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Weaning off of prednisone & pain management
Polymyalgia Rheumatica (PMR) | Last Active: Oct 25, 2024 | Replies (156)Comment receiving replies
I wouldn't go so far as to say that lowering by .5 or .25mg was my idea. My guess is that the rheumatologist uses the easiest instructions to follow - i.e., after 10mg, reduce by 1mg every 2 to 4 weeks. As well as the Mayo PMR forums, Facebook also has a very busy (and less organized) PMR area with some 16,000 participants when I joined. Polymyalgia rheumatica seems to be the most common ailment that no one has ever heard of, so commonly a first post reflects utter shock.
Tapering by percentages is often brought up and made more sense to me than dropping by 1mg when the base amount kept changing.
Here's a copied list of the percentage drop if you just taper by 1mg each time:
10-9 is 10%
9-8 is 11%
8-7 is 12.5%
7-6 is 14.2%
6-5 is 16.6%
5-4 is 20%
4-3 is 25%
3-2 is 33.3%
2-1 is 50%
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I used to think the 10% rule made a difference. That was before an endocrinologist told me to stay on 3 mg of until my cortisol level improved. I stayed on 3 mg of prednisone for many months without tapering until my cortisol level improved.
After my cortisol level improved, my endocinologist said I could simply stop taking prednisone. I did my final "countdown taper" of 3 mg ... 2 mg ... 1 mg ... zero over a 4 day period. I don't recommend this unless you are certain of what your cortisol level is doing. Otherwise, I would stick with the 10% reduction rule.
The other aspect of this is whether or not the PMR inflammation is controlled. I was pretty sure Actemra had that part covered. Actemra allowed me to taper quickly down to 3 mg and remain there for months. That allowed time for my adrenals to recover as my cortisol level improved.