Still confused about tapering

to pdxmac:
Please remember to remain alert for the possible side effects of taking prednisone with an NSAID such as meloxicam. Good luck.

Which is exactly why I resisted. Is there something specific you are referring to? I know about the gastro issues and am hoping that my need to take them both is not long-term. (I also know that you cannot always tell when the gastro issues are starting). To further protect myself, I even gave up my beloved alcohol (I was never a heavy drinker, but I certainly enjoyed my wine with dinner, sigh).

Please just Google “prednisone and NSAIDS”. That should tell you what to be alert for.
Tapering, I am at 2 mg of prednisone. I had level 3 rotator cuff pain a few times. I asked my doc about taking an NSAID while still on P. She said that infrequently might be ok, since I was on such a low dose, but that I should also take a Prilosec (antacid) as well if I did so.
Just trying to make sure you are alert for the possible bad interactions. Best of luck to you on this.

The lower the dose of steroids the greater the percent of taper when you go down even 1mg. At 20mg a 1mg taper is 5%. At 10mg a 1mg taper is 10%. You may not realize the difference however your body does. Possibly try reducing by 0.5mg once you get low enough that your body reacts to a 1mg reduction adversely. Pill splitters are a great stocking stuffer!

Please read up on adrenal insufficiency since taking steroids long term can contribute to this problem. The oral steroids have taken over the work the adrenal glands normally do. Waking them back up is a big portion of PMR tapering. The symptoms of adrenal insufficiency are very easy to confuse with PMR pain. I'm not even sure they can be parsed by a medical professional. The body is complicated and complex. It is amazing what it does for us that we have taken for granted. I have learned so much about my body - I'm impressed.

"The symptoms of adrenal insufficiency are very easy to confuse with PMR pain. I'm not even sure they can be parsed by a medical professional. The body is complicated and complex"
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This was true in my case. How ironic that the treatment for adrenal insufficiency was the same as the treatment for PMR.
https://www.endocrine-abstracts.org/ea/0056/ea0056p44
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I needed to take a maintenance dose of prednisone until my cortisol level improved. Staying on a dose of 3 mg or less was a low enough dose to allow some room for my adrenals to regain some function. My endocrinologist said to remain on low dose Prednisone "for as long as it takes" and possibly for the rest of my life.

After I stayed on 3 mg or less of prednisone for 6 months, my cortisol level improved. My endocrinologist said it was fortunate that my cortisol level improved after long term Prednisone use.

After my cortisol level improved, I was allowed to discontinue prednisone. My endocrinologist said 3 mg was such a low dose that I could simply stop taking Prednisone without a taper. As long as PMR was controlled AND my cortisol level was good there was no need to take prednisone anymore. PMR was controlled by a steroid sparing medication that didn't suppress my adrenal function.

So often in medicine ... the treatment for one problem creates a new problem.

Like many others I’m figuring it out on my own with the help my rheumatologist. I started on 15 mg, then went to 12.5 mg and then 10 mg, each about two weeks apart. Now I’m reducing 1 mg every two weeks.I had the same problem when I went from 12.5 mg to 10 mg, and had to increase it to 11 mg for a week because I had a lot of pain and stiffness. So far in my experience over the last several months when I lower my dose, I get some pain. It lasts several days, and I would say the pain is sometimes a 4 out of 10. But then it all stabilizes and I spend another 10 days or so at that dose and decrease again. So far it’s going well and the advice for my rheumatologist was she didn’t want me to stay too long at one dose. She is supportive of what I’m doing..

I’m doing very slow tapering: only by .5 change:
7 days old
1 day new
6 days old
2 days new
5 days old
3 days new
4 days old
4 days new
3 days old
5 days new
2 days old
6 days new
1 day old
7 days new
Repeat
I started at 20, no flares so far.
I’m moving right now from 8.5 to 8.
I got this from the Facebook group page for PMR. People who have followed the schedule report great success. I keep a daily log.

Good question. My rheumy started me on 15mg for 5 days but wasn’t strong enough (6-7 out of 10) then upped to 20mg for 2 weeks then back to 15mg for 2 weeks, now on 12.5 for 2 weeks. Same as someone else, I have some pain/stiffness (3-4) for a 5-6 days then seems to get better (my body’s adjusting?). My regimen will be 2.5 tapper every 2 weeks going forward until I get to 5mg? I would definitely talk with your doc re when to go back up or down and if it’s ok to be at pain level 4 for a few or so days to see how your body does. Good luck

That's great since it works for you. I do better at reducing by 0.5 mg every 2-3 weeks. The goal is zero, so however we get there is fantastic! Good luck to us all.

"The goal is zero, so however we get there is fantastic!"
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I very much agree. Sometimes people say one tapering scheme is better than another one. There is no scientific proven method of tapering off prednisone. The doctor in the following video says there isn't any "gold standard" for tapering off prednisone.