reducing prednisolone

[Havanahula]

the consultant has said to reduce Prednisolone by 1mg per month. Am currently just finishing 8mg but am a bit nervous about going to 7mg . Would it be ok to do 7 and a half for a few weeks then do same for 7? I had a few random head pings early on the 8mg dose . Have GCA.

[SnazzyD]

I would! 1mg is a higher proportion of your original dose each time. 0.5mg is more gentle.

[DorsetLady PMRGCAuk volunteer]

Very good idea…. many decide to reduce by 0.5mg once they get to those sorts of doses. I did with my GCA and also used a slower taper regime .

[123-go]

Yes, it would be sensible at this dose to reduce by no more than 0.5mg every 4-6 weeks and only if there’s no return of symptoms. You will hear repeatedly on this forum, “The lower the slower”. There is a lot of information provided in FAQs on tapering methods to help you decide which plan may be best for you/ are most comfortable with:

healthunlocked.com/pmrgcauk...

[PMRpro Ambassador]

Definitely a good idea!

[Miserere]

I agree - 100%

[piglette]

Below 10mg I reduced by 0.5mg. I tried to keep the reduction maximum ten per cent as long as possible.

[Bcol]

Excellent idea, I use a DL 0.5mg five week taper and only start the next taper when it feels right.

[Janet57]

definitely a good idea - 😊

[wendythom]

for the umpteenth time I have been trying to reduce from 8mg per day. My body won’t have it- upper arms, neck etc now aching badly. Have had PMR for over 10 years.

[DorsetLady PMRGCAuk volunteer in reply to wendythom]

Might be a silly question, but how are you trying to reduce? One of the slow tapers we recommend [all of which can be extended to take as long as necessary] and only 0.5mg at a time.. Tapering plans are in FAQs.

healthunlocked.com/pmrgcauk...

[wendythom in reply to DorsetLady]

Thank you for your reply. I have been tapering very slowly. A consultant told me the PMR is a stress response to my other health issues. He said I may be on pred for the rest of my life. I think he may be right!

[DorsetLady PMRGCAuk volunteer in reply to wendythom]

Yes you may be unfortunately- but I’m sure you’d like to probably like get a little lower…😊

[wendythom in reply to DorsetLady]

Thanks- yes of course but ESRs never below 50 even on 8mg.

[PMRpro Ambassador in reply to wendythom]

Has that been investigated to see if it is due to something other than PMR? PMR as we mean it is defined at a pred-responsive myalgia so on enough pred, there should be no inflammation. If there still is enough to raise ESR that much - maybe something else is going on.

After 20 years of PMR symptoms and 15+ years of pred, I am stuck at 7mg, even though I am also on Actemra!

[wendythom in reply to PMRpro]

I have had various tests and scans - my back is in a shocking state (disc bulges at quite a few levels compressing nerves). I think the ESR rate would lower if I took more pred but am always under pressure to reduce the dose. It was the orthopaedic surgeon who made the observations in my previous post. I agree with him that PMR is a stress response.

Without wishing to sound mean I do take some reassurance from you in the number of years you have been taking pred! Not being the only one does help in a strange sort of way.

I am awaiting the results of a recent blood test and, since moving house, now have a new GP who seems quite thorough.

As always, thank you very much for your help.

[PMRpro Ambassador in reply to wendythom]

I have never worried about the pred despite the years I spent at above 10mg! The PMR was far worse when my husband was alive and very ill and after his death it just got worse. That led to my amazing rheumy deciding to try Actemra (not in the UK, Italy) and that has got me to 7mg. Much lower and I have adrenal issues anyway, at 6mg the bicep pain develops. 7mg sorts both nicely - I have to be able to live and I had had 5 years of PMR with no pred to start with and I have no desire to go back there ever again. I never had a raised ESR - no use anyone wanting to rely on that, especially now I am on Actemra!

[Grammy80]

When I was reducing, GCA, I went a half a mg per month after 10. If I had pings, as you said, then I'd stay on the same dose for six weeks. Good fortune....💞