Advice needed please

[Rymer]

I have been using the slow taper method and have reduced my Pred from 10 to 9 and this is my full week on 9. I had intended to start tapering down to 8 but I have a little of the aches and stiffness that I had building up to diagnosis. They are very mild and I don’t need to take pain relief very often. As I am assuming this is inflammation being active rather than withdrawal, my question is should I up Pred to 10 and if so for how many days before coming back to 9 or would it be ok to stay on 9 for a while and if so how long before I start to taper to 8. Thanks in advance to all you knowledgeable people.

[DorsetLady PMRGCAuk volunteer]

You could stay on 9mg for another couple of weeks and see what happens..obviously if it doesn’t improve, then you need to increase.

Even though you are using a slower taper, that doesn’t automatically mean you won’t get issues if you go below the level you need……it just means you get from a) to b) a bit easier ….but if b) is too low, it’s too low.

Maybe once you’ve sorted this blip out, it might be sensible to reduce by only 0.5mg each time.

[Rymer in reply to DorsetLady]

Thanks - I have the coated Pred can they be split?

[DorsetLady PMRGCAuk volunteer in reply to Rymer]

No they cannot..but you can get different doses, 5mg, 2.&mg & 1mg, so you can mix and match…..until you need 1.5mg or 0.&mg…but that’s some time in the future, so don’t worry about it then! Although I think introducing plain ones at such a low dose is what some do.

[Rymer in reply to DorsetLady]

Of course - forgot I had some 2.5 - just need my calculator to work out the combination as my brain is obviously fuzzy - thanks again

[DorsetLady PMRGCAuk volunteer in reply to Rymer]

Can’t help with the fuzzy brain..,sorry 😳…got one of my own!

[PMRpro Ambassador]

I would stay at 9mg for longer and see if the niggles get worse over time - if they do then back to 10mg and wait a couple of months before trying again. If they are stable but there, don;t go back but don't reduce further yet either.

However slow, you are always never aiming relentlessly for zero but for the lowest effective dose. Slow makes getting there less uncomfortable, it doesn't necessarily mean you can get lower - although it makes it easier to rule out the return of pain being withdrawal because it is unlikely with very gradual change.

[Rymer in reply to PMRpro]

Thanks - I knew I could count on you wise people to steer me in the right direction.

[Kendrew]

Hi Rymer. Just to add to what's already been said.....I've been on 8mg for the past 7wks after another slow taper from higher dose. I had a return of some mild aches and pains after 3wks but maintained 8mg to see what happened and thankfully it's all settled down again. Lots of rest and careful pacing has helped facilitate this but I'm mindful I might be getting close to my lowest dose possible for now, so I'm being very careful to not taper lower than necessary.

[SnazzyD]

Lots of advice here already. At these levels I dropped in 0.5mg chunks; 1mg was too large and I felt rough. I was on coated Pred but for the fiddly bits I used non coated. Sometimes I had to use both so took the coated first and then the non coated a few hours later to try to align the peak blood levels. I hasten to add there is no official guideline on this but it worked for me and the GP was happy with that.