PMR in Hands and Wrists

You should not go down by as much as five.  There is a way to go down by five in the same amount of time.  Say you are given a month to reduce from 20 to 15.  Try dropping by 2.5 for a week or two.  If that works, you can try a further drop of the same, although I'd be tempted to reduce by only 1 mg per week.  Do you have 1 mg tablets?  The standard is never to reduce by more than 10% at a time, and to make sure you are stable with the pain under control at each level before reducing further.  

Donna, your rate reduction is much too fast, if you're not careful you will suffer the consequences. Lots of discussion on these threads about tapering very very slowly. Those of us who've tried to accelerate the process live to regret it

If pain returns you have to up your dose again.  This sometimes makes the next attempt at reduction more difficult.  By all accounts the smaller the reduction each time the more successful.  As I pointed out above you can probably achieve this 5 mg drop in a month but in smaller steps.  If you are expected to drop 5 mg in a week and then another 5 mg in another week, then I don't think anyone can make suggestions that can help you.  I live in Canada and from my starting dose of 15 mg I was advised to drop by only 1 mg increments, weekly.  At 10 mg I had to start the dead slow nearly stop taper, with my doctor's blessing, and have so far successfully reduced to 3.5, now tapering to 3.  This has been since my start thirteen months ago. I may be nearing my lowest possible dose, but so far so good.  

If pain returns you have to up your dose again.  This sometimes makes the next attempt at reduction more difficult.  By all accounts the smaller the reduction each time the more successful.  As I pointed out above you can probably achieve this 5 mg drop in a month but in smaller steps.  If you are expected to drop 5 mg in a week and then another 5 mg in another week, then I don't think anyone can make suggestions that can help you.  I live in Canada and from my starting dose of 15 mg I was advised to drop by only 1 mg increments, weekly.  At 10 mg I had to start the dead slow nearly stop taper, with my doctor's blessing, and have so far successfully reduced to 3.5, now tapering to 3.  This has been since my start thirteen months ago. I may be nearing my lowest possible dose, but so far so good.  

I do not think there is a "protocol" in the US as you say. It is just that doctors here are less informed than in the UK since there are more people in the UK with this disease.  My doc knows the slower the better chance of succes.

I am glad to hear that.  I will talk to my rheumatologist about this.  I found out this past week that my primary care doctor's nurse has PMR.  I am sure she was tempted to talk to me when I first went in with all of my pain in my legs, upper arms, and shoulders, but of course she did not.  Anyway, when I saw her last week and told her that I had been diagnosed in early June, she told me that she has had it for two years.  She is down 6mg.  Her doctors is from an eastern European country and was trained in the UK.  She has been reduding her by 1 mg a month.  I would love to do it that way and will discuss it with my doctor.  I have been on 20 mg for about five weeks, so not sure what be the usual time to begin reducing.  Do you know?  The doctor wanted me to be at 15 by the time I see him again in early August.  I have been pain free for one week, only because I started splitting my dose, breakfast and dinner.  By doing that I wake up pain free.  What do you thing?  I love that I get so much help on here.  Thanks, Marian  I apprecite anything you can tell me.  Donna

Thank you so much, I have been feeling so good.  I don't want to be overyly optimistic, but still want to be hopeful.  I agree that a person should listen to their own body.  I know that we are all different.  I appreciate your help.