Tapering prednisone dose for treating polmyalgia rheumatica.

[Streetgang]

I found the first time I reduced dose from 15mg that I probably reduced too quickly and at around 6mg symptoms returned. So went back up by 1mg per week to 8mg kept it there for a month then reduced by 0.5mg every two weeks using combinations of 5mg,2.5mg and 1mg tabs took about nine months. My E.S.R. is around 12 now and symptom free, although do get days when feel tired. I think the very slow tapering dose is the best way forward.

[DorsetLady PMRGCAuk volunteer]

Hi, Was this meant to be an answer to post about tapering issues - we’ve had two this morning?

Or just a statement of where you are?

..and yes you are right, slow tapering is the best, particularly

at lower levels..

...your tiredness may be due to illness (so just be careful with reducing) or your adrenals struggling to function, or most likely, a combination of both.

[PMRpro Ambassador]

I don't know you can say it was too fast - if you do it and it works it is fine. It's when it doesn't work you can get into trouble. But you did what most of us would tell you to try: you found where the symptoms reappeared and went back to a dose you knew was OK quickly. That is the key - and then you tapered in small steps and quite slowly. I think the small steps are also particularly crucial.

When you say 9 months, is that from beginning to end or just from 8mg to zero - I assume you are at zero now?

[sailorman]

Hi Streetgang. I started on 10mg of pred 2016 which helped enormously after suffering pain all over and extremely tired. I even had a steroid injection in my shoulder to relieve the pain i was not aware of PMR then. Once my doctor diagnosed it and put me on 10 mg pred my life returned to my old self. Having found this forum and found out about reducing slowly and my Rumi wanted me off pred as soon as possible I tried his method of reducing one mg each month which soon backfired on me, so I used the method used on this method which is reduce one mg in a weeks dose so on Sunday I take the the 10 mg Monday 9mg the rest of the week i take 10 mg next week monday 9 mg Tuesday 9 mg rest of the week 10 mg next week Monday 9 mg Tuesday 9 mg Wednesday9 mg rest of the week 10 mg then next week Mon 9 mg Tue 9Mg Wed 9 mg thursday9 mg rest of the week 10 mg next week Mon 9 mg Tues 9 mg Wed 9mg Thu 9mg Fri 9 mg Sat & Sun 10 mg next week Mon thru Sat 9 mg Sun 10 mg next week 9 mg every day. stay on 9 mg for a week then start reducing to 8mg and repeat as above. My doctor is happy with this so the way I have explained is long winded but I don't know how else to do it. I reduced to down to 2 mg and was doing ok but I had my first Covid 19 injection I suffered considerable pain and tiredness doctor put me back to 5 mg and did blood tests which said they were ok anyway I am now back to 4 mg about to try 3 mg I have had a steroid injection in my back which may have caused this set back but who knows I have had my second Jab incidentally both were Phiser. Sorry this is so long but this PMR is a very strange thing, I am very active rarely sit down for long I am in my 80 th year and sail my boat most days. Hope this helps.Mike

[Athena2020]

Hi , yes I had the same issue , but I still feel tired every time I decrease my dose and that lasts a few days. in my case my stiffness is always there with pain . Some days are great and some are not good. I would suggest you taper slowly as you are doing, The tiredness can be due to the PMR . There are days were we feel more tired than other days. right now I am on 6mg. and will be tapering down in two weeks by 1 mg. I know I will not feel good for a few days, so I take it easy rest and ride it out. I believe its our adrenals adjusting.