Pre

[Flosy]

Hi.i am on 10mg,on 16th,go down to 10mg.,then on 1st Dec down to 7.5mg.just want to know how I get 7.5mg.havent had to take that dose before.thanks.

[123-go]

You will need to take 5mg + 2.5mg

OR

2.5mg + 2.5mg +2.5mg

I think this is what you're asking. If you have only 5mg tablets at home you can take one of those plus half of another but you can only cut the tablets if they aren't coated.

[Flosy in reply to 123-go]

So cut a mg in half,take one 5mg and a half a one is that right.

[123-go in reply to Flosy]

I think you meant to say " So cut *5mg* in half---" but I'll just repeat to save any confusion......1. Cut a 5mg tablet in half so that you will have two halves of 2.5mg each.

2. Take one of those halves together with a whole 5mg tablet - (2.5mg added to 5mg makes up your 7.5mg dose.)................................................................................................................................................

Save the 2.5mg that is left and take that the next day with a 5mg tablet. Carry on like that cutting a 5mg tablet in half every other day.

...............................................................................................................................................

Of course it would be more simple to have a mix of 5mg and 2.5mg tablets which would save you having to cut but that would depend on your doctor being willing to prescribe those.

Since writing the above reply I have read DorsetLady's response and have to agree with all she says regarding tapering and her advice to discuss with your rheumatologist or the specialist nurse.

[DorsetLady PMRGCAuk volunteer]

123-go has replied, but can I ask what dose has your Rheumy told you to go back down to?

From previous posts see you have had issues/flares virtually all the way through this last year. I know you are working which doesn’t help, but think you have reduced too quickly. Not sure how long ago you were diagnosed, profile doesn’t say, but guessing it’s only a couple of years, if that.

Just make sure you don’t go too low again.

[Flosy in reply to DorsetLady]

Hi.it was last March 2020,was diagnosed,got down to 3mg. In Sept til oct,went to rheumatology put me back to 20mg,on 1st Nov went to 15mg,16th,Nov 10mg.,1st Dec 7.5mg,then from 1st Jan 5mg,every month after that 1mg.tili get to 2mg.

[DorsetLady PMRGCAuk volunteer in reply to Flosy]

Think your original reduction was much too quick, although you probably didn't realise at the time, and only following orders…and that’s in the past anyway, so nothing can be done.

But, this time around think you need to take more control over your reducing and go much more slowly especially below 10mg.. the official guidelines say 1mg every 4-8 weeks depending on patient and disease activity.

You may manage the drop 10-7.5mg, but bearing in mind what’s gone before, in your shoes I wouldn’t want to try it. Rheumy may think you can because you are reacting to a flare, and some patients will be able to drop back down quickly…but not sure in your case.

Think you need to discuss with Rheumy, otherwise I fear you will end up in the same situation again.

[PMRpro Ambassador in reply to Flosy]

That is far too steep a reduction for almost everyone. Below 10mg all the recommendations are for 1mg at a time reductions - which are far less likely to cause problems but are still too much for some. You will end up with a flare if you just plough on - and you have been there far too often already. There is a definition of madness: repeating the same action and expecting a different result!

[Bcol in reply to Flosy]

Hi Flosys, think I'm saying pretty much the same as the others, when reducing from 10mg I used a 5 week taper to 9mg and then stayed on the new dose (9) for at least two weeks until I was happy that all was well and only then start the next progression down. I guess your only problem might be if you have to persuade Rheumy or Doc. My Doc is very good and just leaves me to it.

[SheffieldJane]

After 10 mgs I needed to do the dead slow taper of 1 mg a time, after 5 mgs I was using a pill cutter to go down by half a mg. I am now on coated tablets so I cannot cut them and will have to do as 123-go advises this time round. 2.5mgs would have been a drop too far.

[piglette]

As PMRPro says 1mg a month is really the maximum reduction that is reasonable under 10mg. In fact in my case I feel 0.5mg is better. Take it slowly but surely!!

[PMRpro Ambassador in reply to piglette]

Even rheumatologists admit more than 1mg/month is predictive of flares!

[piglette in reply to PMRpro]

Wow!!

[ignatz in reply to PMRpro]

Wow-seconded!

[Retallack]

I agree with everything said here. I went down by 1mg from 10mg and then 0.5mg from 5mg. Currently doing 4/3.5 with no problems so far. Never seen a rheumatologist and my G P happy for me to do my own thing.

[Rugger]

The steepest drops I've made in 5 years have been 1mg/month and currently doing 0.5mg/month.

Good Luck!

[Nextoneplease]

Flosys, I’m another one who agrees that reducing by 1mg a month is plenty. It’s so tempting to go quicker, especially if a doctor is recommending it, but as you’ve found, it rarely works 😟

I hope you go slowly this time - slowly and surely wins the race x

[Jane424]

a 5 mg and half another 5 mg. It splits quite easily. Good luck.