Reducing predisone side effects

Posted by dga76 @dga76, 5 days ago

I have reduced my predisone from. 5 to 4 and am experiencing nausea, dizziness and slight headache. I reduced a week ago and am still experiencing these side effects. Is this normal?

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Profile picture for pmrsuzie @pmrsuzie

It seems that a lot of people taper in 0.5mg increments below 5mg. My rheumatologist does not believe in splitting pills so alternating in whole number mg is what I was instructed to do.
I am at 2mg. I am wondering if alternating between 2 and 1 mg is more difficult meaning it takes longer to be pain free during the 2 to 1 mg taper. I'm about ready to attempt it. I really do not want to increase above 2mg. My next appt is the middle of August and I would like to be at 1mg when I see him.
If it were me, I would go back to 5mg and rethink my taper.

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@pmrsuzie Why, once you are down to 2mg heading for 1mg, would you become concerned with tapering taking longer? If it is working, don't fix it! - would be my motto at that low a dose.
I know you have a personal goal but your body does not have the same goal. Everyone's goal is to have a successful taper not being at a certain dosage for a doctor's appointment. Slow and steady wins the race when it comes to treating PMR.
That said, alternating dosage for a week or more worked very well for me, especially at low dosages. Unfortunately, my inflammatory markers aways returned even with a slow and paced taper.

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Profile picture for pmrsuzie @pmrsuzie

It seems that a lot of people taper in 0.5mg increments below 5mg. My rheumatologist does not believe in splitting pills so alternating in whole number mg is what I was instructed to do.
I am at 2mg. I am wondering if alternating between 2 and 1 mg is more difficult meaning it takes longer to be pain free during the 2 to 1 mg taper. I'm about ready to attempt it. I really do not want to increase above 2mg. My next appt is the middle of August and I would like to be at 1mg when I see him.
If it were me, I would go back to 5mg and rethink my taper.

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@pmrsuzie
I started the alternating plan in June tho I did 2.5 then 2 every other day then I’d do 2.5 for a day then 2 for 2 days then 2.5 then 2 for 2 days then went to 2 all week this past week. I’ve been feeling sluggish this past week and feeling kinda low these last few days. Curious. Wonder if it’s the lowering to 2mgs?
I’m going full 2 mg this week for the next few weeks see how it goes. I also see my rheumatologist in August. I know he wants me off prednisone!
(I am on methotrexate so that could be causing my fatigue? )

Here goes, eh?

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Profile picture for jabrown0407 @jabrown0407

@pmrsuzie Why, once you are down to 2mg heading for 1mg, would you become concerned with tapering taking longer? If it is working, don't fix it! - would be my motto at that low a dose.
I know you have a personal goal but your body does not have the same goal. Everyone's goal is to have a successful taper not being at a certain dosage for a doctor's appointment. Slow and steady wins the race when it comes to treating PMR.
That said, alternating dosage for a week or more worked very well for me, especially at low dosages. Unfortunately, my inflammatory markers aways returned even with a slow and paced taper.

Jump to this post

@jabrown0407
"Why, once you are down to 2mg heading for 1mg, would you become concerned with tapering taking longer?"
Isn't going from 2 to 1mg a 50% drop? The tapering process invokes aches, pains and possibly stirs up my Meniere's. And I certainly don't want to be in bed throwing up - which is what Meniere's can do to me. These are the problems I had getting from 3 to 2mg. I was at 3mg for months, took several weeks to get to 2mg. Been at 2 mg for a few weeks. Maybe I should stay at 2 mg longer. My PCP said to stay at 2mg til I see him in August. Maybe that's what I should do. Hot, humid weather is here now and that in itself will be unpleasant. I'm talking myself into staying at 2mg. Like everyone here, I just would like to be eliminating
prednisone from my diet.

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Yes it it, but from what you said I inferred you successfully tapered from 3 to 2 which is a 33.3% drop.
Alternating is gentler and since you mentioned the difficulties you have had then alternating makes sense.

You might try extended tapering
Hd =high dose, Ld=low dose

Hd, Ld; Hd, Ld until you feel safe
Hd, Ld, Ld, Hd; Ld, Ld until you feel safe
Hd, Ld, Ld, Ld; Hd, Ld, Ld, Ld until you feel safe
Then straight low dose.

Again you might want to let your doctor know and/or discuss with him before doing it.

What you really want is to successfully eliminate prednisone. I have had to restart it every time I get off. One of the things you don't know about until it's you.

I wish you success on your journey.

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Profile picture for pmrsuzie @pmrsuzie

@jabrown0407
"Why, once you are down to 2mg heading for 1mg, would you become concerned with tapering taking longer?"
Isn't going from 2 to 1mg a 50% drop? The tapering process invokes aches, pains and possibly stirs up my Meniere's. And I certainly don't want to be in bed throwing up - which is what Meniere's can do to me. These are the problems I had getting from 3 to 2mg. I was at 3mg for months, took several weeks to get to 2mg. Been at 2 mg for a few weeks. Maybe I should stay at 2 mg longer. My PCP said to stay at 2mg til I see him in August. Maybe that's what I should do. Hot, humid weather is here now and that in itself will be unpleasant. I'm talking myself into staying at 2mg. Like everyone here, I just would like to be eliminating
prednisone from my diet.

Jump to this post

@pmrsuzie
I don't know if it helps, but I had your same concerns. Our Mentor here gave a little bit of advice from his Doctor, so on the last 2 mg down, I did a so-called sound-check on my body. What hurts, how bad is it, is it lasting more than a few days. I would get nervous as well. For me, the consensus that I read into was a very, very slow taper at the last two mgs. I did quarter mgs steps and would pay attention to the pain levels as I got down to 0. I don't know if that helps, but it worked for me. I completely get your concerns. So far, so good, thankfully.

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I am reducing ever so slowly and after one month of 5 mg started to take 4,5 mg a couple of days ago. Today I have been really not great. Headache, extremely fatigued and a slight increase in physical discomfort. This seems to happen for a week or two until my body adapts to the new dosage. I have watched this over the past months every time I reduce a little more. Started with 30 mg in August 2025. Maybe try to only go 0.5 mg at a time

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