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Are there fewer side effects on low dose Prednisone?

Posted , 6 users are following.

susanjeanne
susanjeanne

I've been told that I must be on 5 mg of Prednisone for 30 days and then wean to 2.5 mg for several months. Kind of concerned about the long term effects. Is that low enough of a dose to be relatively harmless?

1 like, 4 replies

4 Replies

  • Oregonjohn-UK
    Oregonjohn-UK susanjeanne

    Posted

    In my experience the lower the dosage the less likely the side effects.  5 mg is quite low anyway and you would need to reduce quite gently as you are very close to the maintenance level.  It's not a matter of just reducing relentless but a what dose you are still comfortable.

  • EileenH
    EileenH susanjeanne

    Posted

    I'm assuming then that you have already reduced successfully to 5mg without a return of symptoms? If that is the case and you are now looking to reduce to zero because your doctor imagines the PMR has gone, then that is not the way to do it. It would be asking for trouble for most of us. Just because you have no symptoms and you blood markers are normal - that just means the dose of pred you are on at present is high enough to achieve that. It doesn't mean the underlying autoimmune disorder has gone into remission yet.

    5mg may manage the symptoms - but less may not, so just jumping straight down to 2.5mg may cause one of two things: either the halving of your current dose will cause steroid withdrawal problems or you may miss the dose you need and the PMR symptoms will come back. They are so similar you won't be able to tell which is which if that happens.

    The other problem now is adrenal insufficiency - and it appears your rheumy is aware of that. But I think saying to hang around at 2.5mg is too late. The place one top PMR rheumy stops the patients at for several months is 5mg. It is already a low dose with few side effects. He then finds the rest of the taper is much easier, the body has had time to catch up with the idea of making cortisol with a replacement dose that minimises the risk of an adrenal crisis. One lady has had to reduce rapidly to 5mg for her rheumy - at 5mg she has felt really ill with symptoms of adrenal insufficiency even after a couple of weeks and today has gone back to 7mg in desperation.

     

    However - 5mg is a low dose and really isn't a problem to be on for months. Most of us would be delighted to get there!

    • EileenH
      EileenH Oregonjohn-UK

      Posted

      No - you answered the question - I just had suspicions. Which may be correct or not. We'll see.

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