reduction uncertainty

[Sibelius5]

I reduced to 8ml on 5th March and am reducing to 7ml today after my doctor’s appointment yesterday. My uncertainty is whether to follow his suggestion to just do that in one go or follow a tapering plan. He’s fine with either. The reduction to 8ml has been ok but not as settled as reducing to 9ml - I’ve got no pain or immobility so that’s well over the 70% better level, but I’ve got noticeable feelings of inflammation being around when I get up and exercise. That goes after the steroids kick in so obviously the dose is running out earlier than before. Unless this is the adrenal problems already? So is it in one go or space it over a few weeks? Thanks in advance for your help.

[DorsetLady PMRGCAuk volunteer]

It’s always easier (won’t say easy) with a slower taper…. and once people get to the level you are at now and adrenals do come into play, many find it better to reduce by only 0.5mg at a time.

So long as you are using plain uncoated tablets they can be cut quite easily..

[Sibelius5 in reply to DorsetLady]

I was thinking of your week by week taper - 7 once this week, twice next week etc - is that likely to be easier or would reducing by 0.5 be better? I guess it’ll really be a matter of how it affects me individually as everyone is different.

[DorsetLady PMRGCAuk volunteer in reply to Sibelius5]

You could try that this time - but I’m slightly concerned you mention you are getting some issues which could indicate you are teetering on the cusp of enough Pred/not enough Pred. A 1mg reduction could well tip you into the not enough zone.

If you try the 1mg reduction, and find on weeks 2 or 3 things deteriorate then return to 8mg… get back on track, and then try the smaller reduction.

As you say, it is an individual thing, but just saying, don’t rush…. Good luck with whatever you decide.

[Sibelius5 in reply to DorsetLady]

I think I’ll try the 0.5 given what you say

[SnazzyD in reply to Sibelius5]

I always found 0.5mg to be more favourable. Even if you still do 1mg per month but 0.5mg per 2 weeks instead. However, at this stage many start to hit a bit of a fatigue wall, so a much slower introduction of 0.5mg may be needed. As DL says, do heed those niggles; it would be a shame to have a flare now.

[PMRpro Ambassador]

And I agree with everything DL and Snazzy have said. The smaller the step and the slower the change in dose the less uncomfortable it tends to be, It may SOUND slow - but it isn't slow when it works.