I'm looking at people's posts re tapering down from 10 or 15 mg by 1 or even 0.5mg at a time.
How have people reduced down from larger daily doses please?
My husband does not have a great deal of patience and I can't imagine him calmly reducing from 40mg by 1mg at a time in stages.
Would it be fair to say that none of us men have patience? Certainly would apply in my case. But with PMR one doesn’t have a choice. it’s not about mind over matter. Your body tells you what is prepared to do. And by that I mean each person can only taper at their own rate. From 20 mg, I tapered initially at about 2 1/2 mg every two weeks. From 15 to 10 it was at a rate of about 1 mg every two weeks. And from 10 mg to zero it was about a half milligram every two weeks or about 1 mg a month. Overall it took me 18 months, and when I found it I got too far or too fast, It was my body and not me telling me to slow down or even reverse course for a few weeks.
We like to think we are in control…you know masters of our universe. PMR teaches us a painful reality. If your husband tries to force it and drive his way to zero as if a car to a destination, he will, as the analogy goes, run out of gas rather quickly.
No - from 40mg down to 20mg then he should manage fairly well with 2.5mg at a time, maybe even 5mg to 35 and 30. But as Daniel says, his body may rebel - if the step down is too big then you may experience one of two things: steroid withdrawal rheumatism or a flare of the symptoms because the dose is now too low to manage the inflammation.
If he has "just" PMR then 40mg is a high dose (it isn't if it is GCA that he has, then it is the bottom of the required range) and he should be able to drop 5mg at a time and could even try going from 40 to 30 at one go if he hasn't been on the 40mg too long (more than a couple of weeks for example). It is very individual - he will have to try and see how he gets on. You don't really need to go to 1mg until you get to 10mg - unless you have problems with the size steps you try. It is a bit of experiementation - but we can assure you that once he gets below 20mg it will pay hime to tread carefully! It isn't slow when it works - when it doesn't work because you are pushing to go too fast or too far, all that happens is that you flare, you have to go back to a higher dose and start again and sometimes you have to go to a higher dose than first time around.
He's been on 40mg for two weeks and waiting for rheumatologist to comment re temporal biopsy taken a just over a week ago, with just under 2 weeks of 40mg left we're hoping reduction can start soon.
Thanks for the info Eileen.
temporal artery biopsy
Hi Jones, none of us like being on Prednisone and want off it a quick as possible. I started on 20 mg and following the advice of my doctor dropped down to 7 mg too quickly and had a bad flare need to go up to 30 to get any relief. Still tapering for about a year now at 7 once again tapering to 6.5. I look at all the extra Pred I have had to take because I rushed last year. Slow and easy this time around. Think positive and smiling. ☺️