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Typical dose of prednisone for PMR
Polymyalgia Rheumatica (PMR) | Last Active: Sep 2 7:20am | Replies (39)Comment receiving replies
When I had PMR with pain in my shoulders and hips my rheumatologist at UAB, one of the top rheumatology centers in the US, had me taper prednisone very slowly in order for my body to adjust and start making cortisol on its own again. I started at 20 mg then 15 mg then 10 mg/day for a month. I then tapered down from 10 mg/day by 1 mg/day each month. This process took almost a year to get to 0 mg prednisone but I have been in remission with no symptoms for the last 5 years. I had no side effects from the prednisone except that it gave me a lot of energy. I think many doctors taper down too fast.
My rheumatologist had me taper slowly: once I got down to 10mg the protocol was first month 10mg/day, second month 9mg/day, third month 8mg/day……until you get to 0 mg.
Replies to "When I had PMR with pain in my shoulders and hips my rheumatologist at UAB, one..."
@slh317 My rheumatologist here in Spain is also quite conservative in tapering the prednisone. I'd been tolerating the small decreases in dosage fairly well, until I tried to go below 2.5 mg. (Here in Spain they don't make 1 mg. prednisone. the Lowest dose tablets are 5 mg. and 2.5 mg., and the tablets are scored so you can cut them in half.)
Currently I'm alternating between 2.5 mg. one day and 1.25 mg. the next, but I'm struggling with blurts of cortisol that leave me shaking inside, and especially with the accompanying mood swings. This is the second time that I've tried reducing to this amount, and I'm running into the same wall.
I'm really glad to have found this group, if only to realize that I'm not alone on this journey.
Thanks for sharing your post.
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@slh317 Tapering by 5mg even if you are staying at each level for a month is not what I would consider " very slow". Tapering my 1mg per month is slow. Two stages to the tapering process you described - Stage 1 - rapid taper to 10mg; Stage 2 - slow taper from 10mg to zero.
Your move from 20mg to 10mg took 2 months, then from 10 to zero at one month per level would take 10 months, exactly a year if all works as planned. You are lumping the move from 20mg to 10mg in the same category as moving from 10mg to 0mg.
You are indeed fortunate if you only needed one year of treatment. I am in year 7 and now have asymptomatic GCA with vascular damage requiring two different highly trained and sought after specialist to watch over my aorta and my neck and head to try to prevent a dissection.