How to Slowly and Safely Taper Off Prednisone but ... no set rules.

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.

"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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True in the majority of cases. However, sometimes PMR doesn't burn itself out and sometimes people take 5 mg of prednisone for the rest of their life.

If a person has trouble at approximately 7 mg and always seem to flare at lower doses of prednisone their adrenal function might be the problem. It is hard to ignore withdrawal symptoms and adrenal suppression as a side effect of long term prednisone use. However, a slow taper is still the key to success.

Otherwise a biologic like Kevzara or some other medication that doesn't suppress adrenal function might be helpful. Lifelong prednisone is hard on the body and not a good outcome according to many medical professionals.

Thank you for the reply. im very new to this. Very unsure and unsettled about the whole thing

Here is another good video.

I wonder if it would be possible to compile a bunch of good videos under various topics.
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I started with 15 mg daily in 2020. Tried to go down a couple of times. This time when I went to 2 mg I got severe jaw pain and headache. I even have visible vessels on my temple. I am afraid of gca and have to find out what I should do now

Are you seeing a rheumatologist? You might ask them, if you are a candidate for Actemra. If you do a search in this forum, you'll find a lot of discussions on the positive benefits from those of us who get it. I've only been getting it for 3 months and there is a huge improvement in my health. Others have been taking it for longer.

If it was me, I would be in the ER. Save your vision. Do not wait.

There was a point where I was worried about GCA as well. Fortunately, I did not have it but every health care professional I spoke with emphasized the need to be seen ASAP to preserve vision. Don't delay!!

This is a better video than the first one. They first one, despite recognising there was no gold standard towards the end, still promoted rapid tapering schedules. It gave the impression that the dose of steroids was curing the PMR in a relatively short period of time, when PMR runs it's own course and the steroids just control the superficial symptoms at best.

Both videos come from a rheumatologist's perspective and are based on the medical "guidelines" for treating PMR rather than rules. I guess it is just a matter of personal preference. Successfully tapering off prednisone is difficult no matter how a person tapers their dose. My perspective is from 12 years of taking prednisone for PMR before I was able to taper off prednisone ... not exactly a fast tapering schedule.

I love how people name different taper schedules. The name I called my tapering method was "It Depends How I Feel Method of Tapering." It was very slow but not really a method that determined in advance what my daily dose would be. It was more weekly or monthly based. My goal was to stay on one dose for a period of time. My rheumatologist emphasized a "stable dose" rather than tapering. I needed more encouragement to speed up my taper rather than slow things down.

I remember when I first heard about the "Dead Slow" method. It seemed to suggest to me that I would be dead by the time I was able to taper off prednisone. I thought it should be renamed. I tried it anyway without success. I always say to do whatever works so I'm not partial to any tapering method.

I finally got off Prednisone after Actemra was started. It still took me more than a year to taper from 10 mg to zero. Actemra made a mockery of slowly tapering off Prednisone. I was tapering by 1 mg per month at first but then I went to 1 mg per week from 7 mg to 3 mg. I had to stay on 3 mg because my cortisol level was too low to go any lower. When I was finally able to taper off prednisone an endocrinologist said I didn't need to taper from 3 mg to zero as long as my cortisol level was good AND if PMR was under control. I could check both boxes so basically all I did was stop the prednisone. I stayed on 3 mg of Prednisone for more than 6 months without any taper until my adrenals started to function better.

I realize these biologics are expensive and might not work for everyone. I'm just grateful that Actemra works for me and it doesn't suppress my adrenal function. My rheumatologist says if Actemra stops working or if it causes too many side effects ... I can stop Actemra cold turkey.