Prednisone tapering and extreme sweating

Hi @jj8431, Welcome to Connect. Sorry to hear you are having the extreme sweating side effects from prednisone. Connect is a great place to share and learn from each other on what works and helps with our treatments. For my 2 occurrences of PMR, I just took my days prednisone dose in the morning along with my blood pressure meds. I never needed to split my dose because it kept me pretty much pain free until the following morning when I would wake up with some stiffness and at times a little pain. My rheumatologist had me keep a daily log with my levels of pain and prednisone dose for the day which really helped when tapering. If my pain was higher than 2 to 3 on my scale, I wouldn't taper down to the next lower dose and would either stay at the current dose or increase by half of my previous taper depending on my level of pain. The one lesson I learned from my rheumatologist was we are all a little different with levels of pain and when tapering we need to listen to our bodies and taper accordingly.

I was started on 20 mg prednisone for both occurrences of PMR but I know others that have started on lower doses so I've often wondered if the starting dose may be the problem when the pain doesn't stay controlled during the night.

Has your rheumatologist offered any suggestions to help with the extreme sweating?

As far as split doses.

My PCP first diagnosed my PMR while I was waiting to see a rheumatologist. We started at 20mg once a day and when we followed up a week or so later, I mentioned that it seemed to start wearing off before bedtime and it was very uncomfortable sleeping. So we made the logical decision to split 10 and 10 morning and evening and things worked out great.

A month and a half later, I finally had my initial visit to the rheumy, she confirmed it was PMR, but then went on to question why I was on such a "high dose" and why I split doses. I felt this was in a very condescending way! She insisted I start tapering immediately by 2.5 on a two week schedule and was very insistent I only take in the morning. So I went to 17.5 in the morning and a couple days later the pain and stiffness returned pretty significantly. I went back to 10/10 for a couple of days and immediately improved. I then went to 10 morning and 7.5 evening and this worked with minimal shoulder pain. I've since tapered to 10/5, maintaining the same minimal shoulder pain. I will keep the split dose and tapering at a schedule my body tells me is OK. Also, per other recommendations in these discussion, I will stick to a 10% taper to avoid shocking the system.

My personal opinion is that some doctors are "book learners" and stick to the "published game plan" while others are "listeners" with good common sense. I'm glad many here have good common sense doctors and encourage the others to have a heartfelt discussion with their doctor. At my follow up in a couple of months, I will have a frank discussion on what works with me and will mention about this forum. I will be open minded to her suggestions as well, but if she still doesn't listen to what my body is telling me, then I will need find another doctor.