Tapering, when will PMR resurface

[emmamom]

I am tapering and wondering how long it usually takes for PMR to pop back up if it is going to. In other words, if I have been on a reduced dose for 4 weeks, is it pretty safe to assume that that dose is safe for me if I have had no return of symptoms during that time? I was at 8 mg a day and did very well on that for a few months, but I went down to 7.5 4 weeks ago and have done well at that. No return of symptoms. Is that long enough to now go down to 7.0 mg a day?

[DorsetLady PMRGCAuk volunteer]

Four weeks is certainly long enough to know the current dose is okay....but you do need to remember the lower you go, the less Pred there is in system to control your PMR.... so good idea to only drop 0.5mg a time .

Many do find that adrenals do need to start to think about waking up at the dose you are at now, so just be aware of that, and sometimes that can make tapering a bit more troublesome... so they go to a slower tapering regime we often talk about on here. Not everybody is affected in the same way...

.. and if you taper/are allowed to taper, sensibly the PMR should not resurface... not a guarantee of course.😏.

[piglette]

I found reducing by 0.5mg every four weeks worked well.

[PMRpro Ambassador]

It should be enough to start on the next taper step. However, at the end, it isn't unknown for someone to be fine on 1mg or even 1/2mg and decide to stop as a result - but after a few months the niggles appear showing zero is a step too far. So theoretically, a half mg change at any dose could be a problem. But if you stayed 3 months at every dose, you'd be a long time getting off!

[MiniSpec]

Personally I would give it another 4 weeks before reducing any more, and I'd make sure to reduce as little as possible each time. Around 10% seems to be a good maximum value for change.

So if you were on 7.5mg, you'd not want to reduce by more than .75mg at a time. Use a pill cutter (available cheaply from chemists and the internet) to cut tablets down into halves or even quarters if necessary.

I recently reduced from 2.25mgs to 2mgs, and had a bad reaction within 4 days, but that's just me. I don't expect anyone else to suffer a flare as quickly as I did. However, I had to take fairly drastic action in order to overcome the pain in my neck and shoulders, and am currently on a high dose for the next week to make sure I've really overcome the inflammation and pain, before dropping back to where I was three months ago.

Ah well, all part of life's rich tapestry I s'pose.

[emmamom in reply to MiniSpec]

Thank you for this perspective. I think I will take this advice. Better slow and steady than have to go back up to a higher dose.