Splitting dose of Preds while tapering?

Well I know some one will say that that is tapering to fast. My doctor did that to me to and I got down to 10 from 20 and started

hurting again so she said I could go back up to 12. But that wasn't enough so I'm finally back up at 15 and no more pain. Now

I've got to convince her that if I taper slower I'll not hurt as much. Are you familiar with their slow taper method they talk about

in here? Some one else can give you the short cut to it. I'm not sure where to go to find it. Honestly I find it very confusing so I'm

not going to try to sell my Dr on it. Just a slower taper then 2 or 3 mg at a time.

Hi Dea

You sound alot like me when i first reduced. The rule of thumb is to drop no more rhan 10% which you did but you may not have used the drop dead slow method that tapper's you into your new dose over 30+ days.

I use this method but actually add days to it because I'm so sensitive to the withdrawal and my PMR is not willing to let go so i only drop 0.5mg at a time not even close to 10%.

I have also from week 1 split my dose and take the majority in am and 5mg at 3pm.

My advise is slow down the tapper and stabalize when down. If you found it hard do not tapper as much and definitely use the drop dead slow method.

I hope this helps Mariane

My Dr. And I decided that when tapering, if PMR pain comes back, i.e. Neck, shoulders, or hips then we go back to where it didn't hurt, wait a week and try again.  Some pains can be from other problems and those should be addressed differently.   Everyone is different.

In the beginning, I flared with every drop of 2.5mg. My revelation was that I was not managing PMR; I was managing prednisone.

my advice would be to taper slower, and alternate your "down" dose every other day so that for hte transition week you are averaging a 1.25mg drop.  Basically, you are easing down vs dropping down.

As for the other drug your doc recommended, these docs are drug-happy. If you don't absolutely need it, I wouldn't touch it with a stick.  

https://patient.info/forums/discuss/reducing-pred-dead-slow-and-nearly-stop-method-531439

Another thread I didn't get told about!!!!!!!

Dropping by 2.5mg every week is far too fast - it may work for other illnesses where pred is used to reduce inflammation and then patient has to then taper down and stop, but it rarely works in PMR unless you are going to need a really low dose. If a doctor starts you at a high dose for PMR it just adds to the complication of reducing - because changing the dose can often induce what is called steroid-induced rheumatism. If you were started at such a high dose because it was thought to be GCA then you need to stay at each new dose for at least 2 weeks to be sure it is still enough. If you reduce too fast you have no idea at what point the dose became too low.

Another thread I didn't get told about!!!!!!!

Dropping by 2.5mg every week is far too fast - it may work for other illnesses where pred is used to reduce inflammation and then patient has to then taper down and stop, but it rarely works in PMR unless you are going to need a really low dose. If a doctor starts you at a high dose for PMR it just adds to the complication of reducing - because changing the dose can often induce what is called steroid-induced rheumatism. If you were started at such a high dose because it was thought to be GCA then you need to stay at each new dose for at least 2 weeks to be sure it is still enough. If you reduce too fast you have no idea at what point the dose became too low.

I don't think anyone responded to your comment about Alendronic Acid, although I thought I had - maybe I neglected to post that reply.

First things first.  Make sure you have a DXA scan first to determine your bone density.  Unless you are already at the osteoporotic level you should not even be offered a bisphosphonate, or any other drug which acts to damage the osteoblasts (this is how drugs like AA and denosumab work).  Increasing bone density this way is a gamble, and it is healthier to work at using more natural means.  Many people are opting for this and you'll find some interesting threads in the Osteoporosis forum.  I know we are constantly being told that choosing to take the drugs or not is a personal decision, but increasingly I feel many patients are not receiving enough information in order to make a fully informed decision.  

Yes, pred may well have been and currently be affecting your bones, but there is a great deal you can do through diet and appropriate exercise to slow these effects and even to reverse them.  And many people do not suffer anything more than normal slow bone thinning caused by increasing age.  

Take your calcium, D3, Vitamin K2, magnesium, and walk or do other weight-bearing exercise.