Tapering down from 4 mg of pred to 3 mg
Posted , 14 users are following.
Hi. I started tapering from 4mg to 3 mg on the slow method 3 weeks a go and i have started to get really stiff after sitting , my legs are really painfull. I have had a blood test and that is normal so my doctor has told me that it is not a flair and to carry on , i just wanted opinions please what would other people do, go back up to 4 mg for a while my doctor told me this morning to carry on tapering down to the 3 mg . Many thanks
0 likes, 24 replies
Twopies Royall
Posted
yes, it sounds like the beginnings of a flare. i would go back to 4 mg for awhile and try again. and i would reduce to 3 1/2 mg., not 3 the next time. going from 4 straight to 3 is 25% reduction, a big leap. some people even go to 3 3/4 mg., but im not that good a pill cutter.
Royall Twopies
Posted
thank you for your reply i think that it is a flair as i have pain in the lower part of my legs now as well. i take a split dose so i will increase the dose this evening. I am not very good at cutting pills either
judith87642 Royall
Posted
sometimes my blood markers are ok when I have pain..
I would go back to 4mg fir a month at least and THEN SEE IF YOU CAN GO TO 3,5 mg or 3mg...
Royall judith87642
Posted
Hi. I so wish that my blood level was up and then i would have the support of my doctor, he says that i definitely haven't got any inflammation in my body as the blood tests are never wrong
EileenH Royall
Posted
Rubbish - my blood markers were never raised out of the normal range. It happens in about 1 in 5 patients generally and more as long as they are taking pred.
Royall EileenH
Posted
thank you for your reply. I was really surprised by my doctor , he is usually so good. i am back to four mg a day now and plan to stay on this dose for quite a few weeks, i have taken on board what everyone has said so when i go down i will go to 3 1/2 mg on the slow method and hopefully wont have another flair
Michdonn Royall
Posted
Jennyrose, nice and easy does it, it is not a race let your body stabilize on each level, it really works much better. 🙂
Royall Michdonn
Posted
thank you for your reply. yes i am going to go really slow i am not in any hurry. it is difficult when your doctor wants you to get off the pred !!
Michdonn Royall
Posted
Yes Jennyrose, a little over two years ago following my Rheumy's directions I had a very bad flare and went from 7mg to 30 to get relief. Since then I control my tapering, she would still like me to hurry, but now I am in control and taper at my pace, which I am still doing from the 30 mg I needed to be on for 6 weeks to get PMR pain free. Listen to your body, doctors may think they are God's, but they are not!🙂
ninjananny Royall
Posted
I too have had that problem, I have GCA for 18 months the rheumatologist suggested 4mg one day 3mg the next for 1 month, then 3mg and 2mg again alternate days. I am in the third week of 4mmg and 3mg and so far so good. I was also told that the joint pain was most probably OA. I am unsure how you tell the difference.
Royall ninjananny
Posted
Hi. what is OA ? thank you
ptolemy Royall
Posted
osteoarthritis
Michdonn Royall
Posted
Jennyrose, try to listen to your body. If you have any PMR pain don't reduce, the pain is from inflammation which you must control and that is what the Prednisone is doing controlling the inflammation. When tapering use the DSNS method and a small reduction, you will take less Pred with far less discomfort. Good luck and remember it not a race and you know your body better than any doctor. 🙂
Royall Michdonn
Posted
Hi. Thank you for your reply. I think that i am going to increase my pred for a few days and see if the pain will go, Then i will stay on the 4 mg for a while .
TheRaven Royall
Posted
As others have said, it's best if you go back up to 4 mg and get rid of the pain. If it were just minor pain sometimes it's a matter of the body adjusting to the lower dose and then the minor pain subsides. If you've been hurting for quite a while with this new reduction, don't be surprised if you need to increase to quite a bit more than 4 mg to get rid of the pain.
The big item that we all are taught here on the forum is to never reduce more than 10% at a time. In your case, that'd be .4 mg, so I would say when you are ready to try reducing again to go from 4 to 3.5. However, first you need to knock down the pain and inflammation with a higher dose. It may be a while before you want to take another shot at reducing the dose.
You are the one that's hurting - not the doctor. It may not be a flare but pushing on with the reduction to 3 mg is likely only going to make it worse for you. Also, you are now at such a low dose that I'd be in no rush at all. If it were me, I'd be fine taking 4 mg the rest of my life if it kept me pain free. At that low a dose the negatives from Prednisone are virtually none. Take care and best wishes.
Royall TheRaven
Posted
Hi. i think that i might take 10mg for a few days , i think that i can take the higher dose for a week and then drop back to 4mg, i am really not sure if i should do that or not as my doctor said that the blood test was normal so i should carry on with what i am doing , he does not want me to increase my med . many thanks for your reply it has helped a lot