Any Tips For Tapering Off Prednisone?

My blood pressure used to drop a bit at the beginning of each reduction, but was still in the low normal range. Before PMR I occasionally had low heart rate (42 bpm) and/or low blood pressure and a nurse told me it can sometimes happen with dehydration. So whenever it happened I drank two full glasses of water to get things back to normal within an hour or so. Now I drink extra water every day with no further problems. I don't know if that's your problem, but drinking more water could be worth trying.

Low blood pressure is also one of the symptoms of adrenal insufficiency, so as I drop to 2.5mg pred I'm keeping a close eye on it, but at 6mg, I don't think adrenal insufficiency is likely to be your problem. What does your doctor say?

Does anyone’s blood pressure go low while tapering down ?i have pmr been on prednisone for 2 yrs i can’t get past 7 mg each time I go to 6 mg my pressure drops and I feel terrible ..
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I hate to complain too much about prednisone. It did spare me from having too much pain.

I had a problem with feeling terrible when I reached 7 mg. My belief was that it was a combination of both a low cortisol level and symptoms of PMR returning.

I didn't have the problem when Actemra controlled my PMR symptoms but I felt terrible when I reached 3 mg. That was a low enough dose of Prednisone for my cortisol level to be checked. My cortisol level was low so I needed to stay on 3 mg for 6 months.

Low blood pressure was never a problem until I was able to get off Prednisone. When I was taking Prednisone, my blood pressure would sometimes be higher than 200/100 but not all the time. Three blood pressure medications were needed to control my "labile" blood pressure.

After Prednisone was stopped my blood pressure didn't drop all of a sudden but it gradually decreased over time. One by one my blood pressure medications were stopped. Now my blood pressure is normal without any blood pressure medications.

I have learned to appreciate everything that cortisol regulates in the body. It regulates inflammation, metabolism and so much more. When I was taking Prednisone ... it was impossible for me to keep everything regulated.

This worked for me with minimal issues:
From 10 to 5…1 per month.
Below 5…0.5 per month.
You can expect some pains when you decrease a step, and at random. Tylenol is typically recommended.
Avoid NSAID’s unless your doc prescribes. They interact unfavorably with prednisone.
All pain is not PMR pain as you decrease. Conditions such as osteoarthritis that were formerly controlled by your cortisol production can develop, and can be an issue until it is restored.
Avoid increasing the prednisone as a quick fix if at all possible.
Good luck.

"Avoid increasing the prednisone as a quick fix if at all possible."
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This is the hard part. Many things happened when I tried to taper off prednisone. It was very easy to blame PMR for everything and increase my dose of prednisone.

It is said that prednisone never fixes or cures anything and I now believe that is true. Until something better is found ... we are stuck with prednisone. However, my being stuck on prednisone was more of a side effect of prednisone itself after adrenal insufficiency happened.

I never found that taking more Prednisone was a good solution but it did spare me a lot of pain. It was always curious how my rheumatology visits progressed to how to get me off Prednisone rather than treating PMR.

Thxs Mike. The first year I was on it seemed great.. I was happy to be pain free and be able to move again ..was on 25 but from 10 mg down it has been a struggle to go lower. Got to 6 but at the moment at 7. It does control so many things in your body and it’s a miracle drug but long term not so good. I have fibromyalgia too so. I never know what’s going on with my body. But Thxs for the info. there’s hope I’ll get off of it one of these days ..

Tapering slowly is key. I decrease by half a mg for 1 week & when I'm happy with that, I reduce by another half for 4 weeks.
That works well for me & I have not had flare a flare up.
I started on 25mg some time ago.
Good luck & take it slowly x

I have had tailbone, lower back pain since the PMR started, 2 months ago. Also pain in my shoulders, across the shoulder blades, and back of thighs. As a result of the prednisone, I feel like I'm vibrating inside, my vision is blurry, and my teeth ache constantly.
I have been down to 12.5 mg from 15 mg for 3 days now and the pain in the buttocks is worse.
I see the rheumatologist next week and hoping she can do something to help. What an insidious disease this is!

My rheumatologist, who it took me 4 months to get in to see, told me it wasn't necessary for me to split my dosage AM/PM as my regular GP had suggested I do, to help with the night pain. So I tried the rheumatologist's advice for a month just to see if there was any difference and have been waking up with very, very stiff wrist and shoulder and achy all over. So last night I went back to the old AM/PM split routine, and voila, hopped out of bed this morning feeling fine. I started at 25 mg last December and go down to 7 mg starting tomorrow. Wish me luck!

There is a basis from taking your prednisone dose all in the morning. My doctor said the same but also said it wasn't absolutely necessary that I take it all in the AM.

I took 2/3 in the AM and 1/3 in the PM. Splitting your dose this way isn't absolutely necessary either but that worked the best for me.

I don't think there is any single best way to take prednisone so mostly it is what works the best for you. My doctor just wanted me to keep her in the loop and tell her what I was doing with my Prednisone dose.

Wow! I did not realize nsaids interfere with prednisone. Thanks for that.
I have also been wondering how to taper.
Recently had a relapse after 3 yrs from initial onset.
I started on 10, then 7.5 for one week, then 7 for a little over two weeks, now just started 6.
I am going to follow the taper you mentioned now.
Stay on 6 for a month, then 5 for a month, then go down by .5 mg for each remaining month.