side affects when tapering prednisone

Posted , 6 users are following.

i was put on 40 mg of prednisone, for initial diagnosis of pmr, 16 days ago, then 10 days ago down to 35 for 3 days, then 30 for5 days, 25 last 2 days,and instr to go to 20 starting after today until i see rheumy on nov 7, since tapering those doses, have had some side affects, mimimal pain returned shoulders, buttocks, hamstrings, very tired, but just today, calf muscle pain, has anyone had this experience when tapering on this type of schedule,

0 likes, 6 replies

6 Replies

  • Posted

    Hi Cheryl

    I'm going to say best wait for those more experienced to reply but my first reaction is you're tapering too fast. Was this your GPs advice?

    I started on 15mg at the start of July and am only now down to 9mg.

     

    • Posted

      yes, gp started me tapering oct 18 from 40 to 35 , 3 days, then 30 til oct 25 when saw rhemy, then she said go down to 25 on oct 26 for 3 days, then down to 20, after 4-5 days do bloodwork, see her nov 7th,, 
    • Posted

      Ah, I hadn't realised you've already seen a rheumy. Maybe that changes things. I haven't been referred to one at all.

      I expect others will have their own ideas and will be here to share them with younsoon

  • Posted

    Prepare yourself, Cheryl. You're going to hear now from many experts who'll tell you, "SLOWER!"  We know it's good to be off prednisone. My allergist heard I was on 20 Mg and said, "That prednisone will suck the calcium right out of you!" But my main doctor was pleased when I told him I'm following the advice of many experts on a PMR listserve and all their doctors, and am going really slowly! Yeah, it's a tug of war, prednisone crap vs. pain from the PMR, but the facts say, wean off SLOWLY!

  • Posted

    Definitely, big steps like that every three days is much too fast.  It is possible to reduce in relatively large steps at the beginning because 10% of whatever the dose is, is by definition bigger when you are at a higher dose.  But at every step your body does need a chance to adjust in order to avoid steroid withdrawal symptoms, if not return of the inflammation pred is designed to control.  Ten percent of 25 is only 2.5, and you shouldn't be required to make that reduction until your body has adjusted to the 25.

  • Posted

    I'm thinking that these initial larger drops in dosage might be possible because, first of all, the initial dosage was likely quite to the high side of what was needed, and secondly, the full effect of prednisone dependence my not have established itself as fully in this short an amount of time..

    I think that with every patient, one has to establish early on where the cut-off level dosage is, that is to say, how small of a dosage that the patient can tolerate, then begin tapering from there.  I suspect that at some point the tapering will have to be slower and/or in smaller steps, but first the patient must determine what an approximate minimum dosage in real time. They can then monitor and adjust dosage level from there, while doing everything possible in terms of lifestyle and therapies to allow for progress with dosage reduction, however slow that might be.

    This way, the longer-term side effects of higher dosages can be kept to a minimum, while the initial ample dosage gets the patient back to feeling good, fully ambulatory and without disability.

     

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