Taper

[Maggieart]

So my rheumy had me bump up to 15 mg of pred (I've been at 4.5 for a couple of years) due to the increase in my pain. I was at 15 for a week and it was quite wonderful to feel so good. Now I am to drop by 5 for a week, then 9,8,7,6 for one week each. Because I am feeling so good, I am tapering a bit more slowly. 12.5 right now. Agree? Suggestions for a slower taper? Thank you.

[DorsetLady PMRGCAuk volunteer]

When anyone has your issue we usually recommend the info in this link - so increasing by 5mg rather than 10mg as your Rheumy has done…

healthunlocked.com/pmrgcauk...

So would say that you could probably reduce more quickly that they recommended, but you do need to check with them. Maybe as suggested back to 10mg , but then you may well be able to step down to 7mg for another week, and then back to 5mg…

And with an increase of 10mg you will feel wonderful,- but that will soon disappear as you cut dose.. so don’t be too gung-ho.

[Maggieart in reply to DorsetLady]

Well, it's too late for that. I posted my rheumy's suggestion of 15,10, 9... (up from 4.5) and the response I got from this site was it seemed very reasonable so I went ahead and did it.

[DorsetLady PMRGCAuk volunteer in reply to Maggieart]

What I said was -

Sounds more sensible than many rheumatologists would have suggested- have slight reservations about weekly reductions - but it’s worth giving it a go.

No one can give you a cast iron guarantee it will work perfectly.

[Maggieart in reply to DorsetLady]

I am well aware that there or no "cast iron guarantees." Thank you for your help with this.

[Maggieart in reply to Maggieart]

I am going to stay at 10 mg for two more weeks, per my rheumatologist, due to pain coming back at 9. Then 9 for 3 weeks, then 8 etc. A bit slower taper. Hopefully this will work.

[PMRpro Ambassador in reply to Maggieart]

Hpwever slowly you taper, nothing will get you past the lowest effective dose. You aren't heading relentlessly to zero - and it may well be that your lowest effective dose at present is about 9mg. It doesn't mean you won't get lower, just not yet. Trying to force it to get to a lower dose never works well - it is too likely to result in a flare of the inflammation and a return of symptoms. PMR always wins!

[PMRpro Ambassador]

I would say try going to the 10mg - because unless you have a massive flare going on, that 10mg increase is a bit OTT. What you are suggesting is effectively taking you back to the beginning, and that may not be required.

[Maggieart in reply to PMRpro]

This is really a bummer. I was so hesitant to go to that dosage, but I was reassured by this site that it seemed reasonable. I am not sure what to do now except stay the course and hope it doesn't actually take me back to the beginning. Very upsetting...

[PMRpro Ambassador in reply to Maggieart]

No - I think you are misunderstanding what we are saying - we are both saying don't taper more slowly. Drop to the 10mg as the rheumy says. YOU are saying you want to go slower because you feel so good at 15, of course you do. But stay at these higher doses for long and you have gone backwards.

[Maggieart in reply to PMRpro]

sheeeeeeeew Will do. Thank you. I did misunderstand.