Best safest, fastest method to get off prednisone

[arvine]

at 4 mgs for few mos always ised dead slow method in past , took about 5?weeks to get 1 mg lower,in the past, full of arthritis hipbsurgery coming up, need to be able to take anti inflammatory med for relief of pain, need to get off pred

[SnazzyD]

That’s up to your body really. The mantra here, as you know, is go slow for the adrenal glands to keep up with the pace and to pin point the effective dose. What is too fast for your body will become apparent if you overreach. Sounds like what you have just done was ok for you but that can change of course.

[HeronNS]

Why do you need to get off pred? Have often read about people undergoing surgery not only maintaining their dose but sometimes needing a top up to deal with the stress of surgery. I was still on pred a few years ago when I had a knee injury. Was given Tylenol 3, a combination of acetaminophen, codeine and caffeine.

I've tapered to zero twice (first time unsuccessful) and both times took at least a year to taper from 2 mg pred.

[arvine in reply to HeronNS]

Well not just a matter of getting off pred for surgrty( in Feb) ectracstrength tylenol which i all Im allowed to take right now doesnt hardly touch painful osteoarthritis in hip, back ankles and hands, so need anti inflammatory meds cant take with pred, rhuemy says I no longer have pred, and markers have never been raised in my last 8 yr journey of pmr

[HeronNS in reply to arvine]

Oh I see. Do you agree with the doctor that you no longer are experiencing PMR pain, that it is all down to the osteoarthritis?

I ask because in 2020 I came off pred for about six weeks, but returned to a low dose because of return of symptoms. Still had and tolerated what I thought was pain due to OA, (yes, I have OA nearly everywhere, some of it quite serious, x--ray confirmed). But in 2021 I realized the pain in my neck was just like I'd felt in the final weeks leading up to my original PMR diagnosis (2015). Took 10 mg (had been on 2 and fiddling around with smaller increases, like 3 for a few days). Had the pred miracle. It did take four more years, but got to zero again in February 2024 and have not had PMR (or extra pain I used to blame on OA) symptoms since.

Incidental note, I had trouble reducing below about 8 for a while, but after receiving Shingrix vax (in the middle of all those early years of Covid vaccines) my taper became easier.

[arvine in reply to HeronNS]

Well what I am feeling now is not like my original symptons, I had stiff arms shoulders snd hips, hurt to raise my arms to even brish mybteeth, hair etc, so stiff, that was in 2016, I talked to rheumy about the 5 mg increase for aweek or so, his response was “of course it will relieve your pain, prednisine is a pain killer) believe me with this chrinic pain every day, although exrays , mri s, etc have confirmed osteoarthritis, I am tempted to try the increase for week or so just to see if it relieves some pain, but struggling with that choice

[HeronNS in reply to arvine]

I do understand. I didn't have the disability-type symptoms the second time around. Could still get out of bed, brush my hir, etc., don't think I was doing the penguin walk But that neck! and I've had an arthritic neck for many many years, probably since before the official OA diagnosis age 40. Yet the prednsione dealt with that both in 2015 and 2021 and I'm not having problems now. If anything like me you would know very quickly, soon enough not to have to go through a taper again if you didn't respond quite miraculously. I did go for 10 mg as by then I was getting pretty desperate and wanted to make sure it would work but got back into single digits in a matter of days.

After hurting my knees in 2020 I was so crippled I was on the route to a knee replacement. Everyone is telling me it's OA. But eventually I decided to treat it like the injury it was, and things improved, especially after discovering Flexiseq, which does indeed help OA. In my case it seemed to work very quickly to reduce swelling from the injury, so it was probably a complicated combination of causes, including inflammation from the injury which had become chronic. However it was some weeks or a few months after that when I had to take the extra pred for my neck.

It really isn't simple to separate two different chronic pain conditions needing different treatment is it?

Hugs.

[arvine in reply to HeronNS]

well thank you , I di have to make a decision, as long as no negative rrpercussions and can get back down to 5 mgs( 1 mg above what crrently on) against rheumy s advice but Ivam desperate to get some relief

[arvine in reply to HeronNS]

also 3 yrs ago decascan showed moderate risk for fracture ostopenia , now few mos ago had one done showed high risk, my Gp says prednisone a factor om long term, soooo

[Charlie1boy in reply to HeronNS]

Took me three goes as well to get to zero, with an almost identical timeframe.

[PMRpro Ambassador]

At the doses you have been on for such a long time now there is no fastest way to get off pred - it all depends on your adrenal function. You can only reduce the pred dose as fast as your body keeps up with starting to produce the body's natural steroid, cortisol. The taper you have been using, 1mg over 5 weeks is probably as good as it gets and even then, your body may not agree.

I do wish I knew what makes doctors think pred deals with ALL pain - it doesn't. It deals with inflammatory pain. Not anything else.

[arvine in reply to PMRpro]

Thank you but think logic behind pred deals with pain, is inflammation causes pain in many cases ,

[PMRpro Ambassador in reply to arvine]

It does, but the implication from a lot of doctors is it deals with ALL pain. If it dealt with your pain - it was due to inflammation. And the doctor should be asking WHAT and WHY.

[arvine in reply to PMRpro]

Agreed, so far consensus with rheumy is keeep in tapering, you have osteoarthritis, perhaps fibro? Since all over body pain, have some liver issues , GP dent me for more bloodwork yesterday as was talking about metjotrexate , as mentioned in an earlier post, am tempted to try the 5 mg increase for week or so, just to see if have some relief but am nervous about negative outcome , and rheumy seems to get put off saying “seems like you re prescribing your own doses, and if you keep going up and dow you ll never get off pred” , Ive only increased in Dec 2022 at his advice as seemingly GCA symptons, tapered from then to 5 mgs in the fall of 2023, increased by 5 mgs this past summer for only 3 days, when had to get MRI for hip , as first appt too painful to hold legs in position for test,

[arvine in reply to PMRpro]

Also if I decide to try 1/2 mg derease to 3 1/2 mgs how soon could I expect to have negative results if it happened that dose too low for me?

[PMRpro Ambassador in reply to arvine]

No answer to that - how long is a piece of string? But sometimes you have to put up with it for a long time before it improved. Adrenal insufficiency can cause aches and pains too.

[arvine in reply to PMRpro]

Ah thank you dont see endochronologist until Jan 2025,

[HeronNS in reply to arvine]

And on the plus side 2025 is finally just around the corner. Bet you've been waiting awhile! They don't call us patients for nothing. 😂

[arvine]

yes been in chronic pain since end of June, all day a evening, excruciating on waking trying to get out of bed and move, so patience wearing thin

[proactive]

I had an unplanned hip replacement due to trauma while on 9.5 mg prednisone. There are many pain meds available other than anti-inflammatories and they worked fine for me as far as control of post surgery pain. I would not rush my pred reduction at 4 mg or I fear adrenals would not be up to needed function quickly and you could feel much worse.

[arvine in reply to proactive]

Thank you

[arvine in reply to proactive]

the only pain killer Im allowed is extra strength tylenol, which doesnt help much, what other painkillers are you referring to, and Inam in Ontario Canads