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@jenbillig

I have had tremendous difficulties going below 5mg. When you say you alternate what do you mean? One day 4mg and one day 3mg? Back and forth?? How long?

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Replies to "I have had tremendous difficulties going below 5mg. When you say you alternate what do you..."

There are various ways to taper Prednisone by doing an alternating dose reduction. I don't know how successful they are but it should be discussed with your doctor. Some doctors believe doing it this way is beneficial. The following link talks about tapering with alternate day dosing.
https://www.verywellhealth.com/does-prednisone-tapering-minimize-withdrawal-190242
"When people first decrease the prednisone dose, it is common to feel achy or fatigued.4 These symptoms usually get better within two to seven days. If withdrawal symptoms continue beyond a week, talk to your healthcare provider.

Sometimes, your healthcare provider may temporarily increase the dose and taper more slowly. Even so, some people may still experience symptoms.

One way to deal with this is with a technique called alternate-day tapering. For example, instead of lowering the dose from 4 mg to 3 mg, for instance, a healthcare provider may prescribe 4 mg one day and 3 mg the next day, alternating back and forth for one week.

If that's successful, you may be prescribed 4 mg one day and 2 mg the next, and so on, until you are eventually alternating between 4 mg one day and no dose the next. The healthcare provider would then gradually taper the 4-mg dose".
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I think the theory is to not take Prednisone every day. On the day with no Prednisone that might give a nudge to the adrenals. When I was ready to get off Prednisone, I did a "countdown taper." I did 3 mg one day --- 2 mg the next day and 1 mg on the third day then zero for a day before going back to 3 mg for a couple days. I did that many times just to see how I would feel in preparation for stopping prednisone altogether.

When I felt ready, I did one final countdown and stopped taking Prednisone. I only did this after informing my endocrinologist. She said give it a try to see what happened. When my countdown tapers went well and my cortisol level was "adequate," my endocrinologist thought it might be safe to discontinue Prednisone. However, she told me to "restart Prednisone again for any reason if I felt the need." My countdown tapers gave me some degree of confidence that I could safely stop Prednisone. It worked for me. Prednisone was my security blanket after taking it for 13 years. I wasn't in a rush to give up prednisone but now I'm very happy to be off Prednisone. The added bonus was how many other medications were discontinued in the years after I stopped taking Prednisone. Getting off all my blood pressure medication, cholesterol medications and several more made me feel even better.

The first time I attempted this taper I alternated 4 and 3 for 2 weeks and then just 4 for two weeks before alternating 4 and 3 for 2 weeks.
I could never get rid of the pain in the back of my upper legs and going up steps got extremely difficult.
I had started at 5mg feeling good, started alternating 5 and 4 and followed the plan the rheum gave me.
I started taking Tylenol for pain, obviously took too much because my ALT/AST liver enzymes elevated so I quit the Tylenol, stopped tapering and increased my prednisone a little.
I'm at 4 mg and starting to feel the leg pain but Dr does not think it is pmr. I had a consult appt with a 2nd rheum who ordered PT for gait/stability, gluteus medius tendinopathy and lower extremity weakness. I start PT in 2 weeks, am staying at 4 mg til then.
I have an Achilles problem which compromises my walking, just got foot orthotics.
I also have a BP problem. It's complicated. In a nutshell my low number at times is too low, in the 40's. I'm seeing my cardiologist next week.