When and How to Taper Prednisone

In reply to @tarmansbks please take heart! When I joined the Mayo Clinic Connect group I read postings of people who had been on prednisone for years! Don’t be discouraged at worst case scenarios. From what I’ve been reading most of the people in this group started with 20 mg. A few people started with the regimen I did beginning in March 2023 which was: 60 mg for 4 days, 40 mg for 4 days, 30 mg for 4 days, then 20 mg for 10 days and I’ve been stepping down gradually from 20 mg on a schedule suggested by my doctor. Each time I ‘step down’ I’m on that dosage for about 3 weeks. I’m on 2 mg now and will step down to 1 mg at the end of this month if my SED numbers are still low.

My point here is not everyone suffers for years, and I expect to put this behind me by the end of the fall if all goes well.

Just for reference I’ll be 79 in Nov. I take a hypertension medication, but am not on other meds. I’m a healthy body weight, I exercise regularly and I eat a healthy diet. Factors like this are important when you’re comparing your experience to others. Some people have other underlying conditions, some cannot take prednisone etc.

Remain positive! 😊

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.

I JUST FOUND OUT MY PMR HAS GONE IN REMISSION. I HAVE TO CONTINUE MY REDUCING MY PREDNISONE INTAKE BY A HALF A MG A MONTH. TILL IM COMPLETELY OFF THEM. WHAT ARE THE CHANCES IT COMES BACK WHILE IM DOING THIS? SECOND QUESTION WILL I HAVE TO BE COMPLETELY OFF PREDNISONE TO LOSE ALL THE WEIGHT I PUT ON. THANKS

I got down 1mg to 10.5mg this month but began a flare within 3 days. I am up .5 to 11 and wonder how long before I should try 10.5mg again? A couple weeks?
Another note, My blood pressure had remained high so my doctor put me on a beta blocker, propranolol. I feel so much better. Hopefully this is a temporary thing.
Thanks

Ugh! that is what I was afraid of, making it worse, and causing a longer time on Prednisone than needed. I guess I am just not happy with my doc saying that I would be on the 10mg for the next 2 months, that seems too long, especially when the other two reductions were at one month. I feel like progress is being stalled. I don't know, maybe it is not uncommon to stay on a dosage for two months while on a taper schedule. Thanks for your insight.

Sounds like your doc made the right decision. I know that the lower we go, the higher the percentage we're lowering and probably why he/she wants you to go two months on 10.
It really isn't longer than needed if two months is what's needed at a lower dose. Hang in there, we'll get through this. *hugs

If you are happy to try .5mg reductions - as I'm doing now - it might be worth a go after about 4 weeks. You could see-saw the dose up and down for a week to soften the reduction, (one day at 9.5mg, the next at 10mg), before staying on 9.5?

I'm a bit scared to do 1mg drops in one go now, especially under 10mg, but the drop I've just done from 9 down to 8.5 has been fine. I'm sitting on that for a couple of weeks to stabilise it before doing another .5 drop in the same see-saw way. That should get me a 1mg drop in about 6weeks. Hoping that will work.

Hmmm, I would love to try something, but I feel I should not go against my doctors orders. I may just shoot her a message to let her know that I may try a reduction after one month on 10, or I could just try it and let her know after I have done it, haha. I only have 5 mg tablets that would break easily to 2.5 mg, not sure if that 2.5 would break easily in half (I just tried it, the 2.5 half tab did not break evenly into a 1.25). How are you going to .5mg. Do you have 1 mg tabs? I wonder if a 2.5mg reduction is too much at one time?

2.5mg reduction would almost certainly be too much at one time under 10mg. The standard reduction schedule is 1mg reductions every 4 - 8 weeks under 10. Ask her for a script for 1mg tabs. They're essential for reducing below 10mg. You could tell her you've looked into it and you're on board with the nice slow reductions she suggests (doctors get nervous when people like us say we want to get off the meds fast 🙂 ), and you want to be ready for the smaller reductions of 1mg to come.