When and How to Taper Prednisone

Posted by vellen @vellen, Jun 24, 2023

I was started on 15mg for two weeks. I then was told to take 12.5mg for 30 days.
At day three of the 12.5, I woke in a lot of pain. I went back up to 15 by the doctor's assistant said that was fine, that was June 8 or so. I found out then that the doctor is out of the office until July 11. Yikes, right?
How do you know when to start tapering or is this something I was supposed to be doing already?
I have 5mg pills only and take 7.5 in the morning and at night 12 hours apart.
Any advice is appreciated.

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John, Volunteer Mentor | @johnbishop | Sep 7, 2023

In reply to @barracudacool "That’s it! Thank you so much. Gonna give it a whirl! Melissa" + (show)

Let us know how it works for you!

megz | @megz | Sep 8, 2023

In reply to @johnbishop "Was it this one? Dead slow and nearly stop reduction plan (Tapering) https://healthunlocked.com/pmrgcauk/posts/131189593/dead-slow-and-nearly-stop-reduction-plan" + (show)

I'm trying a modified version of that slow reduction. After having pain increase on the 8mg reduction, I moved back to 9mg and have stayed on 9mg for a few weeks to stabilise the improvement. All good now, just minimal pain in the mornings.

My doctor has agreed with whatever slow and steady taper works for me, so I've started reduction again a few days ago.
My dose was 7mg morning + 2mg evening = 9mg

Reduction schedule:
Day 1 - 6.5mg morning + 2mg evening
Day 2 - 7mg morning + 2mg evening
Day 3 - 6.5mg morning + 2mg evening (dose I have taken today)
Day 4 - 7mg morning + 2mg evening
Day 5 - 6.5mg morning + 2mg evening
Day 6 - 6.5mg morning + 2mg evening
Day 7 - 7mg morning + 2mg evening
Day 8 onwards - 6.5mg morning + 2mg evening = 8.5mg new dose.

The plan is to sit on the 8.5mg for a couple of weeks to make sure pain is still minimal before reducing by another .5mg in the same way. Hopefully, an overall reduction of 1mg will be made within the guidelines of reducing by 1mg every 4 - 8 weeks, so it's not really going slower, just more carefully and gradually.

chickpea44 | @chickpea44 | Sep 9, 2023

In reply to @barracudacool "That’s it! Thank you so much. Gonna give it a whirl! Melissa" + (show)

I find Dorset Lady’s Tapering Plan covering either 4/7/14 weeks better. You choose which plan! Also under pmrgcauk .. health unlocked.

A terrific forum - I developed PMR in 2020 - this forum is so supportive and members are so kind and knowledgeable. I live in UK. 🥰

steph1939 | @steph1939 | Sep 10, 2023

Who would have guessed with PMR you also needed to be a mathematician. I have both 5 and 1 mg pills. After 1 1/2 yrs I’m finally going to 4 1/2 mg a day. So very slow but works for me and absolutely everyone is different. I cut my 5 mg in half and add a 1 mg to get my daily dose of4 1/2 mg of prednisone. It really is trial and error and a lot of patience. Good luck with your journey.

megz | @megz | Sep 10, 2023

In reply to @steph1939 "Who would have guessed with PMR you also needed to be a mathematician. I have both..." + (show)

Half a 5mg tablet plus a 1mg tablet is 3.5mg.

I agree with you that cutting those prednisone tablets of various strengths takes a lot of adding up and care, especially as the dosages change. It doesn't help that the 1mg and 5mg tablets are the same colour and almost the same size and the tablet containers look very similar. Mistakes must be made very often.

steph1939 | @steph1939 | Sep 10, 2023

Thanks for checking my math

megz | @megz | Sep 11, 2023

In reply to @steph1939 "Thanks for checking my math" + (show)

Not so much about checking your math, I'd just hate to think anyone would have a flare through reducing too much, that's all.

tillysam | @tillysam | Sep 11, 2023

In reply to @chickpea44 "I find Dorset Lady’s Tapering Plan covering either 4/7/14 weeks better. You choose which plan! Also..." + (show)

Pmrgcauk- health unlocked is the best for up to date information.
The watchword for tapering is to do it slowly.

John, Volunteer Mentor | @johnbishop | Sep 11, 2023

For anyone struggling with tapering and having to split prednisone tablets, I would ask your doctor or rheumatologist to write you a prescription for the 1 mg and 2.5 mg tablets. Makes a world of difference when tapering to the lower levels and a lot less messing with pill cutters.

54pontiac | @54pontiac | Sep 11, 2023

In reply to @megz "Half a 5mg tablet plus a 1mg tablet is 3.5mg. I agree with you that cutting..." + (show)

Yes, I filled a daily pill container for a trip and some of the pills spilled on the journey. Fortunately I had it in a bag, but I learned that the pills themselves don’t have the dosage on them. And the 10 mg and 1 mg have the same inscrutable number on them but are slightly different sizes. Glad I also brought the containers with me!