Due to GCA I was prescribed 60mg pred. last Sept. the symptoms of the infection disappeared very soon and due to horrific side-effects my rheumatologist advised I should come off the medication asap - if possible in 7 months. I managed to get down to 25 mg and then the symptoms of GCA reapprared and I had to go back to 30 for a while. I am now down to 12.5 mg, trying to reduce to 10mg over a period of 7 weeks but feeling very tired, confused and like a zombie most of the time. The lowest dose of pred, tablets at my Pharmacy is 2.5mg. - my Dr. says they are not supplied any lower but I read on the Forum that most patients are prescribed 1.0 mg.
Hi Mary. I've been prescribed 1mg as I've been cutting 1mg down every fortnight I'm also feeling very tired, totally high & can't focus properly also had slight tension headaches too. They are awful & can't wait to stop fully. X
I live in the United States, and have only been prescribed 5 mg and 1 mg tablets of Prednisone. I cut them in half, when I need 1/2 mgs.
Where are you, Mary?
Hi Mary, if you are taking the coated tablets, red 5mg and brown 2.5mg, those are the only sizes. They are supposed to protect your stomach as the coating means they get down to the gut before they are absorbed. They cannot be cut. You can get uncoated ones which can be cut and they come as 1mg and 5mg. There is a more modern product called Lodotra in Europe and Rayos in the US, which comes as 5mg, 2mg and 1mg. It has a special patented moderated release coating, however in UK it is only available on the NHS for rheumatoid arthritis, although some people in UK have got it for PMR on private prescription. In UK it is 1.66 pounds sterling per tablet irrespective of the size if you pay for it privately.
Hello Mary ,I live in Hertfordshire GB and I have been subscribed 5mg and 1 mg .Every time I drop it is half a mg ,even At that dose I get withdrawal for a few days and this time having dropped from 12 to 11.5 mg After to weeks have had to go back upto 12 mg because of a flare up .After two weeks I will drop again and keep my fingers crossed .that I can then drop another half to 11 mg ..It has taken me five months to get to where I am today .Hope that is of some help .The general advice it appears from this forum is to decrease as slow as possible ,that way you hopefully will get there sooner .Good luck Carol
and these little ones can be cut in half with a tablet cutter which I have done> I'm on 6.5mg and 7mg alternate days for weeks before trying to get down to 6.5mg every day, then 6.5mg and 6mg.
There difinitely as all have said on here is 1mg....but my doctor let slip that 1mg are more expensive!! that might be why they don`t want to prescribe them....
Just one correction - GCA isn't an infection, it is inflammation probably due to an underlying autoimmune disorder which is ongoing. Recent reseach showed that there is still evidence of inflammation present after a full 6 months of high dose (over 20mg) pred. Please be very aware of any return of the symptoms because horrendous as some of the side effects are - they are generally preferable to some of the long term effects of untreated GCA.
As the others have said, in the UK ordinary white non-coated pred is available in 5mg and 1mg and the 1mg is very useful for reducing slowly. You didn't say what side effects you suffered - did you have gastric problems and were you given enteric coated pred as that comes in 5mg (red) and 2.5mg (brown)? It is difficult to mix them as they are absorbed at very different rates but many patients have mixed them successfully in the past to reduce in 1mg steps, even 1/2mg steps, but you must not cut the enteric coated pills - that removes the point of the coating and might cause gastric problems.
You say you are reducing over 7 weeks - I assume that means you are using a reduciton plan similar to the one you will find in posts 4 and 5 of this thread:
https://patient.info/forums/discuss/pmr-gca-and-other-website-addresses-35316
You could try slowing things down even further, repeating stages a few times. I would taken nearly 6 weeks to reduce 1mg - I'm on Lodotra and can't cut them either and am very sensitive to dose changes so I have to be very slow - by my standards you would need more like 12-15 weeks for 2.5mg. I would be surprised if your problems are due to adrenal problems yet as you are still above the amount that is thought to be equivalent to what the body makes itself. But your rapid reduction after several months on pred has probably upset your entire HPA axis (hypothalamus, pituitary, adrenal feedback system). Has your doctor checked you for thyroid problems or pre-diabetes due to the pred?
While being on pred can be very unpleasant, it doesn't excuse us from other illnesses cropping up as well.
I am on 7mg - 5mg +2mg per day and hope to drop back to 5mg in a week or two, after having to go back up with temple pains again. I look forward to the day I can say Goodbye to prednisolone but know it will be sometime in the far future. When I was diagnosed I was warned it would be a long job, three to four years!!
Well, in a sense he is right: 5mg tablets are £1.33 for 28 tablets, 1mg tablets are £1.18 for 28 tablets, so 2mg costs more than 5mg. However, in the great scheme of things it isn't that much is it?
If you need a dose that is between 5 and 10 you need 1mg tablets to make up the dose. And if you are lucky enough to be able to reduce 1mg at a time to 7mg and it works but 5mg too far - being on 7mg rather than 10mg is reducing your risks of longterm side effects considerably. So they are worth every penny.
Sorry Mary. I know what you are going through as I went through that. The drugs effects will go away eventually.