When should I start the 'Dead Slow' taper? - PMRGCAuk

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When should I start the 'Dead Slow' taper?

landyjhm profile image
19 Replies

Having had a disastrous taper last year, I am determined not to repeat it.

I am now down to 7.5mg of Pred, having reduced by 0.5mg every three weeks since I was down to 10mg. At what point would you suggest that I move on to the dead slow taper?

Many thanks, Jonathan.

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landyjhm profile image
landyjhm
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19 Replies
DorsetLady profile image
DorsetLadyPMRGCAuk volunteer

Sounds as if now would be a good time….adrenals will be struggling a bit to be nudged back into life. … so they need a slow taper, as will your PMR…

But a slow taper can be introduced at any dose… and in hindsight it probably would have made your disastrous year less likely had you commenced it at 10mg.

Good luck from now on…

landyjhm profile image
landyjhm in reply toDorsetLady

Thank you, much appreciated.

PMRpro profile image
PMRproAmbassador

You can use it at any dose. The originator of the idea used it below 5mg but when I expanded the concept it was aimed at patients on enteric coated pred who could only taper in 2,5mg steps - no 1mg tablets then - and even patients who were struggling at doses above 20mg. There is no fixed place to start it, The earlier you start it, the less likely you are to run into trouble.

landyjhm profile image
landyjhm in reply toPMRpro

Thank you, I shall start it and my next reduction. Would you advise 0.5mg reductions or 1mg?

PMRpro profile image
PMRproAmbassador in reply tolandyjhm

As small as possible! The basic rule is approx. 10% of the current dose. That is 1mg at 10 - by 7mg 1mg is 14%, by 5mg 20% so 1/2mg at a time is always better.

DorsetLady profile image
DorsetLadyPMRGCAuk volunteer in reply toPMRpro

Know you mean 1/2mg rather than 1.2mg - might confuse newbie.😊

PMRpro profile image
PMRproAmbassador in reply toDorsetLady

It's my Italian keyboard markings ...

DorsetLady profile image
DorsetLadyPMRGCAuk volunteer in reply toPMRpro

I knew what you meant, and I’m sure most would …. 😉

PMRpro profile image
PMRproAmbassador in reply toDorsetLady

Drives me up the wall! Usually I notice but it happens a lot.

DorsetLady profile image
DorsetLadyPMRGCAuk volunteer in reply toPMRpro

Yes you very often have a semi colon in a word when you mean an apostrophe… and that doesn’t really matter, but as you say annoying..

alangg profile image
alangg

I used a DSNS tapering plan every time I reduced the dose and never more than a 10% reduction. Each plan took just over 4 weeks and then I stayed at least a week on the new dose, usually two before starting to taper again. It worked for me!

landyjhm profile image
landyjhm in reply toalangg

Thank you alangg, that's really helpful.

Bedwell profile image
Bedwell in reply toalangg

I tried to reduce from 2 mgs.. to 1.5 ..having been on 2 for a month.. and I had an awful day! Couldn’t function at all. But I had a cold!!! My cranial osteopath said one shouldn’t reduce if you have a cold? Haven’t heard that! Back on 2 .. for how long!?!?

landyjhm profile image
landyjhm in reply toBedwell

Good advice, thank you!

PMRpro profile image
PMRproAmbassador in reply toBedwell

You shouldn't try to reduce if you are at all unwell. We do say it lots on the forum!

PMRnewbie2017 profile image
PMRnewbie2017 in reply toBedwell

Stay on 2mg until you have fully recovered and feel properly well again. Some of these cold viruses are hanging around for a while.

Bedwell profile image
Bedwell in reply toPMRnewbie2017

thanjs yes. It’s been over a week.. seems to come and go. Better at night funnily enough. Homeopath just suggested a remedy so will see how I go. Thanks again!

MillMoor profile image
MillMoor

My slow taper started about 7 years ago. Have GCA and PMR.Had two major flares following consults orders. Finding this site changed everything. Now down to 4mg with no problems from 40mg. Only do half mg at a time.

Good luck with it.

landyjhm profile image
landyjhm in reply toMillMoor

Thank you Millmoor.

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