Tapering off of Prednisone

Posted by e @epvb, Mar 27, 2017

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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@johnbishop

If I was at 12.5 with no pain and I had been on the dosage for a few weeks, I think I might try going down 2.5 to 10 and see what I felt like the next morning. If the pain was too much I would go up 1 mg to 11 or possibly 12 depending on how much pain I was feeling that morning.

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I agree with John. Pain (or lack thereof) seems like the only way to judge if the prednisone is working. At 10mg. I would proceed very slowly. My dr. recommended reducing 1mg per month. She said if I experienced any joint pain try to bear with it for a few days to see if it decreased. If pain did not go away she said to increase prednisone to previous dosage for the next month. It all sounds like a seesaw ride to me but so far I have had no issues. I will say that anytime I feel the least little twinge in a joint, I start to envision the “old days” of not being able to get out of bed on my own😩. I like John’s idea of keeping a pain journal. It really helps to jog the memory. Good luck. Liz Ward. (9mg and counting!)

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@johnbishop

If I was at 12.5 with no pain and I had been on the dosage for a few weeks, I think I might try going down 2.5 to 10 and see what I felt like the next morning. If the pain was too much I would go up 1 mg to 11 or possibly 12 depending on how much pain I was feeling that morning.

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Ah... hmm. I currently take 5mg in the morning and 7.5 in the evening. If I'm more than an hour late with either, the pain starts setting in.
I'll try 5mg tonight and see how I feel in the morning. I'm just a scaredy cat.
Thanks John.

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@lizward46

I agree with John. Pain (or lack thereof) seems like the only way to judge if the prednisone is working. At 10mg. I would proceed very slowly. My dr. recommended reducing 1mg per month. She said if I experienced any joint pain try to bear with it for a few days to see if it decreased. If pain did not go away she said to increase prednisone to previous dosage for the next month. It all sounds like a seesaw ride to me but so far I have had no issues. I will say that anytime I feel the least little twinge in a joint, I start to envision the “old days” of not being able to get out of bed on my own😩. I like John’s idea of keeping a pain journal. It really helps to jog the memory. Good luck. Liz Ward. (9mg and counting!)

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When I have pain set in, it has been like a freight train so I'll not go three days. I do appreciate your input.

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@lizward46

I agree with John. Pain (or lack thereof) seems like the only way to judge if the prednisone is working. At 10mg. I would proceed very slowly. My dr. recommended reducing 1mg per month. She said if I experienced any joint pain try to bear with it for a few days to see if it decreased. If pain did not go away she said to increase prednisone to previous dosage for the next month. It all sounds like a seesaw ride to me but so far I have had no issues. I will say that anytime I feel the least little twinge in a joint, I start to envision the “old days” of not being able to get out of bed on my own😩. I like John’s idea of keeping a pain journal. It really helps to jog the memory. Good luck. Liz Ward. (9mg and counting!)

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Also, reducing one mg per month is fine to a point but at the single digits, the percentage of reduction increases. I'll most likely go to .5 at some point after a successful 10 mg level. We'll see.

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@johnbishop

@vellen, My rheumatologist gave me tapering suggestions but never told me specific amounts or times to drop to a lower dose of prednisone. Instead he had me keep a daily log of my pain level when I got up in the morning and the dose that I was taking each day. Then he said to only taper down if my pain level was acceptable to me when I got up in the morning. For me that was a 1 or 2 on a scale of 0 to 10. If my pain level was higher than 2 I would bump my dosage up half of the previous amount that I dropped on the last taper to see if the pain went down the next day. When I got to 1 mg, it took me six months of going back and forth between 1 mg and 1/2 mg before I could finally stop taking prednisone and wake up with pain less than a 2.

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Oh man. This is just a vent. I didn't hear back on Friday so decided to try 10 mg yesterday. I'm good today so far. I got a notice of an rx filled. I called to make sure both the Pred and Tramadol were filled, Tramadol no, Pred filled 2.5mg. I had just picked up 5mg. What am I supposed to do with 2.5mg? Rhetorical that. Ugh. A call is in to the doctor. I plan to stay on the 10mg but will need the 2mg at some point.
I'm so frusrrated.

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@vellen

Oh man. This is just a vent. I didn't hear back on Friday so decided to try 10 mg yesterday. I'm good today so far. I got a notice of an rx filled. I called to make sure both the Pred and Tramadol were filled, Tramadol no, Pred filled 2.5mg. I had just picked up 5mg. What am I supposed to do with 2.5mg? Rhetorical that. Ugh. A call is in to the doctor. I plan to stay on the 10mg but will need the 2mg at some point.
I'm so frusrrated.

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A cynical mind might say the doctor has mistaken you for a person who unquestioningly follows their orders regardless of consequences, and since their directive was to reduce by 2.5mg in one go, a 2.5 tablet is all you need. You could give that doctor some numerical headaches and cut that tablet in half for a reduction of 1.25mg if the pain tells you a staged reduction works better for you than 2.5mg in one go. If the 1.25 works out okay, you could still reduce by a further 1.25 to get a 2.5mg reduction within the doctor's timeframe.

Whiners unite. Your doctor and staff will learn that they're going to hear from you a lot till they get it right. 😉

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This doctor isn't thinking. He has me on a 5mg rx. I was on 15mg per day then 12.5 and I cut one in half, voila'. so why the 2.5 now?
I've called three times and talked to his assistant as many times and she says she gets it. She assured me this last time that he will send in the 2 as well as refill the Tramadol (for the Fibro as I was out - not a good med to run out of).
I got to the pharmacy to find the Tramadol refilled and Pred 2.5. I refused the Pred and the pharmacist tried to tell me that it was to take with two 5mg for a total if 12.5 *eyeroll. Yeah, I explained as not frustrated as I could.
I'm going to cut some fives into quarters as @megz suggested (thank you), for 11.25. Then to 10 from there?? idk
I would be lost without you my friends. A big hug to all of you and your help and support!!

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@vellen

When I have pain set in, it has been like a freight train so I'll not go three days. I do appreciate your input.

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Does it ever improve on its own? Does it ever go into remission? I am sticking with prednisone with all its side effects but the going is rough.

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What I meant by the pain setting in is when my doctor had me go from 15mg to 12.5.after two weeks. It only took three days to put me back almost two weeks pain-wise.
As long as I stay on a level of prednisone daily, I have very little, if any, pmr pain. That's why I'm not rushing the taper.
I don't know that there is a remission per se but waking up the adrenal glands and them taking over once one tapers off the meds. I undrrstand to go slowly and slower once you're in the single digits. Pain is the signal that you dropped too low in milligrams. Does your doctor have you on a schedule?
Once I'm down to 10, I'll slow the roll.
I just went from 12.5 for six or so weeks (because of rx delay) to 11.25 (same reason). I got notice today that there's another rx called in but I'll call maybe tomorrow, I'm just tired of dealing with the stress of it.

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@vellen

What I meant by the pain setting in is when my doctor had me go from 15mg to 12.5.after two weeks. It only took three days to put me back almost two weeks pain-wise.
As long as I stay on a level of prednisone daily, I have very little, if any, pmr pain. That's why I'm not rushing the taper.
I don't know that there is a remission per se but waking up the adrenal glands and them taking over once one tapers off the meds. I undrrstand to go slowly and slower once you're in the single digits. Pain is the signal that you dropped too low in milligrams. Does your doctor have you on a schedule?
Once I'm down to 10, I'll slow the roll.
I just went from 12.5 for six or so weeks (because of rx delay) to 11.25 (same reason). I got notice today that there's another rx called in but I'll call maybe tomorrow, I'm just tired of dealing with the stress of it.

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Thanks for giving me some hope! I am just beginning a taper.

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