1. < Polymyalgia Rheumatica (PMR)
Profile picture for tyl411

Tapering Prednisone from 5 to 4

Posted by tyl411 @tyl411, Feb 13 3:33am

I am seeking experience from fellow PMR folks please. My RA has given me the go ahead to go down to 4 mg from 5 (present dose) on Prednisone. He has on this journey titrated me with every other day doses (7.5 one day, 5 the next) to ease the transitions, and I have done well. I have severe osteoporosis and am at the six month mark on Pred on April 1st. Bone loss is supposed to be more intense, if I understand that correctly. I sure don't want to start over. So, in your experience, should I titrate every other day (between 5 and 4), or go straight to 4 mg. I will talk it over with my RA after gathering your thoughts. I sure appreciate you all. Thanks. p.s. no pain at present. On anti-inflammation diet, with lots of exercise.

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

Profile picture for John, Volunteer Mentor
Mentor
John, Volunteer Mentor | @johnbishop | Feb 13 8:02am

My rheumatologist told me to always listen to my body when tapering. If my acceptable pain level (2 on a scale of 0 to 10) was 2 or less, I would taper to my next lower dose. If my pain was higher I would wait a day or two to see if it got worse or better. If the pain when I got up in the morning was acceptable, I would taper. If not, I would up my dose half of the previous taper down. He had me keep a daily journal of my pain level and my dose for the day.

You might want to join the following discussion:
-- reducing prednisolone once you get down to 5mg: https://connect.mayoclinic.org/discussion/reducing-prednisolone-once-you-get-down-to-5mg/

REPLY
1 reply
Profile picture for tyl411
tyl411 | @tyl411 | Feb 13 1:51pm
In reply to @johnbishop "My rheumatologist told me to always listen to my body when tapering. If my acceptable pain..." + (show)
Profile picture for John, Volunteer Mentor @johnbishop

My rheumatologist told me to always listen to my body when tapering. If my acceptable pain level (2 on a scale of 0 to 10) was 2 or less, I would taper to my next lower dose. If my pain was higher I would wait a day or two to see if it got worse or better. If the pain when I got up in the morning was acceptable, I would taper. If not, I would up my dose half of the previous taper down. He had me keep a daily journal of my pain level and my dose for the day.

You might want to join the following discussion:
-- reducing prednisolone once you get down to 5mg: https://connect.mayoclinic.org/discussion/reducing-prednisolone-once-you-get-down-to-5mg/

Jump to this post

I sure appreciate the info and the website tip. I will check that out for sure. I have two weeks to get ready for tapering down, and I understand that going down from 5 has attention that is needed. Again, Thank You so much.

REPLY
Profile picture for aisp3b
aisp3b | @aisp3b | Feb 14 7:26am

I don't have osteoperosis but I do have osteopena. I am alternating 2/1/2/1, etc and am doing fine. I started on 20mg/day in Dec '24. It is now 2/14/26. I still decrease slowly and have never had a flare up. I am to be done with preds my the end of May 2026.

REPLY
Profile picture for tyl411
tyl411 | @tyl411 | Feb 14 8:02am

That is so wonderful to hear. I am getting more encouraged to not be so nervous about going down on the dosage after 5 mg. I sure don't want to start over. Thank you so much for sharing.

REPLY
Please sign in or register to post a reply.