How are you tapering prednisone?

Posted by gigilea @gigilea, 5 days ago

Quite a few people have posted about how important it is to taper prednisone slowly.
When you get into the smaller doses, the percent reduction of the taper is larger.
Here is a chart I made of dose and then the corresponding percent reduction.
Hope people can read it and sorry about the shadow

Interested in more discussions like this? Go to the Polymyalgia Rheumatica (PMR) Support Group.

Has anyone experience gastric distress? For example, Stomach burning, soreness and pain during a taper?

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Profile picture for predniso141 @predniso141

@kereno can’t fool mother nature OR PMR!! The UK website has step by step suggestions of tapering prednisone . Getting to the Lowest Effective Dose is complicated but they have it covered!

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@predniso141
Would you send me that link again? If it's no trouble. I'll take another look at it. Thanks for your advice!

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Profile picture for Howdy! @kereno

@predniso141
Would you send me that link again? If it's no trouble. I'll take another look at it. Thanks for your advice!

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@kereno it is PMRGCAuk
Polymyalgia rheumatica and giant cell arteritis i information from people who have one or both conditions

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Profile picture for predniso141 @predniso141

@kereno can’t fool mother nature OR PMR!! The UK website has step by step suggestions of tapering prednisone . Getting to the Lowest Effective Dose is complicated but they have it covered!

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@predniso141

Just so people know ... there is no high-level clinical evidence (such as large-scale randomized controlled trials) in the medical literature to definitively prove that the "Dead Slow Nearly Stop" (DSNS) method works better than other tapering methods. Patients on the UK web site have problems tapering off Prednisone too.

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Remember that if you’ve been on prednisone a very long time, even when you’ve been off it for a while you still may require “stress dose steroids “ during high stress events ( illness, accidents, etc). So be cognizant of this and if you’re ill or break a leg, etc, watch for signs of adrenal insufficiency and contact your doctor if they appear.

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Profile picture for laura1970 @laura1970

Remember that if you’ve been on prednisone a very long time, even when you’ve been off it for a while you still may require “stress dose steroids “ during high stress events ( illness, accidents, etc). So be cognizant of this and if you’re ill or break a leg, etc, watch for signs of adrenal insufficiency and contact your doctor if they appear.

Jump to this post

@laura1970

After a long time on Prednisone it was difficult for me to know if I still needed prednisone for PMR or because I had adrenal insufficiency since both conditions cause muscle and joint pain. Corticosteroids are the treatment for both conditions.

To a certain extent, after prednisone suppressed my adrenal function, it caused me to be "dependent" on prednisone to regulate my inflammation levels. My adrenals weren't producing enough cortisol to regulate inflammation for me.

According to my rheumatologist, both PMR and adrenal insufficiency have similar symptoms like muscle pain and fatigue making a precise diagnosis challenging after prolonged prednisone use. It was easier to differentiate my symptoms when Actemra controlled PMR without suppressing my adrenal function. After my adrenals recovered it was much easier to taper off Prednisone. It was still a slow taper but not for years.

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Profile picture for Mike @dadcue

@laura1970

After a long time on Prednisone it was difficult for me to know if I still needed prednisone for PMR or because I had adrenal insufficiency since both conditions cause muscle and joint pain. Corticosteroids are the treatment for both conditions.

To a certain extent, after prednisone suppressed my adrenal function, it caused me to be "dependent" on prednisone to regulate my inflammation levels. My adrenals weren't producing enough cortisol to regulate inflammation for me.

According to my rheumatologist, both PMR and adrenal insufficiency have similar symptoms like muscle pain and fatigue making a precise diagnosis challenging after prolonged prednisone use. It was easier to differentiate my symptoms when Actemra controlled PMR without suppressing my adrenal function. After my adrenals recovered it was much easier to taper off Prednisone. It was still a slow taper but not for years.

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@dadcue That's an important point you made about being able to differentiate your symptoms with Actemra because it doesn't
suppress adrenal function.

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Profile picture for rickman @rickman

Has anyone experience gastric distress? For example, Stomach burning, soreness and pain during a taper?

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@rickman
Yes, I have had to take pantoprazole to control the excess acid and stomach discomfort and growling particularly overnight. Now I have stomach upset I think because of my tapering from 7.5 mg to 5 mg of prednisone. Also now feeling sluggish so assuming it is due to adrenal insufficiency or withdrawal. Hope it goes away soon!

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