Tapering advice please

[Booklist]

Tapering.

I was diagnosed last December with PMR and started on 20 mg Pred. I am now down to 10 Mg. My Dr has told me to reduce the dose by 1 mg every 3 weeks . Reading all the posts on this site it seems to me that this is too fast and that I will have problems. Am I right?

[DorsetLady PMRGCAuk volunteer]

You won’t know until you try, but for many 1mg every 3 weeks would be too quick.

Guidelines say below 10mg -reduce 1mg every 4-8 weeks depending on patients wishes and disease activity…

[PMRpro Ambassador]

We believe "the lower the slower" - many GPs think if you got this low, the rest is easy. However, either way, you aren't aiming relentlessly for zero, you are looking for the lowest effective dose for YOU. Obviously. the lower you go, the closer you are to that target and often even 1/2mg can make a big difference. Three weeks isn't really long enough to be sure the new dose is enough and 1mg is a relatively big drop at this stage. It isn't a race - though a lot of doctors try to make it one in their fear of the long term effects of pred. That often leads to a flare - needing a higher dose to get control of it and so more pred not less.

As DL points out - the patient is part of this decision. If it feels too fast, tell the GP so.

[Booklist in reply to PMRpro]

Thank you for your advice. The lower the slower sounds good to me.

[piglette]

I found every 4 weeks better. Some people do reduce by more than 1mg from 20mg say 2mg-2.5mg. When you are down to 10mg I reduced by 0.5mg every 4 weeks. Are you taking vitamin D with calcium and have you been booked in for a Dexascan?

[Booklist in reply to piglette]

I take 2 Calchew daily. I haven't had a dexascan. I haven't got a good relationship with my Dr, so I'm hoping to change to someone else in the practice then I will ask about the scan. Thank you Piglette.

[Bcol]

At 10mg I went with 1mg every 5 weeks but extended that if neccessary and from 5mg it's 0.5mg every five weeks, again extended if felt neccessary .

[Booklist in reply to Bcol]

That sounds more likely to succeed. Thank you Bcol

[Broseley]

My rheumy has told me to reduce by 1mg every 6 weeks. I get some 'niggles' after the first 3 -7 days then its been fine so far, I'm currently on 7mg. I think every 3 weeks would be too quick.