Stopping pred

[Painblame]

Hi, I've been on pred for a year and a half, started at 40 then 20 have tapered to 5 for a while now, want to try and stop. So at what dose can you just stop taking pred and test the body? Cheers any help would be much appreciated

[HeronNS]

You don't just stop taking it. You taper slowly. Below 5 mg you have to give your adrenal glands time to pick up the pace, supplying you with the cortisol which pred has been replacing. So even if you don't have any PMR symptoms you do have to be a bit cautious. You will know if all is well once you've tapered off pred and for a month or more had no symptoms. But it can take up to a year for the adrenals to be completely back to normal, and my understaning is there is more than just the adrenals involved, but someone more knowledgeable will be on in due course to explain.

Have a look in the FAQ post for link to tapering plans, if you haven't already been using one of our very slow plans which really help avoid pred withdrawal symptoms and also give the adrenals time to react.

It's great that you've done so well, by the way!

[Painblame in reply to HeronNS]

Thank you I'll keep tapering, . 5mg per month

[Nextoneplease]

Hi, I agree with everything Heron has said. Do look in FAQs on this page to see examples of tapering plans, and be aware that it may take a while to get off pred (or it may be quite quick, it absolutely depends on your underlying condition). We would not usually aim to reduce by more than 0.5mg per month at your stage, and if you feel any pain returning, it’s important to stop for a while. If you press on regardless, you may allow inflammation to build up, and have to raise your dose again, which no one wants.

All that said, I hope you are able to reduce your dose, slowly, and I send you the very best of luck 😊

[DorsetLady PMRGCAuk volunteer]

You can’t - you are likely to cause an adrenal crisis - have a look at the links in this post -

healthunlocked.com/pmrgcauk...

Plus you cannot be sure your illnesses have gone into remission so you need to reduce sensibly.

[PMRpro Ambassador]

When you get to zero - after a long time on pred you cannot - MUST not - stop pred suddenly or you could have an adrenal crisis if the adrenal glands cannot produce cortisol immediately. That can make you ill enough to need emergency treatment and even admission to hospital - and even be life-threatening.

1mg can be plenty to keep the inflammation under control - even 1/2mg, but zero pred allows a drip of inflammation to mount up and cause symptoms again. Slowly is the watchword for this end-game.

[Nextoneplease]

Hi again Painblame

I am not sure whether you mean to reduce by 5mg per month, or 0.5mg?

5mg would be very risky (dangerous even) , and if 0.5mg you still need to monitor symptoms. Good luck and well done for getting this far 😊