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Tapering off of Prednisone

Polymyalgia Rheumatica (PMR) | Last Active: Feb 28 5:49am | Replies (313)

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@johnbishop

Hello @lestep, I would like to add my welcome to Connect along with @tillysam and others. Tapering off prednisone while managing your PMR symptoms can be difficult since there is no one solution that fits all. My rheumatologist told me that I needed to listen or pay attention to my body when it comes to tapering off of prednisone and to go very slowly when needed. He had me keep a daily log with my level of pain when I first got up along with the dose of prednisone for that day. A drop from 20 mg to 10 mg sounds like too big too soon but each of us are different. Here's some information on the topic that might help you discuss tapering slowly with your rheumatologist.

"How do you taper prednisone for PMR?
Tapering once remission is achieved (following initial and relapse therapies): Taper daily oral prednisone by 1 mg every 4 weeks (or by 1.25 mg decrements using schedules such as 10/7.5 mg alternate days, etc.) until discontinuation given that remission is maintained."
--- 2015 PMR guidelines.pdf - American College of Rheumatology:
https://www.rheumatology.org/Portals/0/Files/2015%20PMR%20guidelines.pdf

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Replies to "Hello @lestep, I would like to add my welcome to Connect along with @tillysam and others...."

Thank you John. I was surprised, after taking a little more time to read through these other posts, that my rheumatologist not only recommended such a rapid "taper", but that when I reported that my symptoms returned when I went to 10mg, he cast doubt on whether I even have PMR. Very confusing! However, knowing what I know now, thanks to this group, I feel more confident telling him I want to go back to 20mg and start again with a slower taper. I also will start a pain log. I'll let you know how it goes! Many thanks.