Pill splitting

Hi @pmrsuzie, You might want to scan through the list of comments and discussions by other members who have found splitting the dose of prednisone helpful - https://connect.mayoclinic.org/search/?search=splitting+dose.

It can be discouraging when you get down to a lower dose and then can't seem to go any lower.

HI @pmrsuzie I know there have been other answers to your question elsewhere -- CVS tablets of Prednisone ( in Massachusetts at any rate) are scored , and I had 1mg , 2.5 mg and 5 mg tablets. One can devise all sorts of tapering schemes ! And I assume you have a proper pill cutter - not a knife . And I learned from others in Connect how strange* you will feel tapering below ~5 mg . I'll try to find the conversation I remember .

* But not a flare up !

There were two conversations at about the same time :
https://connect.mayoclinic.org/comment/1023115/
https://connect.mayoclinic.org/comment/1022819/
Highlighted in section 9.3 - "When discussing glucocorticoid taper-
ing, patients should be counselled about the possibility of withdrawal
symptoms."

I have 2 pill cutters. I am now somewhat reluctant to not follow the Drs tapering schedule and split the pills.
And yes, below 5mg, what seems to be a pmr flare may not be a pmr flare.
For now I'm not splitting anymore pills.
I see Rheum in a couple weeks. The last 2 months my CRP has been slightly elevated.

If you've been frustrated with pill cutting with uneven cutting and pill crumbling which can happen, it makes sense that your doctor would suggest alternating daily doses instead. And the math can get complicated when splitting 2.5mg pills, as well as some of the different strength pills looking almost identical, so there is a risk of taking the wrong dose there too.

Alternating dose days is another way to reduce. Let us know how you go.

The decision to use a pill splitter or not is between you and your doctor with possibly your pharmacist being consulted. If you do use a splitter the best one I have found is one where the pil is held in a V shape so it can easily be positioned for the cutting edge. Then when splitting, slowly apply pressure to the cutting edge. Most every pill is not flat and to keep the pill positioned in the proper place a slow and steady pressure is best. I have used a splitter for years for my Synthroid so I was very experienced with the technique I described. You are right, pills are not split evenly and some crumble. This is true for me even with this technique, rarely yet it happens. You must also clean the cutting edge every few pills for clean cuts.

I had no luck splitting 1 mg pills with a pill cutter. My pills are so deeply scored that I can simply snap them in two. Works well for me.

I had no choice other than splitting. My body couldn't handle even a 0.5mg reduction without significant pain flares. I could only manage a roughly 0.25mg reduction at a time. Someone suggested Pediatric liquid Prednisone and I'm considering it for the last 2mg. It's so annoying but if I had to keep taking whole tablets I'd still be stuck on 5mg. My Rheum says that I'm unusually sensitive to it but it seems from this forum that a lot of people struggle with the tablet limitations

I have the V shaped cutter. I am going to ask if the instruction to not cut pills is because of an inaccurate dose issue or the prescribed alternating whole mg dose amount works better immunologically.
I know both rheum Drs prefer a morning dose but went along with my splitting the dose am and pm if it worked better for me.