Prednisone 1mg every other day or 1/2 of 1mg tablet every day?

Posted by mountainbikergirl @mountainbikergirl, Nov 15, 2023

My spouse who was diagnosed with PMR 1 year ago. He is now down to 1mg of prednisone daily for over a month with absolutely no pain or symptoms. We are ready to move down in dosage. Is it better for him to take 1mg every other day or 1/2 of 1mg tablet every day? The pills are so tiny that they are difficult to cut. His CRP and SED are still mildly elevated.

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It don’t think it will hurt to try either method. I tried to stop taking it after one month at 1 mg but still had pain so went to 1/2 mg and it was better. I ended up going back and forth between 1 mg and 1/2 mg for 6 months before I was able to stop taking the prednisone.

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What does the doctor recommend? If his inflammation markers are still elevated, probably too soon to go down….but doctor should know.

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I have frequently read about people who get down to the 1 or 2 mg level and reduce a little too quickly, resulting in a flare up. Actually, I'm at the 1 mg level myself and am in a bit of a holding pattern until I check in with my rheumy in 3 weeks. Because I'm hopefully close to the end of my 7 year journey, I'm more inclined to reduce very slowly. For example, the 1st week I'd do 6 days of 1 mg and 1 day of 1/2 mg. The 2nd week I'd do 5 days at 1 mg and 2 at 1/2 mg. Week 3 would be 4 at 1 mg and 3 at 1/2 mg, going down very gradually each week and then repeating the same process once I get to 1/2 mg. If I feel any resistance to the reduction I'll move back up to the last effective dose or a little above it.

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Profile picture for raven1955 @raven1955

I have frequently read about people who get down to the 1 or 2 mg level and reduce a little too quickly, resulting in a flare up. Actually, I'm at the 1 mg level myself and am in a bit of a holding pattern until I check in with my rheumy in 3 weeks. Because I'm hopefully close to the end of my 7 year journey, I'm more inclined to reduce very slowly. For example, the 1st week I'd do 6 days of 1 mg and 1 day of 1/2 mg. The 2nd week I'd do 5 days at 1 mg and 2 at 1/2 mg. Week 3 would be 4 at 1 mg and 3 at 1/2 mg, going down very gradually each week and then repeating the same process once I get to 1/2 mg. If I feel any resistance to the reduction I'll move back up to the last effective dose or a little above it.

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I am also down to 1 mg and will start doing the same as raven1955. 4 years to get to 1 and in no hurry.

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Profile picture for virginiaj @virginiaj

I am also down to 1 mg and will start doing the same as raven1955. 4 years to get to 1 and in no hurry.

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Thanks for your reply. I guess my spouse is lucky it only took him a year to get to 1mg! He has absolutely no pain or symptoms. We did get an appointment with his internal med doc on Tuesday. We will wait until then and see what she says. I'm thinking stay on 1 for another month and repeat our standing order for SED and CRP tests to see if they are down some.

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I have gotten off of prednisone successfully, though, after a while, my sed rate has jumped and I have to take prednisone again and repeat the slow tapering process. I have gotten used to this after 6 years of PMR.

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Sounds like my situation. I’m at 1 mg daily with very slight elevated inflammation numbers. Having knee replacement surgery this Thursday and even though my surgeon is fine I am thinking about stopping, but I don’t want a flare recovering from surgery? Is 1 mg making that much difference?

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I have been treated for PMR for about two years. Gradually reduced from a start of 20mg of prednisone. No systoms at 3mg of prednisone a day. Sed Rate of 2 and CRP Protein under 3, all normal. Went down to 2.5 mg of prednisone for 3 months, still no symptoms but sed rate went to 6 and CRP Protein still under 3 but a hair higher than before. Rheumy says it's OK to go down to 2mg for 3 months. Does a 1/2 milligram really make a difference. Any thoughts would be greatly appreciated.

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Profile picture for virginiaj @virginiaj

I am also down to 1 mg and will start doing the same as raven1955. 4 years to get to 1 and in no hurry.

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It is so helpful to see this! I am at 2 and 1/2 years and have tried unsuccessfully to go from 2 mg to 1 mg three times. Finally today set up a plan with my rheumatologist that I'll stay at 2mg (and lots of physical therapy) until I feel a shift in symptoms and then will taper by 1/2 mg over at least a month per taper. It lifted such a weight off me, I was really dreading another round of feeling unsuccessful. My feeling is that medical professionals know a lot more about PMR than I do, but I know a lot more about my own body experiencing PMR than they do. It was really empowering!

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Wow, that’s low, now you’re just bragging.

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