Tapering schedule

[landyjhm]

Having been diagnosed with PMR early this year and having had a disastrous previous taper, I am now down from 12mg to 10mg. I have been reducing by 1mg every 5 weeks and have felt fine so far. Now that I am about to breach the 10mg barrier, should I continue with the same rate, or should I consider going down by 0.5mg at the same or perhaps a longer timescale? Your collective knowledge is clearly unrivalled and I would greatly appreciate your advice.

[SheffieldJane]

Tapering this bit, your objectives are twofold. ie controlling the inflammation and allowing your Adrenals to recover. This could be the last lap. I think your suggestion of half a mg and a slow careful taper as illustrated by DorsetLady in FAQs is the best way forward. Pausing at any persistent return of symptoms.

[landyjhm in reply to SheffieldJane]

Thank you SheffieldJane, it's good to get another perspective.

[DorsetLady PMRGCAuk volunteer]

Agree with  SheffieldJane - 0.5mg and slow taper - this is one[s] she was referring to -

healthunlocked.com/pmrgcauk...

..or this one is similar but set out slightly differently, whichever one you prefer - doesn't matter both have same aim -

healthunlocked.com/pmrgcauk...

Good luck

[landyjhm in reply to DorsetLady]

Thank you DL, much appreciated.

[PMRpro Ambassador]

It very much depends - some people manage 1mg at a time over 5 weeks fine, others don't. So you could continue with the 1mg at a time to see if it works. The nearer you get to 5mg though the more likely it is that you will need to switch to 0.5mg and/or over a longer timescale. Only you can tell,

But whichever you use, you won't get past the target: the lowest effective dose. So don't push anything, of symptoms reappear, go back to the last dose, get stable again and try again after a couple of months. Don't get over-confident or let anyone bully you into going faster than is comfortable for you.

[landyjhm in reply to PMRpro]

Wonderful, thank you.

[SnazzyD]

One way to look at it is that 1mg is a bigger proportion of your original dose than it was when you were on higher doses. If you look at it as a staircase, it makes the steps higher the lower you go. 0.5mg adds a smaller one in between and also enables fine tuning of the effective dose.

[landyjhm in reply to SnazzyD]

Thank you SnazzyD, with all of your help and advice, I have come up with a cunning plan!

[Thiago1396]

I am on a similar journey, diagnosed early this year, down to 11mg heading to 10mg in 2 weeks time and then, after 2 or 3 months at 10mg, reduce by 1/2 mg at 5 week intervals to 7mg, then reduce even more slowly, 1/4mg to 5mg. Then stay at 5mg for a period and assess how to proceed.

My doctor is indicating 1mg drops straight through, that is NOT going to happen.

[landyjhm in reply to Thiago1396]

I am continually learning about this medical problem and it would seem as though GP's perhaps are not as up to speed on it as we would hope. I have decided to follow the schedule as outlined earlier by DL and others. It is quite involved, but it does reduce the dose by 1mg a time. It seems to be the case that one size doesn't fit all and we need to act upon what our body is telling us!

[Thiago1396 in reply to landyjhm]

It definitely is the case!