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How to Slowly and Safely Taper Off Prednisone but ... no set rules.
Polymyalgia Rheumatica (PMR) | Last Active: 2 days ago | Replies (65)Comment receiving replies
Thank you to everyone in advance for your insightful comments and support. Much appreciated.
My question is this -- I have been tapering off of prednisone for the last month. It seems that I have pain in the morning, not totally disabling, but significant. I take the prednisone and the pain gradually diminishes, so that by late afternoon or evening, I have better range of motion and am almost pain free. I also take a tylenol if the pain persists.
I'[m wondering if other have had this experience as well. It seems that, regardless of the dose, this has been the pattern.
Replies to "Thank you to everyone in advance for your insightful comments and support. Much appreciated. My question..."
Yes that is familiar. Seems like it is okay to live with a small amount of discomfort and keep working on increasing and maintaining range of motion and exercise. No rush on the taper and ok to increase a bit if needed. You can always reduce back down but I do like to let my rheumatologist know what is going on. He keeps saying it is about how I feel and not so much about the inflammation numbers from blood tests. I am having a blood test this week as I anticipate reducing for 4 down to 3mg. I also take an occasional Tylenol and try to avoid inflammatory foods and alcohol and eat prunes and other beneficial stuff like calcium supplements and a bunch of vitamins B E D omega3 C . Just takes a bit of time but at this point I am starting to feel like my old self. Cheers.
This is exactly where I’m at.
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The effects of prednisone taken in the morning at 8 a.m. will peak in the afternoon and then start to decline.
You are right about the pattern being the same regardless of the dose. A higher dose of prednisone doesn't stay in your system any longer. Medications typically don't work this way. Medications are cleared from the body depending on the half-life of the medication. The half-life of prednisone is two to three hours, which means it'll stay in your system for 11 to 16.5 hours when the dose is at therapeutic levels.
People often take more of a medication thinking it will work better. That becomes a problem when higher doses of a medication become toxic. That is a problem with Prednisone too ... the body can only use limited amounts prednisone before problems arise.
It is the same problem when the body produces too much or too little cortisol. The body regulates cortisol levels according to what is needed in real time. Too much and too little cortisol both cause health problems. That is why cortisol levels are closely regulated by the body.
My pattern was to take Prednisone in the middle of the night at approximately 3 a.m. so I wouldn't have pain in the morning. I needed to be able to work at 7 a.m.
At some point in time I split my Prednisone dose and took part of my dose in the evening usually between 7-8 pm. When I did that, I could go a full 24 hours with little or no pain. That way my prednisone dose was spread out for an entire 24 hours. I didn't need such a big dose in the morning and overall I needed less Prednisone.