Tapering off of Prednisone

What is the most common way to taper off 3 mg prednisone?

Hi @bardy1953, Welcome to Connect. That's a great question and the answer might be easier than you think. You will notice that we moved your post to an existing discussion on the same topic here:

-- Tapering off of Prednisone:
https://connect.mayoclinic.org/discussion/prednisone/
The biggest qualifier is that each of us have different levels of acceptable pain and what I've always been told by my rheumatologist was that I should listen to my body when I'm tapering. If it were me I would try to go down by 1 mg a month. With my first occurrence of PMR it took me 3 and half years to taper off and the last six months were going back and forth between 1 mg and 1/2 mg until I could finally stop taking it without much pain.

@flymetothemoon @sharb @biblern @tsc @suetex @barbararene and others may also have some thoughts on tapering off of 3 mg prednisone.

How long have you been on prednisone?

Took almost 3 years and got down to 1/2 mg. Having pain again, so now I'm taking 1 mg every other day and hopefully will stay at 1/2 and then get off. I don't think this pain will go away so quickly. I also have Celebrex when its bad. I do think stress can contribute to this so it's important to find ways to minimize that stress. It's a journey for sure.

I’m new to this site and so glad I found it. I’m also fairly new to PMR. Mine started about 5 months ago with pain in my neck and upper legs. Celebrex helped me a lot but I saw an endocrinologist and got an accurate diagnosis and then started prednisone the middle of July. I started with 1 mg and ratcheted it up by 1 mg every two or three days until I reached 8 mg. After a few days I felt good with no pain and a lot of energy. I was on 8 mg for about six weeks. My doctor wanted me to try tapering down a little bit so I have now been on 7 mg for a little over a week. I felt spacey and low energy for four or five days but now feel OK and have minor pain.
My big question, that I can’t seem to find an answer to, is…
To achieve long-term remission is it necessary to stay on prednisone until you can taper slowly without the pain returning? I understand that it is important to be on a dosage that deals with the pain completely. Then, when tapering down, do you have to stop tapering or go back up if the pain continues?
I have the beginning of osteoporosis so that is one of my major concerns regarding staying on prednisone too long.
PS. I have also found that curcumin and ginger pills help with minor pain.

Welcome @elt, I think you hit the nail on the head. Prednisone keeps the pain and inflammation at bay until you can stop taking the prednisone and only have what I like to think of as my new normal morning minor aches until I get out of bed and start moving a little.

My rheumatologist had me only taper when the pain was acceptable. I kept a daily pain and dosage log and for me acceptable was a 1 or 2 on a scale to 10. If it was higher, I either stayed on the current dose or upped it a little. I also take turmeric curcumin everyday along with some supplements for my neuropathy.

Have you made any lifestyle changes with diet or exercise?

Hi @bardy1953, I initially was put on 40 mg of prednisone for Giant Cell Arteritis in late May 2021. When I got down to 3 mg, my rheumatologist suggested I stay on it for a month, then taper down to 2 mg for a month, then 1 mg for a month, then .5 mg for a month. I'm now down to .5mg every other day until my pills run out.

Thanks so much for your response. I had a fairly healthy diet to begin with as I tend to follow the O blood type diet for the most part. I i’ve been ordering grass fed meat from Trifecta which has been helpful. I eat very little sugar, very little dairy, no wheat, no alcohol currently and only two or three drinks a week prior to PMR. I’ve exercised at least six times a week for at least 40 years. I have a fair amount of allergies also so there’s a lot of different things there that I don’t eat. I was really surprised when I came down with this. I guess I’m primarily worried about my change in bone density as I choose not to take any of the meds like Fosamax or prolia. I take a lot of supplements but I have a family history of osteoporosis. I have a wonderful naturopath who has helped me tremendously. I am a behavioral psychologist so I do keep a lot of data also. It sounds like you’ve got things figured out pretty well for yourself. How long have you had PMR?

@elt My PMR is in remission but my first flare up was in 2007, lasted 3-1/2 years then went into remission until 2016 and lasted 1-1/2 years. My second time around I started eating healthier and cut out processed foods and cut way down on the sugar along with more exercise. I'm hoping it stays in remission 🙂.

You are tapering too fast. It is not a race.

I would, at first, go down 1 mg. a month. If this is not good go to 1/2 mg a month.