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When and How to Taper Prednisone

Polymyalgia Rheumatica (PMR) | Last Active: Sep 20, 2023 | Replies (39)

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@jj8431

Hi Folks, I am new to PMR, just over 2 months on Prednisone (had symptoms 6 months before Prednisone) Started on 20, to 15 to 10, split dose. I am reading all these stories and am very discouraged that people are on prednisone for years to treat this disorder. I do not want to be on prednisone and am trying to learn tapering schedules and responses to such. I have learned everyone has different experiences.
But what I really need to know is if anyone out there has a story of quickly getting off this medication? What is the shortest taper schedule possible? I do realize the importance of a slow taper in relationship to the adrenal gland but I can't comprehend being on it more than year. Is this possible or is it wishful thinking?

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Replies to "Hi Folks, I am new to PMR, just over 2 months on Prednisone (had symptoms 6..."

Was on prednisone for 12 years. Took me a year working with an endocrinologist to get off it. We substituted my medrol dose for hydrocortisone tablets in an amount equal to the one medrol pill. Every few months, I took one less pill as long as my blood work showed it was safe to do so.

Finally took my last hydrocortisone tablet last February when my cortisol blood work came back as normal. I think anyone going off long term steroid treatment needs to work with an endocrinologist to make sure you don't go into an adrenal crisis. I had to carry extra pills and a hypodermic in case I had any trauma. Good luck to everyone trying to get off. I will say I felt better on medrol but the risk of diabetes which I avoided but the fact I now have osteoporosis made it essential to get off it. No good deed goes unpunished.

I was exactly where you're at, having started on prednisolone in April. I felt the urgency of getting off it as quickly as possible and single-mindedly followed the directive to reduce to the lowest effective dose in the shortest possible time.

That didn't go so well. I got down to 9mg in half the time generally taken and that seemed to be going well...till 8mg. The morning pain increased noticeably, not too bad, but enough that I knew I had to stop reducing so fast or a flare was coming.

I now see the folly of pushing the ailment itself beyond it's own time course. Going faster with the taper doesn't make it go away faster. It just invites a flare which means an increase in dose to get pain and inflammation under control again. Then the reduction has to be done again, more time. In the end, rushing can mean we'll be on the 'roids longer.