Oops! With the Prednisone

[Grammy80]

As you know, recently, I've had a few 'other-unrelated' health issues; nothing to do with GCA. Since February, I've had some help at home, a few hours twice a week. The gal I have, Janice, is really great.

Some of my meds are bottled, and some are in pill packs. I always makeup two weeks of pill boxes and usually add the pred myself before I give it to Janice. I reached 2.5 on March 26. On March 28, when I gave the pillboxes to Janice, I wrote a note that said, "Add 2.5 mg prednisone and Gabapentin AM and PM."

Three nights ago, when I flipped my night-time meds out, a half-pill dropped on the vanity. ?? I checked, and you guessed it, there was 2.5 mg pred, morning and night--which I had been taking since March 28, 5mg per day.😏Totally my own doing. Well, I took the nighttime pred out, but by yesterday morn, I was shaking like a leaf. I took 1 mg and added 1mg for five days. I will drop by .5mg starting next week. Now I feel fine! I shared my error with Janice; she forgave me after feeling terrible. It was my own fault.

So, now I am taking 3.5mg per day. My question to the experts is....at this point, do you think it is necessary for me to drop by .5 every three weeks or could I drop at a faster rate...I haven't had a hitch. Thanks in advance and DUH~! 💞

[piglette]

Personally I find that dropping every three weeks at that level is probably the fastest you should go. Your adrenal glands have got to get going again and by going too fast you might get a flare too. It would be sad to go too fast when you are so close to zero.

[Grammy80 in reply to piglette]

Thank Piglette!💞

[HeronNS]

Don't they say you can take extra pred for as long as three weeks and drop quickly back down? I'm sure if your normal dose had been satisfactory you can go back to it right away, or if you feel more cautious, dropping that .5 mg every few days, not weeks. If you'd been on the mistaken increase longer, then I'd say you might want to go down more cautiously for adrenal's sake.

Always something isn't there? Take care!

[Grammy80 in reply to HeronNS]

😉thanks...reassuring!💞

[Bcol]

Morning Grammy, just when we think things are sorted and going well, these little things are sent to try us!!!!! If my maths is correct then you have only been on the extra dose for a couple of weeks so dropping back down to your old dose should, in theory, be perfectly ok. Guess it's your choice really, try going back to 2.5mg and see what happens or take the slightly longer path and try decreasing by 0.5mg every two or three days until you get back to 2.5mg depending on how you feel at each drop. I would also be tempted to stay at 2.5mg possibly a little longer until everything has totally settled down again. Take care

[Grammy80]

Thank you so much! Good advice and shame on me for not wishing everybody a Happy Easter or Passover!💞

[Kendrew in reply to Grammy80]

Hi Grammy,

Agree with all the advice already offered. Only thing I'd add is that once you're back to what was your normal dose, I'd probably taper really slowly now.

At these lower doses, your adrenals will be trying to increase their function and you may therefore need more time for things to stabilise.

I'm currently on 3½mgs of pred and I usually take at least 6 to 8wks to taper each 'drop'. I use the DSNS method and only drop ½mg at a time.

Taking this length of time not only allows the adrenals to 'catch up' again, but it also allows enough time for any potential flare to become evident. If you taper too quickly, you run the risk of missing the warning signs as these can take a few weeks to fully emerge.

Slow & steady..... it's not a race!

Happy Easter Grammy.

[montebello in reply to Kendrew]

Hi Kendrew.... if I might ask, at what level of PRED did you start the DSNS taper?

[Kendrew in reply to montebello]

I started from 12½mgs... DSNS method straight down to 10mgs. Then I dropped 1mg at a time using DSNS method until I got to 6mgs and then I've been dropping ½mg using DSNS method.

I'm currently on 3½mgs

[montebello in reply to Kendrew]

Well I'm at 20 mg right now, and have started using DSNS. Wondering if I started too soon. Thoughts?

[Kendrew in reply to montebello]

It really depends on what your GP/rheumatologist has advised. I probably wouldn't have done a DSNS at higher doses but my circumstances will be different to yours. I can only speak for myself but I know there are others better qualified who can advise you further.

Sorry I can't be of more help.

[DorsetLady PMRGCAuk volunteer in reply to montebello]

Probably is a bit high, unless you are having difficulty in reducing. I’d didn’t start my slow taper until I reached about 6mg [and then mainly to assist adrenal function] but you introduce when you feel you need to.

[PMRpro Ambassador in reply to montebello]

Depends on the person - some people can drop 2.5mg at a time right down to 10mg. Others struggle with 1mg at time at 20mg.

[Grammy80 in reply to Kendrew]

And to you, Kendrew!! Solid words!💞

[Harry8388 in reply to Kendrew]

sorry to be ignorant what is DSN method

[Rugger in reply to Harry8388]

It's the 'Dead Slow & Nearly Stop' plan for tapering prednisolone.

healthunlocked.com/pmrgcauk...

[Kendrew in reply to Harry8388]

It stands for Dead Slow Nearly Stop and is a tapering regime devised by one of our very experienced ambassadors in order to minimise the risk of either a flare re-emerging or an adrenal crisis occurring.

Really helpful when at lower doses.

There are other regimes offered too if you look at FAQ'S under 'T' for Tapering.

[Harry8388 in reply to Kendrew]

Thank you

[Harry8388 in reply to Harry8388]

Was not aware you could have 0.5 Pred

[DorsetLady PMRGCAuk volunteer in reply to Harry8388]

You cannot get 0.5mg as such...but you can cut 1mg tablets [so long as they are plain uncoated variety]. Plus you can mix and match with 1mg and 2.5mg to get half doses - so making tapering easier....

[Harry8388 in reply to DorsetLady]

Thank you such a lot of good information on here

[DorsetLady PMRGCAuk volunteer]

Normally would say you could drop back down quite quickly, but as you have had other issues, and it’s such a low dose maybe go the slower route this time.

Really is no rush…..and happy Easter to you..

[Grammy80 in reply to DorsetLady]

Thanks so much, I agree. It just isn't worth the risk. Happy Easter to you. 💞

[DorsetLady PMRGCAuk volunteer in reply to Grammy80]

Thank you….

[Luciejc]

I was down to 2 mg in October, then got COVID. Very bad flare put me up to 12 mg. At 4 mg now and ready to begin dropping Since I am on methylprednosolone (Medrol) , it is difficult to cut 4 mg tablets any lower than 1 mg. I will soon start tapering to 3 mg very slowly. For me, very slowly is the best way. Good luck. I think of you often, my friend.

[PMRpro Ambassador]

That's barely 2 weeks and 5mg SHOULDN'T be high enough to have affected adrenal function significantly either. Bet it was just your body resenting being offered less rather than anything serious ...

[Grammy80 in reply to PMRpro]

You are probably sleeping or should be! I did talk to my rheumatologist's nurse this am and she said basically the same thing. I do think my body was a little 'ticked' off~! I went from the short term 5 to 3.5 for 10 days. She suggested I drop by .5 mg every three weeks starting tomorrow. The tortoise wins here or at least has the best chance~~~Right? 💞💞

[PMRpro Ambassador in reply to Grammy80]

Right!