Over the past month, my rheumatologist respecting my rate of tapering I have tapered 2,5mg , 0,5 at a time. My energy level is not perfect and I do have fatigue but I I try to get out and walk twice a day and rest in between. I still have numbness in arms and shoulders but my hips are OK. . My question is it OK to taper even with some degree of fatigue and numbness, Some friends who have experienced PMR years ago said that they tapered only when they were pain free. Come February I would like to taper at the same rate as I did in January, ,at the rate of .5 a week. My GP tells me that the 25mg of Pred that I am taking is probably responsible for the Fatigue and after thee months of Pred this side effect can show up just like that.
On the other hand, am I being too careful and should I taper by 1mg gradually on alternate days ?
Your advice is welcomed , I really would like to go back to 20mg where I was in November and where I felt so good.
Written by
Rose8950
To view profiles and participate in discussions please or .
Wondering if it’s all down to PMR as you aren’t getting better relief at 25mg. Fatigue can be caused by the underlying illness and the Pred, so sometimes it’s difficult to pinpoint what is the actual cause.
No sure that reduce 0.5mg every week is best way to go about things… if you are only on a dose for such a short period you are never 100% sure that dose is sufficient before you drop down. we usually suggest one month at each stage. Nor do we really recommend an alternate day plans- that seems to be more popular in North America than in UK.
I’d suggest only 1mg per month rather that the 2mg or 2.5mg you’ve been doing especially if you still have some issues.
If you felt good at 20mg can you remind me why you increased?
Yes, I felt good at 20 but after 90 days on Pred my rheumatologist wanted me to drop to 15 since I was so well. That’s when I had this awful flare, he then had me go up to 25 and after a few days still in pain to 27, that’s when I first experienced extreme fatigue. If it wasn’t for the fatigue I wouldn’t complain.
If they were to wait to be totally pain and symptom free, some people would never reduce the dose. Fatigue in particular is an inherent part of PMR and, in fact, of pretty much ALL autoimmune disease. The pred does nothing about the actual disease process, all it is doing is managing the inflammation it causes and the disease continues in the background attacking body tissues and creating inflammation in the early morning which the pred mops up quickly providing you are taking enough. The illness process coul dbe likened to flu - and the pred to Lemsip or other remedies that relieve the aches and pain until you recover.
The dose of pred you were given was what is generally loads to do the job at a point where there is quite a bit of existing inflammation and this daily shedding of new inflammatory substances. But after a few weeks it is normal and possible to start to taper the dose to find the lowest effective dose so you are taking less medication and this should reduce the side effects of pred which can include fatigue as well as the better known "pred gives you wings" feeling.
In PMR and at this stage, it is usually perfectly possible to reduce the dose 2,5mg every 3 weeks or so - but by dropping 2,5mg at a time rather than 0,5mg at a time, even if it is every week. It is really only if you have a problem with bigger steps that you need to consider such small taper steps and what you are doing is something I've not come across before. Why did you decide to do it this way?
could you transfer the link to the PMRpro tapering plans, I searched everywhere on the site yesterday and couldn’t find it. The reason I tapered .5mg a week over the lat month is that it didn’t wake up any pain. I had this terrible flare at the beginning of the year when my rheumy had me drop by 5mg , so that’s why I’m being extra cautious. I might try a drop of 1 mg next week after thee weeks at 25.
When I see the tapering plan I’ll see how to do it. I didn’t pay much attention when I saw it in my earlier posts. Thank you so much for your help.
All the tapering plans are to be found under Tapering in the FAQs for which there is a link at the top of every thread, immediately below the post. It is a really good idea to get to know how to use them and then you can look things up any time.
I would suggest trying 2,5mg over a month, that would be normal at this dose level. The fatigue - as explained - is a feature of the illness and not really affected by the pred.
Ok, starting Sunday I will give it a try. As you wrote at this dose level it is only 10% of my present dose and in November I was so comfortable at 20mg.
PMR is life changing and the mantra is to rest, rest, rest. PMR is always hanging around waiting to pounce if you don’t respect it! Of course it is important to exercise, but gently. Look after yourself, you have an illness.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Abandon current taper or?
Increase or Taper?
To Taper or Not?
Prednisone taper with Kevzara
