How to Slowly and Safely Taper Off Prednisone but ... no set rules.

I have been taking prednisone for 15 years or so. I have tried tapering to get off the prednisone many times and even got down to 1.5mg at one point several years ago. However, it seemed that the PMR symptoms came back and I ended up going back to 20mg or so and then tapering back down over time. I am now at 3.5 mg and have been there for several years. My rheumatology Dr. noted that it would be fine, health-wise, to just stay at the current dose. I would like to get rid of the prednisone all together and try tapering off again slowly. Having gone through this so many times I am a bit reluctant to try again and the then have to go back up to a large dose and then take months to taper back down.
Any suggestions or recommendations as to whether to just stay at the 3.5mg or try and taper slowly, maybe 0.5 mg every couple of weeks?

Someone posted recently with an interesting taper pattern. I think it was a decrease of .5 mg over a month. As I recall, it went something like this, starting with 3.5 to line up with your dose.

Week 1 3.5, 3.5, 3.0, 3.5, 3.5, 3.0, 3.5
Week 2 3.5, 3.0, 3.5, 3.5, 3.0, 3.0, 3.5
Week 3 3.5, 3.0, 3.0, 3.5, 3.0, 3.0, 3,5
Week 4 3.0, 3.5, 3.0, 3.0, 3.5, 3.0, 3.0

Now repeat the pattern beginning at 3.0 ...

If the person that posted the pattern sees this post, please correct me if I got the pattern wrong.

I'm following a similar taper for a .5mg reduction every 4wks. My original prednisolone taper instructions were to decrease by 1mg every 4 - 8wks, and decreasing .5mg every 4 weeks is 1mg every 8wks, at the longer end of the range. I'm taking it more carefully this time after my first and only flare at 6.5mg, and having to increase again. I've had no problem so far doing it this way and will start on the same reduction schedule to 5mg in a few days.

Dosage Reduction Schedule, 6mg down to 5.5mg:
Week 1
5.5 / 6 / 6 / 5.5 / 6 / 6 / 5.5
Week 2
6 / 5.5 / 6 / 5.5 / 6 / 5.5 / 6
Week 3
5.5 / 5.5 / 6 / 5.5 / 5.5 / 6 / 5.5
Week 4 (this week)
Stay on 5.5, take it easy for the week and monitor for any return of pain.

.05 every couple of weeks sounds good!

I have used a somewhat similar pattern starting at about 6 mg. I am now on 1/2 mg, alternating with 1/4, then will alternate with none. It is ridiculously slow, but seems to work. When I tried to speed it up in the past, I would relapse.

I know what you meant ... so I'm only joking. However ... a .05 mg reduction would be an incredibly small reduction and every couple of weeks would probably take @tfholman another 15+ years to get to zero. I thought 12 years on Prednisone was a long time for me. I can't imagine 15 years. Being on 3.5 mg might be a great time to get a cortisol level checked.

Good thought, I will look into that.

It took me 15 months to go from 20mg to 0.5mg. No flares, a little pain.

I've been on 0.5mg for 2 weeks. Don't know if I'm reluctant to quit completely or just scared to!

Next week will be the moment of truth for me.

It's not ridiculously slow at 1mg every eight weeks - it's within the prednisone reduction advice I was originally given of 1mg every 4 - 8 weeks. The setbacks and dose increases that come with reducing faster, prompted by my feelings of urgency to get off prednisone as quickly as possible, have increased the overall time and cumulative dose moreso than going at this slower more careful pace.

Your reduction success is very encouraging and I'll stick to the same path, even when tempted to move it along faster because it is going so well.

17 months from 30 to…ZERO on March 1, tapering at 0.5 per month for the last 5.
As with you, no flares, occasional non-PMR pain.
Go for 0 !