Prednisone reduction

[Seal49]

Been reducing prednisone ok so far at rate of one half mg every weeks. Currently at 8.5 and wanted to know if I should reduce slower as I get lower

[PMRpro Ambassador]

1/2mg at a time between 10 and 5mg is fairly usual - it is over how long that really matters and you didn't put the number in!!

[Seal49 in reply to PMRpro]

Sorry. Every 2 weeks

[PMRpro Ambassador in reply to Seal49]

Every 2 weeks is too often - in our view at least. It can take up to 3 or 4 weeks to really know the new dose is still enough and if you have continued to taper so fast, you don't really know where things went pear-shaped.

And as piglette says, you are now entering the realms where the adrenal glands need to wake up again. They don't do that suddenly so a slow taper gives them a better chance as well.

One of our mantras is "The lower, the slower!" and it isn't slow when it works!

[Seal49 in reply to PMRpro]

Thank you and Peglette for confirmation on what I kinda thought. So anxious to get off prednisone I wanted to keep at the pace I did when it was higher. I'll start trying 1 half mg every 4 to 6 weeks. I have been more achy since I started 8 mg about 6 days ago.

[PMRpro Ambassador in reply to Seal49]

Just remember that while you WILL get off pred sometime, a speedy reduction of the dose can often lead to being on it longer!! It isn't the speed of taper that dictates how long it will take to get off but the activity of the underlying autoimmune disorder that causes the symptoms and there is nothing you can do to influence that, as long as the PMR is alive and well, you will need some pred to prevent a return to your pre-pred state. Even slightly too low a dose will result in that over time as the dripping tap of inflammation fills the bucket until it overflows.

[piglette]

You are getting to the point where the adrenal glands will start waking up. In my case they turned me into a total zombie. If you have problems with your adrenals it is a good idea to stay where you are and not reduce until things improve, so the adrenals can dictate your reductions as well as the PMR.

[Seal49]

I meant every 2 weeks

[DorsetLady PMRGCAuk volunteer]

Always slower as you get lower-m for PMR and adrenals… and 2 weeks at any dose is definitely not long enough,,, it can take that long to know current dose is sufficient before you drop lower. Do that a couple of times without being 100% sure and you invariably end up flaring.

[HeronNS]

I used a slow reduction plan which comes to four or six weeks for each taper. 1 mg at higher doses, 1/2 at lower (where you actually are now ). You will never regret going slow enough to avoid flaring and having to raise your dosage again. Slow and steady!

[Grammy80]

For me....the lower the slower mantra was the road for me and has has been suggested for you. As I reduced, I stayed on the new dosage for four to five weeks. The strength the forum gave me the courage to tell the rheumy I wanted to stay on it a few more weeks. For the most part, half a mg every four to five weeks, but listen to your bodily symptoms. 💞

[Oh-my]

I’m glad you asked the question. I too have been wondering how to proceed. Longer at each dose level or split the dose further so it’s a quarter mg drop? Or both? I’m guessing it’s going to be a try and see.

So many other factors to consider too like fighting cold viruses, visitors, life! If only it was all straightforward.

[PMRpro Ambassador in reply to Oh-my]

Depends on you - some people sail down the taper 1mg at a time and stop pred. Others struggle with every single drop. And most are somewhere in the middle. Start with a moderate approach and see how you fare, You can always change horses mid-journey.

[Bcol]

0.5mg on a five week DL taper for me and it worked/works well.

[Birder21]

I have been reducing 1mg every 4 weeks, am on 8mg now for 1 month then will do the 5 week taper to 7.5mg then to 7mg hopefully, will then settle on that until the new year as we have a 3 week holiday mid December.

[CRYSTAL11]

I have found once I get under 5 mg then it gets slower and slower. How long have you been taking them as it can cause problems if you have been on them for a little time. On reducing go with what your body feels