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How to Slowly and Safely Taper Off Prednisone but ... no set rules.
Polymyalgia Rheumatica (PMR) | Last Active: 3 days ago | Replies (65)Comment receiving replies
I started with pain in october 2024 which got really bad by january 2025. The rheumatologist thinks it is PMR, but is not 100% sure. Late January I started with prednisone 15mg daily for 1 week, 10mg daily for 1 week, 5mg daily for one week. Things were feeling great until I dropped to 2.5mg daily. Within a few days, the pain and stiffness returned. Since I was going on vacation, the doctor suggested I take 5mg daily until I returned.
She thought maybe 2.5mg was too much of a drop. She suggested 4mg daily for 1 month. I decided to try 4.5mg for the first week. I am at 9 days at that dose and the pain and stiffness is creeping back in, worse every day.
Can you tell me if you were able to drop in dose and NOT have pain return, or is this not realistic? The doctor said that I may need to start methotrexate. I need to do some research. I feel very hesitant about that.
Replies to "I started with pain in october 2024 which got really bad by january 2025. The rheumatologist..."
This video is also helpful. I like how she explains it.
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Your rheumatologist can answer this better than anyone but going back up a little bit is a fine answer. You can always taper back down again , and next time taper at a slower rate. like 1mg per month. My rheumatologist agave me two choices the methotrexate or something like that and prednisone. They both will work he said. I picked the prednisone and am at 4mg. My inflammation blood work is finally in the normal range after about 6 months of this. My plan is to taper at 1mg per month for the rest as long as all goes well. I also started at 15mg. My non medical understanding is it just takes a bit of time for the PMR to burn itself out. And when you get down to 5mg and less a slow taper is key to success.
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Welcome @christineb23, It sounds like you may be tapering too fast. Each of us are different. You might find this discussion started by @dadcue helpful, it has some good references that provide and explanation:
-- How to Slowly and Safely Taper Off Prednisone but ... no set rules.:
https://connect.mayoclinic.org/discussion/how-to-slowly-and-safely-taper-off-prednisone-but-no-set-rules/
My PMR experience with 2 occurrences 6 years apart starting at 20 mg prednisone for each - the first time took 3 and half years to taper off with the last six months going back and forth between 1 and 1/2 mg prednisone until I could stop taking it with little to no pain. Second time it took me 1 and half years to taper off.