When to start tapering

Posted , 17 users are following.

I understand the need d to taper off prednisone but what I don't know is when does one attempt to taper,. I've been mostly pain free for over a week st 25 mg/day and wonder how long to maintain that dose. My first symptoms appeared about 9 weeks ago and I started prednisone about 5 weeks s ago


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8 Replies

  • Posted

    If you were on 25mg for 5 weeks, you can try to reduce by 2.5mg to a dose of 22.5 Taper can be in one go, or you can use gradual taper DSNS - "dead slow and nearly stop", which alternate old and new dose like this:

    dead slow and nearly stop method

    1 day new dose 6 day old dose

    1 day new dose 5 day old dose

    1 day new dose 4 day old dose

    1 day new dose 3 day old dose

    1 day new dose 2 day old dose

    1 day new dose 1 day old dose

    1 day old dose 2 day new dose

    1 day old dose 3 day new dose

    1 day old dose 4 day new dose

    1 day old dose 5 day new dose

    1 day old dose 6 day new dose


    Hope that helps..

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  • Posted

    Someone else will be alo. ng to advise. I started on 20 mg and I think I stayed on it for 3 weeks then 15 mg for 4 weeks. My sticking point was 10 mg when the pain returned and I went back to 15 mg. It's a very personal journey regarding the amount needed to be pain free. It is suggested that we do not reduce by more than 10% at a time. Best wishes

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  • Posted

    If you have been at above 20mg for over a month it is high time to taper.

    If it were me, I would either stay at 25mg for another week of drop to 22.5mg for 2 weeks and see how that goes. If that is OK, drop to 20mg for another 2-3 weeks. From there, if everything is still OK, you could do 17.5mg for 3-4 weeks and then to 15mg. Below 15mg you will need to slow down - but worry about that when you get there or if you have problems before. What did your doctor suggest?

    And I see Nick has given you a slow taper approach.

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  • Posted

    Thanks for this! So far my GP has said nothing about tapering. Last visit his only advice was to take prescriptions to protect stomach and bones - alendronate and a ppi, neither if which, thanks to the wisdom here. have I started. A Dexascan scheduled today. Again, thanks to you!

    My first rheumy appointment is scheduled in two weeks, so I will take your suggestions and try a 10% reduction and see how that goes for two weeks.

    So grateful for this forum and every beautiful pain-free day!

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  • Posted

    Jack, the tendency is to rush off Prednisone this is a mistake you end up flaring and using more not less, at least that is what happened to me. I no longer have all my records, but as I remember I did a modified DSNS method, but always stayed at 10%. My first taper from 30 mg was 4-1 to 27 mg. I never tapered if I had any PMR pain. The secret is to control the inflammation, do not let it get ahead of you. The inflammation got ahead of me, I was at 7 mg and had to increase to 30 mg to get relief. Good luck on your PMR journey, stay active, positive with a smile. šŸ™‚

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  • Posted

    You need to feel sure that you have the PMR under control and have hit it on the head before tapering. Have you asked your GP about starting to taper? He may have just forgotten to say anything. Really you should take your doctor's advice, at least to start with, rather than listening to us who are non medics.

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  • Posted

    Sorry to say, but the medics don't always give the best info. The blood tests do not always give the best information as far as state of the PMR. You will find good info on this site, some are extremely knowledgeable and helpful. You have to use your judgment. I too believe you could start a slow taper, but you have not had PMR that long. so using the DNS method would probably be appropriate way to start. I had PMR for 2 1/2 years, and when I got down real low is when I had problems. So take it slow, listen to your body. PMR cannot be rushed. I've been good now for over a year! Good luck to you!

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