← Return to If you have tapering problems below 5 mg this might explain why.

Discussion
Comment receiving replies
@dadcue

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".
---------------------------
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.

Jump to this post


Replies to "There are various ways to taper Prednisone by doing an alternating dose reduction. I don't know..."

I started seeing a new rheumatologist yesterday who I thought was great, and she wants me to start alternate day tapering (I am currently at 5). She feels it is a way to “trick” the adrenals into getting busy again. She didn’t object to .5 mg increments which I have been doing, just thought this is a better plan.

Thank you so much. That was helpful. I noticed that you mentioned an endocrinologist? Not a rheumatologist? My rheumatologist is the absolute pits.
How do they measure your Cortisol? A blood test??