Query re tapering down from initial larg dose of prednisolone.

Posted , 8 users are following.

I'm looking at people's posts re tapering down from 10 or 15 mg by 1 or even 0.5mg at a time.

How have people reduced down from larger daily doses please?

My husband does not have a great deal of patience and I can't imagine him calmly reducing from 40mg by 1mg at a time in stages.

0 likes, 5 replies

5 Replies

  • Posted

    Would it be fair to say that none of us men have patience? Certainly would apply in my case. But with PMR one doesn’t have a choice.  it’s not about mind over matter. Your body tells you what is prepared to do. And by that I mean each person can only taper at their own rate. From 20 mg,  I tapered initially at about 2 1/2 mg every two weeks. From 15 to 10 it was at a rate of about 1 mg every two weeks. And from 10 mg to zero it was about a half milligram every two weeks or about 1 mg a month. Overall it took me 18 months, and when I found it I got too far or too fast, It was my body and not me telling me to slow down or even reverse course for a few weeks.

    We like to think we are in control…you know masters of our universe. PMR teaches us  a painful reality. If your husband tries to force it and drive his way to zero as if a car to a destination, he will, as the analogy goes, run out of gas rather quickly.  

  • Posted

    No - from 40mg down to 20mg then he should manage fairly well with 2.5mg at a time, maybe even 5mg to 35 and 30. But as Daniel says, his body may rebel - if the step down is too big then you may experience one of two things: steroid withdrawal rheumatism or a flare of the symptoms because the dose is now too low to manage the inflammation.

    If he has "just" PMR then 40mg is a high dose (it isn't if it is GCA that he has, then it is the bottom of the required range) and he should be able to drop 5mg at a time and could even try going from 40 to 30 at one go if he hasn't been on the 40mg too long (more than a couple of weeks for example). It is very individual - he will have to try and see how he gets on. You don't really need to go to 1mg until you get to 10mg - unless you have problems with the size steps you try. It is a bit of experiementation - but we can assure you that once he gets below 20mg it will pay hime to tread carefully! It isn't slow when it works - when it doesn't work because you are pushing to go too fast or too far, all that happens is that you flare, you have to go back to a higher dose and start again and sometimes you have to go to a higher dose than first time around.

    • Posted

      He's been on 40mg for two weeks and waiting for rheumatologist to comment re temporal biopsy taken a just over a week ago, with just under 2 weeks of 40mg left we're hoping reduction can start soon.

      Thanks for the info Eileen.

  • Posted

    Hi Jones, none of us like being on Prednisone and want off it a quick as possible. I started on 20 mg and following the advice of my doctor dropped down to 7 mg too quickly and had a bad flare need to go up to 30 to get any relief. Still tapering for about a year now at 7 once again tapering to 6.5. I look at all the extra Pred I have had to take because I rushed last year. Slow and easy this time around. Think positive and smiling. ☺️

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