Tapering Prednisolone

[CL2023]

Tapered down to 1mg or less after about a year and then stopped 2 weeks ago. Pain has returned to shoulders so I need to start Pred again. Do I go back up to 1mg?

[DorsetLady PMRGCAuk volunteer]

1mg may be enough, if you act swiftly and don't let the inflammation build up any more- but i'd be inclined to may try a little more say 2-2.5mg for a week, or so, and provided you get relief you can drop back down to 1mg ....

A year is very quick to be off Pred, and as as many have found there is a vast difference to 1mg being enough, to 0.5mg on the borderline, and zero definitely not enough.

[Zebedee44]

WOW, most of us would be thrilled to have managed to get PMR out of our bodies and our lives in such a short time, but sadly I think it is possible that the inflammation has NOT gone away and that you will need to look again at the dose of prednisolone that you need to keep the condition at bay.

It is also possible to taper the dose by smaller amounts at this stage if you are really so close to the end, just by cutting the tablet in half and even in quarters. The final step of 1mg is quite a shock to your body. No wonder your shoulders are hurting.

Others on this forum will be along to advise what you might increase the dose to, or you could run it by your doctor!! But well done for your rapid reduction and let’s hope it is just a blip in the final furlong. Best wishes, chrissie

[PMRpro Ambassador]

Try 1mg first and see if that works. If not, try 5mg for a few days and THEN return to 1mg. You may have to clear out some accumulated inflammation to get a good result with 1mg.

[Zareda]

I have tapered to 1mg and that’s where I am stuck. I’ve tried two times this year to decrease to 1/2mg and both times were unsuccessful. Within two weeks, my symptoms were flaring and then it took another two weeks to get back to where I was on 1mg. So I’m thinking my body is telling me to stay at that dose.

[Flivoless]

It sounds like you're a victim of more haste less speed.

[Denbo51]

Yes ,after 2 years iv been of them for 3 months but the same happened to me neck shoulders arm's so went back to 5 mg and solved the problem,I feel great so staying on 5mg for a while

[CamGina]

The best advice is to speak to your GP.

[Simplewish]

I'd been on Pred. for about 3 years and slowly tapered down to 1mg last October and in November stopped altogether. Within 2 weeks I had terrible leg pains and struggled getting upstairs also had head and neck pains. I spoke to the Doctor as I'm reluctant to self medicate and wouldn't be prescribed Pred. in any case. She immediately put me on 15 mg which I thought was a bit high and referred me to rheumatology. The rheumatologist immediately reduced the dose to 10 mg and to come quickly down to 5mg then 3 mg which I am now taking until they send for me in 6 months time. I think that the rheumatologist is willing to keep me on the dose which suits rather that come off altogether and said it can take up to 5 years to recover. At the time I was disappointed that I was back on steroids after such a short time but better to feel well than struggle along.

[PMRpro Ambassador in reply to Simplewish]

Hope you didn't have to wait to see the rheumy? Always add 5mg to the flare as a first measure - so for you that would have been straight to 5 not 15mg. Having got to 1mg OK - that is most likely what you need now.

[DorsetLady PMRGCAuk volunteer in reply to Simplewish]

GP’s reaction was OTT - in hindsight had you had the wherewithal you probably could have managed it yourself by returning to 2mg or maybe even 1mg to get things back under control.

You probably don’t need to remain at 3mg long term -but you do need to reduce slowly -in time and dose. And certainly not drop from 1mg to zero within a month. As many will testify on here -0.5mg can make a huge different in controlling PMR