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Still confused about tapering
Hi there, I was diagnosed with PMR about 4 months ago ... my rheumatologist gave me a "schedule" for tapering but I haven't been able to follow it because my symptoms return if I do. I understand tapering is variable but my question is this: How do I know when to go down in dose? Should I be completely symptom free before going down to next dose or 80% or 90% symptom free? Or 50%? And if I go down and symptoms worsen should I wait at that lower dose for a few days and hope the symptoms will settle or do I need to go back up? (I am on Prednisone only and currently 15mg daily and can't seem to go lower than that. I started at 20mg and was about 95% symptom free on my starting dose).
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From Drugs.com:
Pills with no line in the middle
In general, do NOT split tablets that are not scored unless your doctor or pharmacist has given you the okay to do this. Some tablets may be extended-release, enteric-coated or have other characteristics that might affect how the tablet is absorbed or works if you cut it in half.
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4 ReactionsI think this is good advice. I haven't looked at 1 mg tablets of Prednisone recently. From my memory, they can't be broken in half very easily. I don't know if they are scored or not.
I think it is okay to split 1 mg tablets in half if people want to. I don't know how useful that is though. I could couple a 2.5 mg tablet with the 1 mg tablets and get any dose I wanted except for 1.5 mg. I have split the 5 mg tablets in half because they were bigger than the 1 mg tablets. People just need to ask for different sized tablets as needed.
I'm not sure a 1 mg tablet split in half is feasible or not. I doubt the score mark is a cross mark (+) like this plus sign. I wouldn't ever cut a 1 mg tablet in fourths but I know people do this. Trying to cut a 1 mg tablet into fourths is too much work for me.
People should do what their own thing ... I guess.
My 1’s are scored, and my taper is 0.5 per month from 5 to 0. Need to split the 1’s at 1.5 (current) and 0.5. No prob.
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2 ReactionsHow do you feel??
I posted some new guidelines about how to deal with low cortisol levels when you are on low doses of Prednisone. I'm glad the medical community is starting to look at this problem more closely.
I have been splitting the 1 mg tabs for a couple of years now. As soon as I dropped below 8 mg I needed to taper .5 mg at a time. I use 5 mg and 1 mg tabs. My ones are scored down the middle and I use a pill cutter. It was hard to find one that did a good job. Even if the pill is split unevenly I get the whole 1 mg over 2 days. Unfortunately, my ones and fives are both orange, just a slightly different shade and size. My doctor thought a .5 mg drop was too small but I told him that was how I needed to do it.
Occasional fatigue, occasional right shoulder rotator cuff pains (but I think I strained it lifting bags of pellets). Low energy, but cannot really complain.
My 1mg tablets are scored and split easily.
My rheumy however gave me a schedule tapering by 1mg even below 5mg. He does not believe in splitting pills.
I am supposed to be at 1mg now according to his schedule but alas I am at 4mg going to 3 (via 3.5 mg first).
Next appt in Feb. Hope I can get to 1 mg by then.
I don't think the reason is the even distribution of ingredients, no. But the rule of thumb is that a scored pill is fine to split and an unscored pill may not be.
For example, my 5mg Apixaban pills are not scored and a googlesearch said they can be split, but the second half has to be discarded if not used within 24 hours of cutting because the second half may lose strength after exposure to air.