Polymyalgia rheumatica: Any thoughts on my taper plan?

I have remained on 5mg Prednisone for over 4 months as when I reduced to 2.5 the symptoms increased so back to 5’s again. I’m hesitant to reduce further however my real issues is the skin with it being so fragile the skin lifts off and wounds don’t heal quickly. Any comments would be grateful.

I am no doctor, but you may have reduced your Prednisone by too much. 5mg down to 2.5 is a 50% cut. That's a big amount. Try going down to 4mg for three months, see how you feel, then 3mg for three months and so on. After 3mg for myself, I have been going down 1/4mg every six weeks. Maybe other members can chime in and give their thoughts. Hope you feel better and best of luck.

Thank you for ur reply. Your suggestion seems to be a more cautious approach which I’ll take to my G P as I parted company with my Rheumatologist who was useless. Best wishes

The standard recommendation for tapering off prednisone is to reduce by only 1mg (or less) at a time under 10mg. If you reduce the dose from 5mg to 2.5mg in one go, it's inviting a flare.

It's taken 18 weeks for me to reduce from 5mg to 2.5mg with no problem, reducing by .5mg every 3-4wks. You could try making small reductions gradually. An example of the gradual way some of us reduce is -

WEEK 1 (7 days of dosing, for example, starting at 5mg):
4.5mg / 5mg / 5mg / 4.5mg / 5mg / 5mg / 4.5mg
WEEK 2
5mg / 4.5mg / 5mg / 4.5mg / 5mg / 4.5mg / 5mg
WEEK 3
4.5mg / 4.5mg / 5mg / 4.5mg / 4.5mg / 5mg / 4.5mg
WEEK 4
Stay on 4.5mg and notice if there is any new pain or aches. Wait till they resolve, or move to the next .5mg reduction if everything is fine.

I found this gradual tapering method here on Mayo Connect after a flare last year, and haven't looked back since then. My rheumatologist told me to keep reducing the same way as it's working.

I got to 5 mg and couldn't get past that. Finally I tried the Dead Slow Drop method I learned about here. Briefly:
Week1: day 1: 4 mg, days 2-7: 5 mg
Wk2: days 1-2: 4 mg, days 3-7: 5 mg
Wk3: days 1-3: 4 mg, days 4-7: 5mg
And so on. Once you're on the lower dose for 1 week, remain there for no less than 2 weeks and 3 weeks is fine. Then repeat. If you have any return of symptoms - dont wait for a big flare - go back to the higher dose or your most recent successful dose for at least 2 weeks then start again.
I needed to increase my dose to the higher dose once for 2 weeks.

Currently working on getting down to 2 mg, using this method.

My rheum advised splitting 1 mgs into 1/2 and even 1/4 may be needed but so far Im ok going to 2 mg. Time will tell.

I had trouble going from 4mg to 3. I am now rotating days 4-3-4-3-, etc. My Rheumy recommended Extra Strenght Tylenol to help me arrive at the lower dose. I normally have to wake up around 3 or 4am to relieve myself. At that time I started taking my 2 pills of extra strength Tylenol and I am having much better results - far less PMR symptoms in the AM hours and descreasing to almost no symptoms during the day.

My skin seems very thin since starting prednisone. I’m currently on 5 mg I was on four but the pain was too much now. I take Tylenol every morning. I’m also on methotrexate 20 mg once a week. I’m very stiff in the hip area and sore around my neck but once I take the Tylenol. I’m able to try and play pickle ball and move around in the day

I was at 5mg, then Dr wanted to drop to 4 mg. I elected to split a 5 mg in half and add two 1 mg to go to 4.5 for three weeks, then drop to 4mg. So far so good. Next will try 3.5. Hopefully no relapse. I’m going very gradual after following this group chat.
Good luck

Glad things are working out for you. My belief is the slower the better. I know we all eventually want to get of the prednisone but there is no need to rush when the doses are below 5mg. That is what I truly believe, but as I said before, I am no doctor. Stay healthy my friend and best of luck.

What dose of prednisone did you start at before weaning down?