PMR, RECOVERING FROM A FLARE

I went from 12.5 to 10 in one lump and it was a disaster. Back up to 15 for 6 weeks was my G P's instructions. It's now been 7 weeks and I think I'm just back on course. I'll see the G P next week and see what he says.

Thank you Steve...helpful information. I am going to stay with 10 mg until the pain is gone!

The current thinking is that a reduction should not be more than 10% of the whole and that is a lot less than you were trying to attempt  A drop that big - and at that fairly low dose - was a recipe for disaster.  In fact, some patients find that they have to reduce a lot slower than the 10% to prevent flares or relapses. 

Once you have recovered think very carefully about the next reduction.  It really can take a toll on a body which has become used to a particular dose and steroid withdrawal symptoms can be just as bad as a major flare-up.  (It's hard to tell the difference at times)

Try to ensure that you choose a time when you will be able to rest for a few days following the reduction.   If that doesn't solve the problem then perhaps one of the very slow reduction plans would help you.  There are several versions and I'm sure that one is detailed here on this community.

Kathy

Try this plan, it works for quite a few people. Reduction Plan - recommended current thinking is no more than 10% at a time.

Once down to 10mg, many people have difficulty in reducing, there can be reasons for this:

withdrawal symptoms

you are not ready to take a drop

3) the drop you are trying to take is more than 10%

The following is a way that can help you achieve the next steps.

Day 1 10mg

Day 2 9mg

Day 3 10mg

Day 4 9mg

Day 5 9mg

Day 6 10mg

Day 7 9mg

Day 8 9mg

Day 9 9mg

Day 10 10mg

Day 11 9mg

Day 12 9mg

Day 13 9mg

Day 14 9mg

Day 15 10mg

Day 16 9mg

Day 17 9mg

Day 18 9mg

Day 19 9mg

Day 20 9mg

Day 21 10mg

Day 22 9mg

Day 23 9mg

Day 24 9mg

Day 25 9mg

Day 26 9mg

Day 27 9mg

Day 28 10mg

Day 29 onwards 9mg

If at anytime the pain increases, wait two or three days, if it is still there then the drop is to soon, go back to 10mg, wait a couple of weeks and try again. If after waiting the two or three days it subsides then it was probably withdrawal symptoms.

Once stable on 9mg wait two or three weeks and then try to take the drop down to 8mg following the same pattern. You don't have to wait the two or three weeks if you think you are fine, just go straight to the next step.

Once you have got to 5mg, then the drop is 0.5mg at a time. So you need a pill cutter to split the 1mg tablet in two. Using the same pattern but this time wait at least 1 month before attempting the next drop.

Below 7.5mg is where the adrenal glands start to wake up and work but they can take up to a year to become fully functional. This is why even when off pred you have to carry the Blue Steroid Card with you which contains the date of the last dose.