Posted , 14 users are following.
Hi,
Following my previous discussion on trying to taper off prednisone at 5mg - I was thinking of reducing my steriods by 0.5 mg (I feel 1mg is too much of a reduction when tapering down from 5mg) using the Ragnar formula. Has anyone been successful with this procedure when tapering at this level?
kind regards to all affected by the above.
0 likes, 21 replies
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Michdonn ann17692
Posted
Ann, tapered off 5mg reducing by .5 mg using DSNS method currently on 3 mg tapering to 2.5mg. Had a flare caused by some else. I would like to reduce by .25, but the pills split on me.
Good luck on the rest of your journey. 🙂
bob73443 ann17692
Posted
Ann,
May of us here on the forum are familiar with the dsns (dead slow nearly stop) method, but I for one have never heard of the Ragnar Formula, and a quick Google Search did not yield anything relavent.
What it is?
Thanks!
Anhaga bob73443
Posted
Ragnar is the Swedish gentleman who first developed the slow taper method, later somewhat developed by other PMR patients and now successfully used by many of us, and also often tweaked by us as we are all different. For example I'm currently tapering to .5 from 1 mg and for the last several tapers have done each step twice, so it takes me three months to taper by .5 mg! But that is a whole lot better than constantly failing, which I was doing for a couple of years. Of course PMR may be less active now and fingers crossed for remission!
bob73443 Anhaga
Posted
Could you share the details of this method please?
BettyE bob73443
Posted
https://patient.info/forums/discuss/reducing-pred-dead-slow-and-nearly-stop-method-531439
Hope it works for you.
bob73443 BettyE
Posted
Hi Betty,
Thanks for the link to the DSNS method, but I really asking about this "RAGNAR" method. Are they one in the same?
BettyE bob73443
Posted
As I understand it, yes but if I'm wrong I'm sure there will be someone along to correct me.
EileenH bob73443
Posted
There isn't a "Ragnar method" as such. Ragnar is a Swedish gentleman who still posts very occasionally and who struggled to get down from 5mg even 1mg at a time so spread the change in dose over a few days. He talked about it on the forums - I suppose it must be more than 10 years ago now - and some of us took it over and experimented with it a bit and realised that, while using it below 10mg was a no-brainer, lots of people struggled long before that. So a few of us worked on it, tweaking it and sharing experiences until I developed the DSNS approach which we felt could be used at any dose and be adapted for speed - and to some extent probably also with larger doses than 1mg since in the UK we could have 5 and 2.5mg gastroresistant tablets but there was no 1mg tablet at that time and they can't be cut. 2.5mg at a time, especially overnight as doctors would have us do it, is a big step and we were sure contributed to many of the flares people had.
Using the DSNS approach or something similar people have managed an entire reduction journey without a flare - which is more than can be done with most suggestions from doctors!!
marg44743 ann17692
Posted
i agree that 1mg reduction is too much, especially when one is on lower doses. i am steadily tapering 0.5mg using DSNS method. Tapering this method takes around six weeks, then I sit on the new dose for around a month, then start the tapering process again. Thus, I am reducing 1mg every 20 weeks.
cheers
ann17692
Posted
Many thanks to everyone for such valuable feedback - I had never heard of the Ragnar/DSNS method of tapering down from steriods until i saw this forum. The support is very much appreciated. ive tried a number of times previously to reduce steriods and never managed this.
Sorry - correction on a previous post - I take injections of mepolizumab (trade name Nucala) every 4 weeks for severe refractory eosinophilic asthma. This treatment has made a great improvement to my asthmatic condition (it reduces the number of eosinophils in your blood leading to less inflamation in your lungs). My asthma consultant pointed out i no longer need prednisolone to control my asthma - thus I'm trying very carefully to taper down my steriods.
kind regards to all
Silver49 ann17692
Posted
I used the DSNS method to reduce from below 10mgs and have now been off for 4.5 months. I had one flare at the beginning of my journey because the reduction was too big....for me. I then had problems, but no actual flare, reducing around the 1.5 mgs and it took time to finally drop completely. I think Anhaga is experiencing something similar or had been at that stage as we did compare notes at one time.
ann17692 Silver49
Posted
That is great news that you managed to eventually taper of prednisolone using the DSNS method. I have had very positive support from my Drs and health proffessionals but have never been introduced to the above approach. So glad to hear it is working for patients who try this reduction scheme.
Anhaga Silver49
Posted
I think a lot of my difficulty the last year or so has been due to more active osteoarthritis muddying the waters. So far taper going well, but I'm being super cautious having had a genuine flare at 1 mg two summers ago.
Anhaga ann17692
Posted
You can only taper to zero once PMR is in remission, but dsns is invaluable in helping us get to lowest effective dose without flaring.
Silver49 Anhaga
Posted
That would make it more difficult than my taper which was only PMR. I hope your taper continues to go well, Anhaga.
Anhaga Silver49
Posted
Thank you. It certainly feels like residual pain is only OA now, but I'm taking extra time tapering just in case. It's great that you're well, very encouraging!