I am on 18 years of prednisone :0. I am down to 10mg and need to taper and my doctor just told me to try this DSNS taper but I don’t understand it in the examples. The examples say to take the new dose 1 day, the old dose 6 days, then the new dose 1 day and then the old dose 5 days etc. So do I actually stop taking the medicine for 7 days per week? When my doctor explained it in the office I thought she meant take the new dose 1 day, then the old dose 6 days, then the next week take the new dose 2 days and the old dose 5 days, etc. l the examples here show lowering the number of days as you taper. I would think you would feel very sick on the days you don’t take any if that’s how it is? Can someone give me an example of my situation of going from 10mg to 9mg using this method? Thank you so much!
DSNS Taper: I am on 18 years of prednisone :0. I am... - PMRGCAuk
DSNS Taper
No you don’t stop taking Pred on any day…
For you, new dose is 9mg (so take that for one day) then next 6 days take 10mg (old dose) .. then 9mg one day, 10mg for 5 days etc ….until you get to the stage where every day is new dose (9mg) .
Just write it down on a piece of paper -and think of it in days rather than weeks….
You are probably getting confused because some plans are viewed in days -and others in weeks. Don’t mix the two.
Thank you - this makes sense. Thank you so much!
Don't think of it as weeks, it is a continuous process,
Get a monthly calendar and a highlighter pen and mark the day you choose to start as a New Dose Day with the highlighter.
Count 6 days, on those days you will take the old dose. Mark them in a different colour if you like and it is easier for you to see.
The next day is a New Dose Day, mark it with the highlighter you have chosen for the new dose.
Count 5 days - all old dose days. The next day is marked as an NDD.
Count 4 days, the next is an NDD.
Keep doing that with the number of old dose days always decreasing by one so the NDDs get closer together until you have consecutive days as NDDs.
For most people by then you are probably fine to keep on at the new dose.
Thank you so much! Yes, I was stuck on weeks not days. This is very helpful - thank you 
so I’m adding a chart N is for new dose O is for old dose
Is this chart correct?
I think so!
I think so? I’m really not sure how to ise the DSNS chart
Can you explain it?
Sorry you are defeating me - you have written it out on a calendar, it is quite difficult to see because the contrast isn't too good, but it looks correct, that is what I meant by I think so. You are repeatedly challenging your body with the new dose and each cycle you have the days of new dose closer to one another until the join up. You don't have to start with 6 days between 2 days of new dose, you can start with fewer, There is a longer description of the idea in the post on tapering in the FAQs.
Thank you for your advice on 1 May 2023. I went back to 13mg on 2/5 to 14/5/23. But felt insecure about dropping to 9 mg in one jump. So on 14/5 dropped to 12.5.
Would you and DL advise me to follow what you have set out for saintmels now between 13 and 12.5 .mg or just remain on this dose and try tapering to 12 after some time and then by 0.5 till the symptoms flare again?
covid vaccine
I have checked out the different vaccines because a specialist in UCHL suggested that my PMR was linked to the Pfizer. She said that because she felt that I would have presented with PMR well before the age of 80 if it was in the family.
The Sanofi VidPrevtyn Beta says that it is not suitable for people on steroids. The providers of the vaccines in N london never know which vaccines will be delivered each day, and you have no choice. The adviser at the provider chemist thought I should wait until I was on a lower dose of Pred anyway. They are only offering this booster till the end of June.
Lansoprazole 30 mg
This was prescribed with AAcid electronically, but in the notes it warns about people with osteoporosis which I found strange. I am going to find out how long I have to take the AAcid and how I will know if it has made any difference.
Thank you for all you do for us. Without this support things would have been overwhelmingly miserable.
They will decide one day - there are doctors who get all iffy about under 70s having PMR and say it is too young! I don't think familial necessarily presents earlier and loads of people develop PMR without a close relative having had it.
You really can drop in a couple of steps when you have only been at a higher dose for a couple of weeks - a lot of people do it in 2 or 3 steps a few days apart, say 13 to 11.5 to 10,5 to 9mg. It is entirely your choice but you really don't need to do a slow taper in this situation.
I just put it into my calendar and. Now it makes sense. I get IVIG infusions every month for 4 days and I get 16mg infused steroids on those days in order to not have a reaction to the infusion. Isn’t that going to mess up the taper. The doctor said I need to continue the steroids during infusion and usually I take my regular daily dose plus the infusion. She said she wants me to get to the point where the only steroids I get our during infusion, and not on a daily basis. It just seems it will affect the taper though
No, it shouldn't affect the taper over that 4 days, it might slow the taper slightly but shouldn't make a significant difference, The thing you are most tied by really is the return of adrenal function and 4 days of a high dose is not usually enough to set that back but it is known that repeated administraion of moderate dose courses of pred can lead to impaired adrenal function so that would remain an unknown factor - and it is possible your doctor hasn't appreciated that.
Hi Saintmels, I have done a post showing a chart I made of the DSNS reduction plan. I have been using it for years with no problems. I cand send you a copy if you message me an email address. Good Luck!
Hi,
My experience with prednisone spans the last 4 years I take it for Polymyalgia. In the early periods I was on high dosage - i.e. 10mg per day. This was tapered down over the years till I’m now on 2mg per day. But this tapering was very slow, 1mg decrease every 6 weeks or so.
What were you prescribed Prednisone for?
I confess I’m not familiar with the tapering process you were given! But it does sound strange!
Other than what I’ve written above I have no great expertise in Prednisone other than it’s unfortunate side affects!
Sorry I couldn’t be more helpful but I wish you the best of luck in your endeavours .
Paddy
Not what you're looking for?
You may also like...
Need to clarify DSNS tapering.
DSNS Taper Question
Quick statistical perspective on DSNS tapering
Have you successfully tapered with the DSNS approach? (For newsletter.)
Quickie version of DSNS?
DSNS didn't work for me
Which DSNS to use--fastest or slowest?
DSNS method
To taper tonight or not to taper.
