PMR reducing question

[Artwatercolour]

have reduced from 20 to 14 every 5 days at 1 drop each 5 days. It’s never been this easy. Am beginning to feel tired- am I going too fast?

[DorsetLady PMRGCAuk volunteer]

See you asked a similar question 6 months ago -not quite sure what is going on with you/ your doctor. Is this latest regime a follow on from a flare -or what?.

If it’s from a flare then it should have been okay - and are you trying to get down to a specific dose?

If it’s part of normal taper, then every 5 days at a dose is not enough to know that dose is enough before you drop down (even at 1mg).

Perhaps you could clarify please, then we could give better advice.

[Artwatercolour in reply to DorsetLady]

I have slowly been reducing from 20. Example 20 for 5 days then 19 for 5 days etc. as I mentioned it had been relatively easy except feeling tired. Am I going to hit a wall - going to fast?

[Artwatercolour in reply to Artwatercolour]

I have been slowly reducing all along

[DorsetLady PMRGCAuk volunteer in reply to Artwatercolour]

Would suggest you slow down from now on….

[PMRpro Ambassador in reply to Artwatercolour]

That isn't slow - slow is 1mg every 2 weeks at this stage - 5 days isn't enough to know the new dose is still enough, you flare but the border may have been crossed a few mg earlier. If it has worked so far then fine - but I would suggest you have a couple of weeks at your current dose to be sure you are still OK. And then slow down.

[Artwatercolour]

So when you say slow down do you mean 1/2 tab? And for how long…5 days or 2 weeks

[PMRpro Ambassador in reply to Artwatercolour]

Depends on the dose in a single tablet doesn't it? And every 2 weeks at least - 5 days between drops is never classed as slow by anyone here. I doubt most of us would reduce every 2 weeks either - it isn't a race, it is a titration looking for the right dose for you. Go too fast and you will miss it, cause a flare and end up needing more pred, not less.

[DorsetLady PMRGCAuk volunteer in reply to Artwatercolour]

Two weeks definitely initially, and maybe 0.5mg once you get to single figures....

[Artwatercolour in reply to DorsetLady]

So are you saying- I’m at 14 stay for 2 weeks then 13.5 for 2 weeks and 13 for 2 was and 12.5 for 2 wks then 12 and 11and 10 for 2 wks.,,then what?

[DorsetLady PMRGCAuk volunteer in reply to Artwatercolour]

If you want to continue to reduce every 2 weeks then what you suggest sounds okay, but you’ll have to see. If it doesn’t work then stay at each dose for longer…but as I said,not sure every 2week is a good idea. Just personal opinion.

At 10mg most people reduce monthly so 1mg per month, but then once they get to around 6 or 7mg some find that too much, so change to 1mg every 2months/0.5mg every month.

You need to listen to your body and reduce in a way that’s best for you and your illness.

[Meggsy]

My flares always occurred around the 2 week mark. I would have been in big trouble had I tapered weekly.

[DorsetLady PMRGCAuk volunteer in reply to Meggsy]

My point exactly…😊

[Bcol]

Morning, I had a week on 15mg, a week on 30mg, a week on 25mg, two weeks on 20mg then started tapering on a modified DL plan. I got away with dropping 2mg every five weeks until I got to 13mg but at that point it became obvious that I had gone too far too quickly, so back up to 15mg for a couple of weeks and then nothing more than 1mg every five weeks which I extended if I felt it was necessary which on the whole has worked very well.

[Artwatercolour in reply to Bcol]

Thanks for your response

[hugovictor]

I find it is better to extend the the the time between doses of prednisolone; e.g. a dose at 8am and the next at 10am. This fine-tuning may be more acceptable than dropping 0.5 at a time.

[PMRpro Ambassador in reply to hugovictor]

I don't see how that helps? Could you explain?