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Has anyone else had pain return after reducing pred by only 2.5 mg?
Polymyalgia Rheumatica (PMR) | Last Active: Oct 24, 2023 | Replies (53)Comment receiving replies
Like all of you, I have found that coming to grips with the taper has been a challenge. Over time I learned that, for me, over 1 mg/month is too fast, and the single dose in the morning recommended by my rheumy is not effective. I have been splitting the dose evenly AM & PM. After 11 months I am at 6 mg, 3 in the AM and 3 in the PM, and am symptom-free. So far so good (touch wood).
My thought is that dividing into two daily doses makes the taper gentler because although you are decreasing by 1 mg daily, at any given moment you are not seeing a decrease greater than 0.5 mg.
However, splitting pills is a pain. You almost always end up with two unequal "halves" and a scattering of crumbs and dust. These you sort into two "equal" doses, one of which you try to extract while leaving the other in the splitter. This is all done with large fingers, crummy vision, and rising impatience, with the toilet beckoning.
On the other hand, being alive is pretty wonderful! Gorgeous clouds yesterday evening.
Replies to "Like all of you, I have found that coming to grips with the taper has been..."
Yes, that is the problem -- splitting the pills into small enough pieces and getting the dose right. Next time I renew the prescription, I'll ask for 1 mg pills too. I take my entire dose of pred in the mornings, because if I take it later in the day it will interfere with my sleep.
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I had my follow up with my Rheumy two days ago. She originally insisted that I only take a single dose in the morning, but was much more receptive that I am splitting my dose and tapering at a schedule that fits my body. When I mentioned that for now I was splitting a 5mg tablet in two (along the break line) and then splitting each half in two with an exacta knife to taper at 1.25, she immediately sent in a new Rx for 1.0mg tablets to taper at a 1mg rate. The tablet still has the break line, so it can be split easily into .5mg doses. I figure if I need to I can taper at the .5 anytime and especially when getting below 10mg per day to keep the taper within 10%.
Now 3 months into Prednisone. Started at 20mg and started taper 8 weeks ago and am currently down to 14. Splitting 10 morning and 4 evening. CRP was 6.0 and now < .5 (normal!) and ESR was 52 and now 14 (normal < 15!)
Cautiously optimistic and sticking listening to my body with slow and steady tapers.