Tapering commenced. What should I expect?

[LBM1953]

Tapered from 30 mg to 25 mg in two 2.5 mg drops (two weeks apart). All OK so far. Plan is to keep dropping 2.5 mg every two weeks until I get to 15 mg then adopt one of the User Plans from PMRGCAUK. If I have a reaction to a 2.5 mg drop then go back on the original dose for a further week and try again. Doctor talked about 2.5 mg drops at 15 mg but having read various things on PMRGCAUK I think one of the slower Plans has lesser risk and my GP is fine with that. She just needs me to inform her of what quantity of Pred I need and in what tablet sizes. My next drop to 22.5 mg is next weekend and it will be the first dose I will be down to at which I had symptoms (25 mg ameliorated the pain and stiffness), so am a bit concerned. The question is what should my expectations be? Should I hope to stay exactly as I am after a reduction or is a minor reaction acceptable? If there is a minor reaction should I go back up the original dose or carry on at the lower dose and see what happens, and if so for how long? LBM1953

[PMRpro Ambassador]

The basic rule is that any step down should not be more than 10% of the current dose. That means the steps get smaller as you get lower. Adding in a slowed taper also helps - and may even make bigger steps possible if you HAVE to do them (depends on the tablet sizes available to you). Whether you can manage any step depends on a range of factors - so it really is a case of try it and see how you get on. After any step down you shouldn't really have any worse pain/stiffness than before so the small steps can be critical as it reduces the chances of it being steroid withdrawal if the drops are small,

Steroid withdrawal tends to be an immediate reaction - a flare often takes a few days to build up. So immediate pain - wait a few days and see how you get on, If it improves that's good. If it worsens, go back and let it settle down again. Then try a smaller drop if you can, if not, possess your soul in patience and wait a couple of weeks and try again. It isn;t a race - often more haste means less speed

[Bcol]

Good morning, glad to hear things are going well so far, always a bit scary when pain is under control and things going well to start thinking about dropping. When diagnosed I had about 3 days at 15mg, doc then put me up to 30mg due to inflammation markers. I had 3 days at 30mg, 7 days at 25mg, 7 days at 20mg. I then started a taper down from 20mg. I dropped 2mg over a 4 week taper until I got to 14mg.

[DorsetLady PMRGCAuk volunteer]

Further to PMRpro ’s comments re difference re steroid withdrawal and flare you might like to read this - healthunlocked.com/pmrgcauk...

And if haven’t see this, maybe a read through - apologies if you have -

healthunlocked.com/pmrgcauk...