Hi again- Echoing the others here and sending support.

We worked with my dad’s rheumatologist on the tapering, following general guidelines but honestly it’s more guided by his symptoms. As she puts it: “We have to listen to what his body says.”

He was on his initial prednisone dose of 20 mg for at least a month, but sadly this was because he has a stroke two weeks after diagnosis of PMR was diagnosed and we didn’t want to rock the boat while he was recovering. He was eventually out on 30 mg for at least another two weeks because it wasn’t enough; after an initial drop in his ESR and symptoms, it spiked again.

His rheumatologist has him take a new dose for at least 2 weeks and if his pain and fatigue are stable and no sign of a flare, plus labs look ok, he reduced by 2.5 mg. (We tried dropping by 5 mg, and that was too fast, so again, she was deferring to how his body responded).

We continued that way. If after a reduction in dose, there was a flare or an initial increase in symptoms didn’t resolve after 2-3 days, we went back up to the previous dose for another 2 weeks and would try again to drop the dose.

After getting to 10 mg, we’re going even slower. He took 10 mg for 4 weeks. Then alternated 10 of and 7.5 mg for 2 weeks. Now he alternates 7.5 mg and 6.25 (it’s a 5 mg tablet + half of a 2.5 mg tablet—so crazy).

Why all the craziness with the numbers? We tried to put him on alternating 7.5 and 5 mg and he had a flare!

I guess we’re lucky in that his insurance will cover the different denominations of tablets. We need to get 1’s. I’m planning to ask his rheumatologist for those this week because he just had new labs drawn.

I think I mentioned this in the other thread you cited, but you might be able to try getting your entire prescription in the smaller denomination of pills i.e. I take 112.5 mg of a different medication.

However, the script is written that I should take 5, 25 mg tablets every morning (I take 4.5 tablets). My doctor did it that way because 25 mg is the smallest denomination of these tablets, and we wanted to titrate slowly. 112.5 mg was where we landed.

Hope that helps!