Alternate days for Prednisone Dose

Posted by tiateacake @tiateacake, Jul 26 11:19pm

When I had a problem dropping from 12.5 to 10, I put myself on 11mg and it worked. I did manage to get a phone appointment two weeks after requesting one with the nurse and she agreed it was the right thing to do. About to load up pill pots for the last two weeks of 11mg before dropping to 10mg. Common sense tells me I should try alternate days of 11mg/10mg and then my body will have more time to get used to it during that last two weeks. When I drop to the 6 week 10mg and all goes well will do the same on the last two weeks of that, alternate 10mg/9mg. But that is a way off yet, if I am wrong then my body will point that out quick enough.

Interested in more discussions like this? Go to the Polymyalgia Rheumatica (PMR) Support Group.

Good plan. Yes, the alternating dose works for some of us to help ease down in dose with fewer reduction aches. I always alternate the current dose with the new one for a week before dropping, and throw in one day of the old dose a few days after the switch, just to be sure. I'm about to start on a week of 9.5mg/9mg alternating day reduction.

I've found that alternating dose helps reduce tapering aches but doesn't necessarily avoid a flare once the tapering is reduced below the "lowest effective dose". For me that was around 6.5mg - 7mg. It's different for everyone, and I hope different for me this second time around, reducing again after a flare at 6mg.

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Hello @tiateacake, You will notice that we added to the title to better describe your discussion and help members find it. I think I've read in other PMR discussions where members have alternated doses to help manage symptoms when tapering. It's great that it has worked for you and hopefully other members that are struggling can give it a try.

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In another support group I belong to, your method was discussed. I used it when tapering and found it helpful. Also dropping more than 10% of the dose at a time was not recommended. Very slow tapering seems to work best for most people.

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When I got to 5mg I started one week at 4.5mg to give my body time to adjust. Kept it up until I was able to go off. I let my doctor know before and she was good with it. She also told me to go back to the last stable dosage if I started having problems and let her know.

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I've gone from 15 mg daily to 9 since February. However, my body doesn't seem to like my attempts to go down to 8. PMR pains in upper body and occassionally the lower. Much more chronic fatigue. I've been alternating doses, 9 one day and 8 the next. For now, I'm going to tough it out, see if it gets better so I can keep reducing.

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@richardab

I've gone from 15 mg daily to 9 since February. However, my body doesn't seem to like my attempts to go down to 8. PMR pains in upper body and occassionally the lower. Much more chronic fatigue. I've been alternating doses, 9 one day and 8 the next. For now, I'm going to tough it out, see if it gets better so I can keep reducing.

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You might try 8.5 every day rather than alternating. This gives your body a constant level with the overall amount being the same as alternating. This approach worked for me and in talking with the PA this technique is something they use on an individual basis. You might discuss approach with doctor but do realize that the percent of decrees goes up as the dosage amount goes down. 1 mg decrease at 10mg to 9mg is 10% decrease whereas the same 1 mg decrees at 5mg to 4mg is 20% decrease. Your body has a certain dependency on the oral prednisone and you need to reteach your body to be independent. Not always a straight line.

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I've tried a number of different tapering strategies but the one working well for me is 0.25mg every 7 to 10 days. Have been doing this since I got down to 8mg, now down to 4mg from a high of 25mg 11 months ago. Plaquinil has definitely helped. Still get a bit of PMR pain from time to time but manage with Paracetamol. CPR markers show that inflammation is receding and my energy level is increasing. There is light at the end of the tunnel !! The anti- inflammatory diet is important for me, it took a while and a lot of trial and error but I eventually figured out what triggers an increase in pain. It is a long, slow, lonely and torturous journey and a steep learning curve but thank God for this forum. We would be lost without it.

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@mtr2601

I've tried a number of different tapering strategies but the one working well for me is 0.25mg every 7 to 10 days. Have been doing this since I got down to 8mg, now down to 4mg from a high of 25mg 11 months ago. Plaquinil has definitely helped. Still get a bit of PMR pain from time to time but manage with Paracetamol. CPR markers show that inflammation is receding and my energy level is increasing. There is light at the end of the tunnel !! The anti- inflammatory diet is important for me, it took a while and a lot of trial and error but I eventually figured out what triggers an increase in pain. It is a long, slow, lonely and torturous journey and a steep learning curve but thank God for this forum. We would be lost without it.

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So true about anti inflammatory diet. I have always eaten healthy and loved my fitness and pretty sure my diet helped me get back to serious exercise after each joint replacement due to OA. When this hit me like a ton of bricks a voice in my head kept screaming why me? Probably hereditary on my part. Do you chop your pill into quarters yourself or does it come in correct dose. Asking as getting help or advice from my Dr surgery in the UK is like playing the lottery. I will be interested in seeing how you progress. You are right about this forum as else where on google etc it is just same old same old which is very frustrating. Well apart from a study done on rats in Sweden 1997 I believe. They delayed starting the treatment for 3 weeks on some and they had a better outcome. I delayed going to Dr for 3 weeks so hope I am one of the lucky rats.

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To tiateacake,
Sounds like a good plan to me. I have not been on alternate day tapering recently, but have been on it in the past and it worked for me!
Good luck on your health journey!

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@tiateacake

So true about anti inflammatory diet. I have always eaten healthy and loved my fitness and pretty sure my diet helped me get back to serious exercise after each joint replacement due to OA. When this hit me like a ton of bricks a voice in my head kept screaming why me? Probably hereditary on my part. Do you chop your pill into quarters yourself or does it come in correct dose. Asking as getting help or advice from my Dr surgery in the UK is like playing the lottery. I will be interested in seeing how you progress. You are right about this forum as else where on google etc it is just same old same old which is very frustrating. Well apart from a study done on rats in Sweden 1997 I believe. They delayed starting the treatment for 3 weeks on some and they had a better outcome. I delayed going to Dr for 3 weeks so hope I am one of the lucky rats.

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I chop up the pills myself, it's a pain dealing with the tiny pills. In Australia they only come in 1mg and 5mg. They disintegrate if I'm not careful, have to line up the score mark on the pill cutter to get half then very carefully cut the half again with a sharp knife. It's not precise but definitely working for me. It's a source of constant amazement to me that such a minute quantity of a drug can have a profound effect on my body !!! I notice the difference in pain levels within 3 days of such a minor change..if the pain doesn't settle after 3 days and I need Paracetamol to get me through the day, I know I need to wait a few extra days before making the next reduction. I believe I can get off the Prednisone completely but will probably need the Plaquinil (possibly at a higher dose) for quite a while in order to continue functioning.

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