Are There Guidelines for Prednisone Tapers

@jcapra51
I'm doing 15mg/14mg/15mg/14mg etc alternate day dosing for 3 weeks.
Then 14/13/14/13 etc alternative day dosing for next 3 weeks.
And so on until down to around 5 or 6.
Will continue with alternative day dosing but cutting down by a factor of 1/2.
In other words 5mg/4.5mg/5mg/4.5mg/5mg alternative day dosing for 3 weeks.
Dropping 1 mg as you get lower represents a higher percentage drop in relative terms compared to going from 15 mg to 14mg which is a small percentage drop. A drop from 5 to 4 represents a 20% drop. From 4 to 3 is a 25% drop. 3 to 2 is a 33% drop etc. It is thought this increased percentage drop in steroid can possibly be the cause of flares.
But who knows? There's no doubt from all of the research I read that more research is certainly needed on tapering steroids.
My GP says "we're all individuals and have to find what works personally for us." She is hugely supportive in helping me do what I think might work for me. Lots of prescriptions for 1mg tablets and a tablet cutter required :-))
What about you @jcapra51? What's your tapering plan?

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 was diagnosed with PMR in October 2025. I started out at 10mg prednisone and due to concerns of also having Giant cell, my dose eventually reached 60mg/day in February 2026. In March I began to taper my prednisone intake by 10mg every 2 weeks. On May 8th, my dosage was down to 10mg/day. At this point, my rheumatologist had me reduce my 1 mg every 3 weeks. There was a good reason for slowing down the taper once I reached 10mg. The bodies adrenal glands won't start to kick in to produce cortisol until you are below 7mg of prednisone. The body produces about 6-7mg of cortisone daily, so at a dose of 7mg or higher prednisone, the body stops producing it and shuts that down. I am now at 5mg prednisone and will begin to drop my dosage to .5mg every 3 weeks. This will allow my adrenal glands to hopefully have enough time to produce the cortisol I need to
prevent a relapse of PMR symptoms. I think the main goal is to go very slow during the taper at this stage to allow the bodies adrenal system to get back to normal. I still feel kind of strange with being light headed and sort of a numbing feeling and fatigued, but for the most part my pain is at a tolerable level and mainly in my hips when I first get out of bed and getting up after sitting awhile.