Vaccinations and tapering

[Tribie]

Hello everyone, hoping for advice from you knowledgeable, lovely people. I’m on 15 mgs of Prednisolone, 20mgs am and 5mgs pm, tapering by 1mg every 2 weeks if no symptoms. Due to reduce to 4 mgs pm tomorrow but am having a Covid booster today. I have had no pain or discomfort so far while tapering, would it be sensible to delay the taper by a week or do you think this is unnecessary? (I’m just thinking about the possible/theoretical risk of exacerbating symptoms). Many thanks in advance.

[DorsetLady PMRGCAuk volunteer]

Irrespective of the booster, I think you’d be wise to leave taper for another week anyway… every 2 weeks is hardly enough time to know current dose is sufficient before you reduce. You really need to be at each dose for at least 3weeks.

..and as you are on 15mg… guess the 20mg is a typo - and you mean 10mg am/5mg pm 😊

[Tribie in reply to DorsetLady]

Thanks so much for your speedy reply! Yes sorry the 20mg is indeed a typo! Re the timing of tapering, I thought 2 weeks was ok as I’ve had no pain at all so far during the whole time I’ve been reducing, so assumed that no inflammation was building up, but maybe I should adopt 3+ weeks as I go lower? Was thinking about this for when I’m down to 10 mgs daily (assuming no symptoms before this) but perhaps I should start it sooner. I will indeed postpone my taper for a week at least anyway. Thank you so much.

[DorsetLady PMRGCAuk volunteer in reply to Tribie]

You may have been okay so far, and good that you have, but as you get lower in dose each 1mg reduction becomes a bigger drop in percentage terms - and that’s when people sometimes run into trouble.

You will hear people on here talk about the ‘reduction should be no more than 10% of current dose’ mantra once you get into singles figures …at 10mg, 1mg is 10%, at 5mg it’s 20%…

Once you get to 10mg then definitely every 4 weeks…. and lower still even longer. .. guidelines do say once below 10mg reduce 1mg every 4 -8 weeks depending on disease activity and patients wishes..

[Tribie in reply to DorsetLady]

Brilliant, thank you so much. Fortunately my rheumy gave me pretty much a free pass to do as I felt best and my GP seems happy to go along with this. (To be honest I feel she’s not that interested so long as I’m not too demanding and just jog along by myself…)

[Thiago1396 in reply to Tribie]

My GP is the same, I’m pleased to state 😉

[Thiago1396 in reply to DorsetLady]

From a negative experience this is so important “Once you get to 10mg then definitely every 4 weeks…. and lower still even longer. .. guidelines do say once below 10mg reduce 1mg every 4 -8 weeks depending on disease activity and patients wishes..”

[DorsetLady PMRGCAuk volunteer in reply to Thiago1396]

As that what I often quote I’m not sure you meant this for me…

[Thiago1396 in reply to DorsetLady]

I definitely meant it for you 👍

[DorsetLady PMRGCAuk volunteer in reply to Thiago1396]

Okay -thought you were just reiterating to Tribie -me misunderstanding 🤦🏻‍♀️

[PMRpro Ambassador]

And I agree with the entire conversation with DL!!! There's a surprise - not ...

[DorsetLady PMRGCAuk volunteer in reply to PMRpro]

Great minds .. and all that 😊