Are There Guidelines for Prednisone Tapers

The following video talks about the "guidelines" but the "reality" of tapering prednisone is different for everyone.

Thats a good question. I dont think an answer fits everyone. The Dr, after doing tons of testing to determine what you dont have will start you on prednisone and then tell you to start tapering. Most of the data for PMR suggests it can last for years. The fact your sed rate is normal also doesnt catch everyone. My sed rate and crp were never elevated. Yet the fact that prednisone worked in 4 hours was the diagnosis. I think one other issue is , I had never had a crp or sed rate test. What was my normal? Maybe it was elevated for me. Prednisone is a nasty long term drug. I tried to taper several times and could not get below 10mg. Then on month 5 I tried a taper to 5mg and it worked. Over that 5 month I tapered to zero. My cortisol restarted and I moved on. That is not everyone. The longer you are on prednisone the harder this will get. So I say just pay attention to what your body tells you and be determined to not stay on corticosteroids. good luck

I just visited my rheumatologist this week for what I hope is the last time (in reality I know that flare-ups are possible) and would like to share my tapering experience with some very specific advice. DO NOT ATTEMPT TO TAPER DOWN TOO QUICKLY. I did, not wanting to be on prednisone for too long. Started at 20mg and quickly went to 15…. Mistake…. Everyone’s experience will be different and I wish I could tell you my tapering will work for you but as it has already been mentioned each experience is unique to the individual.

But what I will suggest is tapering down by 1 or 2 mg at a time. Go at least 1 month before reducing by 1mg and repeat as necessary. You can play around with mg’s and time as you progress. I began to fluctuate towards the end by 1mg less one day and then 2 the next for a few months. But I did learn and followed from this site was when I reached 5 I reduced by only 1/2 mg daily until I reached 0. There is a lot of great advice on this site so stay with it.

Good luck and God Bless

Be grateful if you are done in a year. I took my last pill a year and a half ago and am feeling fine. Good luck to you. Bill

I'm going to preface this with saying that I'm on a fast taper because of an SMM diagnosis and everyone has to taper at their own pace based on their own body's reaction.
I started at 25mg and tapered down 2.5mg every week until I hit 10mg. The first three days I felt the effects of the taper but it started feeling normal again on day 4 or 5. If it stayed that way I moved to the next taper. From 10mg I tapered down 0.5mg every 4 days until I reached 5mg. Once at 5mg I started 0.5mg decrease every week, and will do that until I reach 3mg. I'm at 4.5mg now. I started kevzara a little over two weeks ago and I take 3mg LDN to help bridge the change.

@kjoed53 read @dadcue He got me through my darkest days. Incredibly informative. But yes, it seems so very different for each person on this terrible ride. Some, like myself, have been on Pred for a shorter period, since March 2026, and the tapering was not so challenging. Just that the PMR is still there. Good luck

The guidelines in this paper (https://pubmed.ncbi.nlm.nih.gov/26359488/) are outlined in the following paper. https://www.ncbi.nlm.nih.gov/books/NBK537274/

I followed this and was done in ten months. I tweeked it a bit by speeding up the 1 mg moves to be at two to three weeks and not a month. I also did a slower and lower dose when I got to around 4 mg.

I had no flares on this protocol.

I have been off prednisone and "healthy" since March of 2026.

Good luck

@pmrnew
The daily digest is part of my morning routine along with that first cup of coffee.

@petermccarville here's the thing... a 2015 standard is over 10 years old! That's significant in medicine. WHere nis the research in an growing area

I have seen nothing newer. I guess one could add the biologics but when it comes to prednisone protocols, they seem to have not changed much. In fact, that is one of the major gripes ......a drug used in the 1950s seems to still be the standard of care.

The following video is the latest I have seen in terms of the newest research into PMR. Biologicals seem to be the newest wave but they can take 2-3 months to kick in. I would hate to have suffered anymore than I did just waiting to get on pred.