PMR tapering

It sounds like 5 mg is your "lowest effective dose." To be at 5 mg already after starting at 15 mg in January 2025 is doing extremely well. It isn't always about tapering your dose lower. My rheumatologist told me to find a "stable dose that worked" when I was newly diagnosed with PMR. I don't think a stable dose of 5 mg for a few months will do much harm. I assume you have enough prednisone to stay on 5 mg for awhile. If not, your primary care doctor should be able to tell you what to do until you see a rheumatologist.

Thank you for your input. When you say to stay on for “a while”, do you mean a month or more? I was going to take the 5 mg for a week or two and see how I feel, then go down to 2.5mg, but maybe that is too soon?

"A systematic examination of the peer-reviewed literature, which included 30 studies, found that most patients seemed to achieve remission of PMR with a starting dose of prednisone at 15 mg/day. A slow tapering of the prednisone, less than 1 mg/month, was associated with fewer relapses. Once prednisone is tapered to 10 mg/day, a further slow taper by 1 mg every 2 months until treatment discontinuation was associated with optimal control of disease activity."
https://emedicine.medscape.com/article/330815-treatment
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It would be better to see what your doctor recommends. However. staying on 5 mg for a month or two is reasonable. You really need to have 1 mg tablets when your dose is less than 10 mg.

Thanks again for all the info, which I will talk to my NP about.

I just went from 5 to 4 mg and I’m feeling more pain and stiffness every day. My oncologist told me to check with my rheumatologist, he said 4 to 5 mg is what the Adrenal gland should produce every day. After taking Prednisone long term and at higher doses that that, the Adrenal may not be functioning yet and the body is deficient, which is a serious condition.

Below 5, consider decrementing at 0.5 per month. By 1 at that point is often too much, according to most experiences documented here.
Be alert for adrenal insufficiency or (especially) adrenal crisis symptoms.
Also…some pain is normal, and is often/usually not PMR at this level.

A lot may depend on your experience with side effects. I tapered up to 8 mg, got full relief from the pain but also got major weight gain, vertigo, jitteriness, anxiety. All gifts. So I'm down to 5 and tapering a half mg every two weeks. I want off!

I agree with you when you say "I want off"! I was diagnosed with PMR in January and ended up in Urgent Care unable to walk or get out of bed unassisted. I went from a high dose and in the past month have started to taper off. I have been on one 5mg a day pill for the past 2 weeks and now my doctor wants me to taper off by taking 4 mg for 14 days, then 13 mg for another 14 days, etc. These pills are one mg only so I have to take 4 of these pills each morning.
I would like to know if anyone else has experienced gut pains from taking 4 at a time or any other side effects.

Replying to @allinger

Regarding “gut pain”:
Hopefully you are 1) taking prednisone with food, and, 2) NOT also taking an NSAID without your doc’s specific approval AND then with an antacid like Prilosec.
Be careful with these powerful meds. Good luck.

I take a prescription proton pump inhibitor, Pantoprazole, to protect my gut. I have been taking prednisone for 10 months to treat GCA and PMR. I started at 60 mg per day, and now I'm down to 4. I always take the prednisone with breakfast.