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Tapering off of Prednisone
I am currently on 20 mg prednisone after tapering down from 40 mg which I was on for 2 weeks. I have been directed to taper down again next week to 10 mg. I am experiencing terrible headaches lasting days at a time as well as neck pain and insomnia. Has anyone found any relief or remedies for headache/neck pain? Thank you.
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Hi! I'm new to this group as I was diagnosed with PMR in December 2022. I am 62, very healthy, and generally very active and enjoy walking/hiking/biking/skiing etc. In November 2022 I woke up with pain in my upper quads/tendons which then spread to pain in my hips, shoulders and neck. I couldn't lift my legs out of bed, or lower myself onto the toilet without support. I felt like I aged 30 years overnight! Started on 20mg/day of prednisone, first for only 2 weeks followed by tapering to 10mg. Symptoms started returning so I went back to 20mg for a month. Symptoms returned again when I tapered to 10mg. Rheumatologist has not suggested tapering more slowly, instead he recommends adding in Methotrexate (which I don't particularly care for the side effects), or biologics in addition to the prednisone. He has not mentioned a different, slower tapering protocol. Is it common for symptoms to return when going immediately from 20mg to 10mg? He doesn't seem to think so, but I'm guessing there are many of you out there with a different opinion? Thanks in advance for your help.
Healthunlocked.com has a couple of tapering plans which are excellent. My best to you.
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2 ReactionsHi, lestep. In my. opinion (not a physician), going from 20 to 10 mg is not a taper. I was initially at 15 mg, and after about 6 months was told to start tapering, first to 12.5 for several weeks, then 10. I hit a wall at 7.5 mg, and had to go back up a bit. Then I started tapering by 1 mg every four weeks, and also started taking Methotrexate. Right now I am juggling between 4 and 3, and my next taper will be to 2.5. We're all different, and you will probably get information from other posters, but a taper tends to be slow with smaller increments. Good luck to you.
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2 ReactionsIs anyone out there suffering from MDS and RA?
I am in continuous pain with the RA but cannot have methodextrate due to blood complaint.
They have prescribed hydroxychloroquin while tapering the steroids but still in a lot of pain.
Topping up with paracetamol.
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
Welcome @rebel123, I am sorry to hear you are in continuous pain and haven't found something that helps yet. There are a couple of other discussions that you might want to join in to see if others can offer suggestions from their experiences.
--- Rheumatoid Arthritis (RA) - Introduce yourself and meet others:
https://connect.mayoclinic.org/discussion/rheumatoid-arthritis-ra-introduce-yourself-and-meet-others/
--- Myelodysplastic Syndrome (MDS): https://connect.mayoclinic.org/discussion/myelodysplastic-syndrome-mds-1/
Thank you.
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1 ReactionThank 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.
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6 ReactionsWow, reading your tapering off situation. It’s also very confusing. I was diagnosed with PMR and then I had a GCA biopsy that turned out to be negative. I am currently on 40 mg of prednisone and now that my GCA is negative. My SED rate is 7 ( Was 80 and then 40) and my CRP went from 6.92 to
I don’t think my post was finished … so my CRP went from 6.92 to