I don't believe it!!

[Fredddie]

Hi All

After posting 9 days ago on advice how to taper from 8 weeks on 1mg I started on a very slow taper.

I started the taper last Sunday. The last 3 days I have had increasing stiffness in the neck, elbows, wrists and hips in the morning and eases a bit during the day but doesn't completely go away. The slow taper consisted of 0.5mg one day and the rest of the week at old dose.

I don't know how to proceed and don't know why this has happened after being fine on 1mg for 8 weeks - is this withdrawal? Should I go up to 2 mg or higher or could it be the withdrawal?

Would appreciate your advice.

Thank you.

[piglette]

Withdrawal tends to start in a day or two after the reduction and then improves. I would stick to the 1mg as you are not ready to reduce at the moment. Remember going to 0.5mg is a fifty per cent reduction in dose. If carrying on at 1mg starts to be a problem increasing by 5mg for a week to hit the PMR on the head and then dropping back to say 2mg and then 1mg.

[Fredddie in reply to piglette]

Thank you for your speedy reply - most grateful.

[piglette in reply to Fredddie]

Hope things improve.

[PMRpro Ambassador]

"The last 3 days I have had increasing stiffness"

When it is increasing - that is a sign that the dose is not enough rather than withdrawal. It is perfectly possible that 1mg is very slightly too low and for the last 2 months the inflammation dripping tap has been dripping away and you coincidently started on the next taper as it reached the brim. You probably need something between 1 and 1.5mg.

But I wouldn't worry, it is a very low dose, I'd take 2mg for a few days and see if that's enough and then try 1,5mg.

[Fredddie]

Thanks for reply.

[Exflex]

following the excellent advice you’ve already received, I’d consider tapering at 0.25mg / month using DL’s simple plan when ready to resume the reduction. But get stable for a while before proceeding.

[Fredddie in reply to Exflex]

I took an extra mg yesterday and already the pain is a lot less. So will stick at 2 mg for a while and take on board 0.25 when I taper again. Thanks.

[Burroughs123 in reply to Exflex]

I’m now doing 0.25 drops for 3-4 weeks and have found it makes a significant difference. I didn’t experience any withdrawal aches for my last taper and so far so good with my current drop to 8mg (she says, grabbing onto a piece of wood!).

[Fredddie in reply to Burroughs123]

Thanks

[Exflex]

In similar circumstances I would taper down from 2mg ultra carefully (I did) using 0.25mg increments over 5w, or 7w. We must be guarded not to undershoot and start playing the ‘game’ of snakes and ladders. As you know, 10% of 2mg is 0.2mg, so even 0.25 is just within the recognised guidance.

When I got to something like 1.25mg my Dr thought / suggested coming off. I said that sort of dose isn’t doing long term damage, and he agreed with me.

[PMRpro Ambassador in reply to Exflex]

Not only that - even 1/2mg can be plenty to keep low level disease activity under wraps - no shortcuts with PMR!