The Prednisone Taper - 1 mg per month

[Paulsnow]

Hi there ,

I am on presently taking 9 mg of Prednisone while using 1 mm of Methotrexate each week .

Is there anyone else who is or has been on this regiment with the tapering of prednisone ?

Thank you Paul Snow

[PMRpro Ambassador]

Sorry - don't understand your dosage of methotrexate. mm is a measure of length and 1 isn't an available dose of MTX, it comes in 2,5mg tablets. The usual rheumatology dose is 15 to 22.5, occasionally trialing lower if patients don't tolerate it.

[Paulsnow in reply to PMRpro]

sorry. my dose is 25 mg MTX

my mistake , 1 mm is the amount per the syringe

are you on or have been doing this Regiment ?

Thank you for the Reply , Paul

[PMRpro Ambassador in reply to Paulsnow]

MTX made me so ill I stopped it after a month. However, that is a common approach using MTX in general although it isn't used that much in PMR. Some people do very well with it but they are a minority, I hope some of the MTX people come and tell their stories.

It can take quite a while for MTX to have a noticeable effect - at least 6 months for many There are no good studies backing its use but many rheumies seem to think it is wonderful! Prof Mackie in Leeds is currently running a study to try and establish if it is worth using but such studies take several years to complete.

If you had included the fact you are on MTX in your title then Related Posts would have come up where it has already been discussed in the past. 1mg per month is also a usual taper step below 10mg

[Paulsnow in reply to PMRpro]

Thank you again

I will repost again with Title Change

maybe I will find some info on MTX that gives good news .

[PMRpro Ambassador in reply to Paulsnow]

There are people who have done well with it and got to a lower dose - as well as the people it did nothing for. But you have to try it to find out if you are in the group which does get a good result.

[Paulsnow in reply to PMRpro]

ah so good to hear this Thank you very much .

I am just feeling depressed each morning when i wake up .

[PMRpro Ambassador in reply to Paulsnow]

Hang around here and we'll cheer you up! Tell us more about your journey and I'm sure we can help.

Any idea WHY you feel depressed?

[Hollybee21 in reply to Paulsnow]

I have been on Methotrexate for two years next month and I am doing a very slow taper, currently going down to 2 mg of Pred and just had my Methotrexate injection reduced to 15. Having such a slow taper I have had no flares (touch wood) and I have had PMR for 14+ years.

[Nidgey]

I was finding it very difficult to taper off steroids, so my Rheumatologist introduced Methotrexate in 2022. I take 20mg orally, and have never had any side effects. I have managed very slowly to taper the steroids down to 5.5mg daily at present.

[Mamamia21]

I'm on 12.5mg of methotrexate, to get me off the steroids. I was a serial yoyoer bouncing between 8 and 10mg of steriods for years... I could not get below 8mg. Now I am down to 2.5mg Steroids. I have never had any problems with methotrexate but to be honest I am not sure if they helped me get lower or not. They added 4mg Barcitinib into the mix shortly after for my arthritis.

My plan is to keep reducing the steroids, then come off the methotrexate and then all being well I will tackle the Barcitinib. A long journey ahead but currently in a good place and it is working for me at the moment.

I too have had my ups and downs.... hang in there you just need to find what is right for you. Try not to overthink it. This journey is different for all of us but we are in this together.

[Noni71]

I have been on Prednisolone for 2 years and had Methotrexate added almost a year ago. It really didn’t suit me as it played havoc with my liver function so had to cease taking it. Was on Tocilizumab (Actemra) but my year is now up and I I’ve been moved on to Leflunomide. Early days but so far so good. I’m down to 5 and a half mg of Pred but having bad times with anxiety. It will pass! Hope you can see a way through all of this.

[GCAsurprise]

I am currently on Methotrexate 20 mg orally once/ week and am tapering down Prednisone 1 mg per month. I am currently on 5 mg. I started with 40 mg Prednisone in February 2024.

I have not had any difficulty with the Methotrexate.

Good luck with your journey.

Cheers, Nancy

[AmbientB]

This sounds quite similar to my regime. I take 20 mg of methotrexate weekly in tablet form and have had no side effects to speak off. Doctor also prescribed folate (one of the vit Bs) at the same time in a high dose of 5 mg six times per week to reduce side effects of methotraxate. Prednisolone is currently at 11 mg daily. I've tapered down from 50 mg in August last year. Methotrexate was introduced when I was bouncing around between 45 to 40 and making little progress. After 5 weeks tapering started to become easier. Since reaching 15 mg of prednisolone, I've been reducing by 0.5 mg every 3-4 weeks. Progress was very good and the doctor wanted me to drop from 11 to 10 mg - which I tried last week and it was a disaster. After 3 days all the aching returned and and intense fatigue, I went back up to 11 mg and am now trying to stabilise before dropping to 10.5. I am in Australia and methotrexate is used a lot for PMR here, mostly when people have trouble reducing shortly after the start of treatment. Some people seem to need it more than others.