How do you taper Prednisone pills, by crushing and weighing the powders?

[sdowney717]

I am not talking about a taper plan schedule. I mean how do you cut 1 mg from a 10 mg tablet?

[PMRpro Ambassador]

Well a good start would be to ask for 5mg tablets which are definitely available in the USA. However, according to NIH, prednisone comes in 1, 2.5, 5. 10 and 20mg tablets

dailymed.nlm.nih.gov/dailym...

[Louiseiw in reply to PMRpro]

Yep I currently take 1 x 5mg and 4 x 1mg a day

[HeronNS]

Incidentally, once you get yourself some 1 mg, you don't have to waste the 10s. They can be cut into two 5 mg pieces, very useful for mixing and matching with 1 mg. Same with 5 mg tablets. I never had 10 but 5 mg was really useful for giving me 2.5 (which doesn't appear to be available where I live), again 2.5 useful for mixing and matching with 1. Below 2.5 one cuts a 1 mg to continue tapering by half a mg at a time. That's fun!

[Bcol in reply to HeronNS]

My present 1mg pills are so small, new supplier I think, they are difficult to see and hold let alone cut in half.

[HeronNS in reply to Bcol]

Gosh, it's hard to imagine why they'd make those tiny pills any smaller! Although you made me curious so just measured one and it's actually 6 mm which isn't all that microscopic after all. Any idea what size yours are now?

[Bcol in reply to HeronNS]

Just measured one, 4mm

[HeronNS in reply to Bcol]

If everyone starts to shrink them like that we'll have to demand they make .5 mg tablets for us!

[Bcol in reply to HeronNS]

Not made it to 1.5mg yet, so not had to try and cut one of these tiddlers. 2.5mg is my next goal, probably on Sunday, and cutting a 5mg which is no problem.

[Orange_2022 in reply to Bcol]

Pharmacists have pill cutters which are quite cheap - I've managed to cut 1mg tablets in half with those (occasionally they crumble!).

[HeronNS in reply to Orange_2022]

I used to get one good half and a pile of crumbs until I accidently discovered that if you don't put the cutter on the counter but hold it in the air as you firmly snap it shut the pill breaks more cleanly, although not usually into absolutely equal halves.

[Orange_2022 in reply to HeronNS]

I'll try that next time I need to cut one!

[AshPen9 in reply to HeronNS]

Yep, if you hold it sort of upside down to steady it you get a far more accurate cut!

[HeronNS in reply to AshPen9]

I think it may be something to do with vibration, at least on my counter. Maybe using the cutter on a wooden board would be more cushioned?

[AshPen9 in reply to HeronNS]

I think you're right. I've found that it's a much better cut if you hold it and tip it backwards a bit until the tablet is firmly resting in the 'v' of the cutter, then cut whilst still in that position. Not that it's much use to me at the moment, I'm somewhere between 5mg and 4mg!

[Dewdrop456 in reply to Orange_2022]

Well I successfully snap them with my fingers. Probably not the most accurate way but the next day you can use the other side so in 24 hours it's alright if one side is a few crumbs over. It's worked out fine for me and I am very sensitive to the Prednisone, so much so that I reduce by .25 mg each time.Good luck.

[HeronNS in reply to Dewdrop456]

I don't think I could break the 1 mg by hand. There's no score line and they are kind of small in relation to fingertips. My pharmacist gave me a free pill cutter which used to have a big pharma logo on it, long since worn off. Been using it since late 2015!

[Louisepenygraig in reply to Bcol]

I had thought that they'd be difficult to cut as they're not marked by I cut them fine with a pill cutter

[Feelingpoorly]

Whilst taking prednisone and subsequently asked by my Rheumy and GP to begin tapering, my GP gave me a selection of 5mgs, 2.5 mgs and 1mgs tablets (I hasten to add these were not prescribed in bulk and the quantities that I requested were monitored closely by my GP) the steroids were available for me to order as I needed and as I reduced.

The 1mgs were the most useful in terms of being able to reduce VERY slowly . We are of course all different but for me I dropped one tablet every 6 weeks until I got to 3mgs. I then reduced to 2.5 mgs and stayed there for quite a while until I felt completely comfortable and confident to drop to 2mgs and over quite a long time I was able to come off completely (assisted by methotrexate as well).

The last 1mgs was an eye opener as I realised that I was mentally more dependant on this little tablet than perhaps I should be! I was quite scared to come off what I had come to see as a lifeline for my pain! I decided to drop one table every six days for two weeks to see what happened - as all seemed well I then dropped one tablet every five days for two weeks. I reduced in the same pattern until I was off completely.

My other insight was that everytime I reduced prior to being on 1mg was to experience a short burst of pain and discomfort which lasted around four days before everything settled (I came to call this rebound pain - I’m not sure if this is a real thing or not )

So in conclusion talk to your Rheumy or GP or both and I’m sure they can put in place a prescription plan to help you achieve your tapering goal.

In addition this site as always continues to be a massive help to us all.

Good luck ♥️

[DorsetLady PMRGCAuk volunteer in reply to Feelingpoorly]

My other insight was that everytime I reduced prior to being on 1mg was to experience a short burst of pain and discomfort which lasted around four days before everything settled (I came to call this rebound pain - I’m not sure if this is a real thing or not )

Commonly referred to steroid withdrawal - see here -

healthunlocked.com/pmrgcauk...

[julesonthebeach]

My doctor prescribed a combination of 5 mg and 1 mg tablets. So far, it allows me to adjust my dose adequately.

[Manihiki]

I get a range of 1, 2.5, 5, 10 and 20. Tapering under 5 my body only tolerated dropping by a quarter so I cut the 2.5 in half and that gives me my one and a quarter. I guess I am going to have fun when I get to 1 and below! I get a couple of hundred of one and two and a half at a time when I need more.

[HeronNS in reply to Manihiki]

I think they are less generous with prescribing in the UK. One time my former doctor let me have 300 1mg in one go, and no doubt with a refill because I think I actually asked the pharmacist to reduce the number when I refilled. I was really low and it took ages to use up. It was probably the time GP told me she'd see me in a year.

Current GP hails from the UK and he only gives me 100 tabs at a time which I found a bit of a nuisance when I was using more from a flare for some months, but now it's fine again.

[Manihiki in reply to HeronNS]

yes I have had 300 when I wanted them. Just have to ask here.

[HeronNS in reply to Manihiki]

Exactly. I never think about it, and as he sends the prescription directly to the pharmacy (in the past I used to take a piece of paper in myself which was much better for me) I forget, until I go in and see what I get. However he had no worries prescribing me 5 mg when I had my flare and even continues to ask if I need more 5 mg, although I never even needed all three refills of those. Again 100 at a time. It was nice to have the leftovers from my second bottle to make 2.5 for a while.

[MiniSpec]

This is a pill cutter. They are available from most, if not all, pharmacists and cost less than £5.

The ones in the picture are blue and clear. I have an orange coloured one myself, and now that I have it I wouldn't be without it.

Pill cutter

[Wizards in reply to MiniSpec]

These pill cutters are great. I had one right from the start. It's a must have

[Theziggy in reply to MiniSpec]

Same as he one I use, good results

[Lafontainepam1]

I am from Michigan, I’m on 5 mg tablets, but also have 1 mg tablets.

[Missus835]

It is difficult..not impossible, but very frustrating especially if shaking is one of your things. If you ask, sometimes the pharmacist will cut them for you or you can buy a pill cutter. Still difficult with shakiness though.

[HeronNS in reply to Missus835]

Yes, and asBcol said, the smaller pills are almost hard to see let alone hard to hold. I wouldn't want mine any smaller than they are. His new batch is 4 mm in diameter, 2 mm smaller than mine (and I assume yours too).

[waltztherapy]

The prednisolone tablets come in 1mg, 2.5mg, and 5mg tablets, so easy to combine to get the dose you want. Halving the 1mg tablet when I get below a 2 mg dose, will be the option at that point I guess, but at 0.5 mg reduction per month, this seems a very long way off for me.Good luck.

Waltztherapy

[emsscot]

I am presently living in Mexico where I was diagnosed with PMR. Unfortunately, there is no such thing as a 1 mg tablet here. I did get a small eyedrop bottle of 5 mg liquid but, after having learned so much for this site, I realized that my rheumy was trying to get me off the prednisone too quickly. I was diagnosed on February 9th and started on 10 mg of prednisone and the pain miraculously disappeared after 3 days. My rheumy told me to start tapering but the pain came back before I could do that. I am now on 15 mg prednisone and have no intentions of tapering so soon. I discovered I can get 20 mg here and will cut those in two as it will be cheaper for me. I cannot thank everyone on this site enough. Without all of you, I would have been struggling to know what was going on and would have not questioned my rheumy. Thank you, thank you.

[Dydee]

I am in US and my doc prescribes me 30/10mg tablets that says 1 a day and 120/1mg tablets that says 4 a day. I am trusted to split the pills. I currently split the 10s into 5s and the 1s into 1/2 and take 5.5mg. As I tapered from 10 it would be 1/2 a 10 and a few ones to make correct dose. Under 8mg I tapered 1/2mg at a time staggering the old and new dose.