Prednisolone increase: 0.25mg to 1mg

[Exflex]

During wk 5 of my slow D-L taper from 0.5 to 0.25mg, bi-lateral shoulder discomfort started yesterday. Based on the knowledge gained here I have increased to 1mg and plan to stay at that dose for 5 days, and then drop to 0.5mg, sticking at 0.5 for a month at least before trying the last step once more.

Any thoughts on my strategy?

PS: Discomfort has disappeared at 1mg.

[SheffieldJane]

Your strategy seems sensible. Do not overdo physical activity - this can be a factor too.

[Exflex in reply to SheffieldJane]

That’s a good point, thank you.

Who would have guessed anyone running into problems at such a low dose step (0.5 to 0.25mg)? This disorder is absolutely ‘nuts’!

[DorsetLady PMRGCAuk volunteer]

Sounds sensible -but on next taper you can either use the slightly longer 7 week one, or ultra long - which is 14 weeks [and is just repeating each step described in the 7 week version].

[Exflex in reply to DorsetLady]

I think I will do that.

I’m struggling to understand my body’s sensitivity to such small change from 0.5 to 0.25mg. But I could not risk a runaway return of symptoms and thereafter needing a much larger dose. My thoughts of the dripping tap came to mind (thank you PMRPro!).

[DorsetLady PMRGCAuk volunteer in reply to Exflex]

Just go back to 1mg... and stay there as long as you want/need... tbh it's such a low dose in the great scheme of things...and if it works then good.. You can always try again in a few weeks/months even. QOL is all... 😊

[PMRpro Ambassador]

Me - I wouldn't bother until spring. Take 1mg for the winter and wait for warmer weather.

[Whist]

You may not agree with my reply.I decreased slowly as you did Once I got to half a mgm I went cold turkey I was in pain about a month I used standard pain killers and heat relief.It took about a month but I had been on pred 3 years and I thought enough was enough

Just thought I would let you know my experience

[Exflex in reply to Whist]

Thank you, in my case I thought about the dripping tap and I have had intermittent headache to the left hand side of my head, about the height of the top of my ear. Bothe the arms and the headache have gone. It could be due to other reasons and not PMR, but I thought shall I risk it and end up going to a higher dose, or take 1mg immediately (which is 4x the dose I was on, ie 0.25mg) and nip in the bud. I’ve been on Pred for nearly 4 years, btw.

[Whist in reply to Exflex]

Yes it's a difficult decision to make.