Prednisone Tapering questions

[musclesinflamed]

While I had minor symptoms back in Nov-Dec '22, it really hit me in early Jan '23. GP diagnosed PMR after many tests, etc. Started me on 10mg Prednisone which did nothing. Referred me to a Rheumy who bumped me up to 15mg and then 20mg. That did the job for about 11hrs/day. I split the dose to cover 24 hours but then tapered off the night dose by slowly moving it to the early morning dose. That worked.

My Rheumy never told me to taper but gladly this site did. Then she said I should just drop directly to 16...which I ignored. I have been tapering down from 20mg to 15 by approximately 10% every 3 weeks. (So far this has been going well.) From this site and the good advice it gives I understand that, at some point, as I get to lower milligrams, I will need to slow down even though the 10% will be automatically become smaller drops.

I'm thinking that, at some point, I need to use DL's system of 5-7 weeks by adding a day each week at each new mg goal. My question is: at what point should start stretching out the tapers? In other words, how long can I continue on this 3 week schedule? (12, 10 or what?)

I am very grateful for the discussions and expertise on this site!

[PMRpro Ambassador]

I would say get to 10mg and reassess but really it depends on you and your PMR - you may be able to steadily continue as you are. Or you may do a reduction and feel it isn't as good as it was before and then you go back and slow the next taper down.

[musclesinflamed in reply to PMRpro]

Thanks PMRpro!! I will definitely slow down at 10 and probably more at 7. I'll approach 12 cautiously but hope be able to get to 10 without rebounds!

[DorsetLady PMRGCAuk volunteer]

Agree with PMRpro,10mg is usually a point when you need to adjust tapering regime.

[piglette]

I must admit I always allowed four weeks between drops, but if three weeks works for you. Any less probably would not be a good idea. It is when you get to under 10mg things seem to need more care and then at 7mg when the adrenals start to wake up. You may sale by of course.

[musclesinflamed in reply to piglette]

Thanks Piglette. My fingers are figuratively crossed.

[piglette in reply to musclesinflamed]

Best of luck.

[Charlie1boy]

Way back in 2015 when I got to 10mg, lots of people with pmr spoke of the issues they had in getting down from that level. I guess I was no exception, as it finally took me six months to get from ten mg to eight mg, and any reductions I tried were for a half mg.

Not saying it would, or will be, the same for you, but I would certainly endorse the advice given about slowing down at 10mg.

[Dydee]

I definitely agree to taper 1/2mg dropping from 10. And don't rush things. Slow and easy worked best for me.

You are very blessed to get a diagnosis so quickly. Many docs take months to figure it out.