thoughts on tapering

[Fishtacoqueen]

Hi , I was diagnosed with PMR in May 2023. I responded to 15 mg prednisone very quickly and have been following a typical monthly reduction of 1 mg. I have had no PMR pain although I seem to be having right shoulder pain which , I believe , is unrelated. The way I have been tapering is by reducing by 1/4 mg. Every week rather than jumping by a whole mg. So far it seems to be working for me and I am currently at 4 3/4 mg.

Does anyone see any problems with this method?

Maybe I have just been lucky up until now. I also think my PMR may have been triggered by Covid vaccines..which may be a reason I am able to (so far) reduce without much issue.

any thoughts or ideas ??

Thanks for all the great advice and insights I have gained from this site. You are all amazing.

Best of the season to you all🎄

[PMRpro Ambassador]

None at all - if it is working! That is the test! I think @HeronNS did something similar at the start and it worked well for her.

I think I would consider now going to 1/4mg every 2 weeks perhaps - the lower you get, the closer you are to the dose you are seeking - the lowest effective dose - that is, if your PMR hasn't already gone away! I in 5 are said to be able to stop pred in a year or less so it is possible. Really you need more than a week to be sure the new dose is enough and when you just keep going, you may suddenly find symptoms reappearing and you don;t really know where it went pearshaped.

You have been very very luck to get from 15 to under 5 in under 9 months - did your PMR start after having the Covid jab. it happens and those patients do seem to get a short version.

[SnazzyD]

I went for the smaller more frequent drops too. One person’s successful taper is another’s high road to pain because every disease trajectory is different. If it works for you there’s nothing wrong is there?

[SheffieldJane]

If it works for you, then carry on. 🍀

[Grammy80]

The tortoise wins the prize in this game. Good for you, patience pays off.❣️

[Bcol]

All sounds good at the moment, so no real need/reason to change. However, the last few mg usually seem to be the hardest to get through, so may be worth slowing things down a little , perhaps 0.5mg every four weeks and see how things go. My 1.0mg tablets are so small I'm not sure I could cut them into 4!

[Timek]

This is interesting as mine started after covid jab...icing on cake after being under pressure for a while! Ive been on 15mg pred for 8 wks and worked well. Yesterday dr stared tapering...12mg from today. Now wondering if thats too swift? Any help/ advice welcome. Or should I go with it and see what happens?

[PMRpro Ambassador in reply to Timek]

That is a fairly typical taper used by medics though 15/12,5/10 is more common.. It may or may not be too fast - depends on the person. If it works, good, you get down the pred quickly. If it doesn't, go back to 15, let it settle down and do smaller steps, 1mg at a time. And don't let them rush you, 1mg every 3 weeks is quite fast enough!

[LabradorH]

I agree with your idea of 1/4 mg. decreases. I have found that below 1 mg. I have needed to slow the 1/4 mg. drop to about every 3 weeks. That’s in my experience this fall. Yes, best of the season 🌲 to all.

[PMRpro Ambassador]

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