - how silly!!!!

[Thelmarina in reply to PMRpro]

What she said 😀

[paulst955]

The answer is in your question don't just get another opinion get a new GP.

[tangocharlie]

Give me strength ... what a stupid attitude for a doctor to take, helpful to no one. Tell him he is welcome to ring us on the PMRGCAuk Helpline if he would like further information on how to help his patients with this disease.

[Plonkerme]

Get lots of 1mgs. You shouldn't have to do halves. MOST advice is to not hurry with the reductions. It is very hurtful to have an unhelpful GP - perhaps seek a private consultation. Just once in a while it is worth the extra expense!

[artisam in reply to Plonkerme]

Have you tried talking to your pharmacist? Mine was so helpful when my GP clearly didn't understand the rheumatologist's instructions. He put in an urgent request for Img tablets which seemed to work. Getting a referral to rheumatology might be a good course of action too, although some are just as bad! I'm lucky mine really listens now he knows I know what I'm talking about - thanks to everyone here for that.

Good luck🤞

[Crossstitchfanatic]

Thanks for all the advice and support. Another G.P. from same practice saved the day! SHE knows all about P.M.R. and has taken me under her wing. What a difference from yesterday!

[PMRpro Ambassador in reply to Crossstitchfanatic]

Excellent - it was the same in my practice. My doctor was useless with PMR but there was one who knew, just she was part time and had been on a few maty leaves in the time so was next to inaccesible! But the time I really needed her after 2 disasterous rheumy appointments, she came up with the goods: pred!

[Singr]

I really feel for you. It's so disheartening to hear that some Dr's do not get the implications of making such a large jump. Greater level of withdrawal symptoms, causing flare or return of symptoms. Ultimately it could mean you having to jump up again taking you longer to reduce. I reduce by 0.5 mg and although it's been established I am very sensitive to withdrawal even that small amount can be a nightmare for me. Emotional fallout plus various random physical things such as really painful hacks on my hands making it impossible to button trousers or fasten a bra, bruising, bowel and bladder issues...the list goes on. I now have 2.5 mg but when I did not I used a pill cutter. Now there is a nack for doing it. I find it easy but the rest of my family leave the tablet like a crumbled mess. :-). Don't know why. I'm sure the learned people on this site can lead you to useful information in support of your situation. Wishing you every success.