My rheumologist wants me to start reducing from 7.5mg to 5 mg. I am so scared I will start to feel bad again. I have been at 7.5 for two months. Any recommendations on how to best reduce. Thank you!
From what I've read the best way is the dead slow taper. I haven't gotten down that far but from reading all these postings its seems you can't go too slow.
I wrote down the dead slow taper so I don't have a link to send it to you. If you ask someone to send it, I'm sure they can.
Why does he want you to reduce are you on other meds. I understand under 10 mg pred is pretty safe I know people have been on 7.5 for 10 years plus. I take it too if I try to reduce i sieze up its terrible.
What ever you do, don't drop too fast. Try the 'dead slow, nearly stop' method. It's in the pinned posts somewhere.
Im on methotrexate and dropping .5mg a week and it's still hitting me hard.
Anything I have read about tapering below 10mg of Pred with PMR has clearly stated 'no more than 1mg per month'.
Personally, I found that reducing by a half mg a month prevented minor flare ups. Even then, I sometimes had to increase temporarily, depending on symptoms. You know your body best, so if you are concerned, then it's best to go slow- no more than 1 mg reduction per month.
I think the key here is "start" reducing. You can do that, IF your symptoms are currently under control Do the dead slow nearly stop method which means you will sart your taper by one day at 7 mg, then six at 7.5, another day at 7 mg and five at 7.5, and so forth, a day less at the old dose each time. This is all spelled out somewhere but I bet if you just google dead slow and nearly stop prednisone you will find it! Once you finish that step and you are feeling well, the next step will be to start a new dose of 6.5, old dose now being 7. And so it goes. Good luck! BTW I've been following this regimen and it took several months but I am nearly at 5 (still have a couple more doses of 5.5 and then I'll stay on the new dose a few days to make sure it really is enough).
Thank you! My prednisone is in 2.5mg increments. I will have to ask for 1mg tabs.
Do you have .5mg tablets or do you split tablets?
I am taking Metholtrexate too and my rheumatologist is hoping I can get down below 7.5 mg
Thank you!
I've been trying to think of a way of coming up with 1/4 mg. I think a 2.5 mg tablet would have given me 1.25 split in half. But I only get 1 and 5 mg. Perhaps one quarter of a 5 will be easier to create than one quarter of a 1, which is already a midget size.
There are people who manage the drops using 2.5 mg tablets by, in fact, cutting them - but you can only do that with non-coated tablets. The taper can be more finely tuned when dealing with slightly larger drops by alternating dosages somehow. Sure that has been spelled out somewhere.
So you could take one of your 2.5 tablets, cut it in half, and presto you have a dose of 6.25 if my math is right, which isn't perfect but better than a sudden drop to 5.
Absolutely your tablet's size should not be keeping you from taking an appropriately incremented dose. Your doctor should be prescribing 1mg tablets at this point!
Has your methotrexate prescription been timed with this abrupt reduction in pred dosage? Even with that, I would not hesitate to make any small needed adjustment to dosage, short term, in order to stay clear of the crippling effects of pmr, since the patient is the only one who knows the real-time level of symptoms. I don't expect to be pain-free, but when things get really bad I immediately take 1mg extra at whatever time of day that symptoms become troublesome. Be sure to keep your doctor informed as to any sustained adjustment to dosage that you require.
I have both 5 and 1mg tablets. And as Dan mentioned, the reduction was timed to coincide with me taking methotrexate for (at least) 6 weeks before I got below 10mg.
I'm struggling a bit this week and I'm convinced it's because I'm asking my adrenals to do some work.
All you can do is give it a go.
Hi i am reducing because my rheumologist is not sure if i have pmr, but she has asked me to reduce slowly using the dead slow nearly stop method(as she was impressed by it, this is Eileens way.) I am at 7mg now reducing to 6.5mg, and have the same reservations as yourself.
As i have been having temporal pain and eye problems she is not ruling anything out, but they need to find out what is wrong with me and can only do this by me not having to take prednisolone.
They will start from scratch when i get there, so i wish you will, take care, regards Mags.
Hi there,
Here is my slow taper plan that is working. You might consider reducing in 1/2mg steps, instead of 1mg. You'll need to buy a pill splitter to cut the 1mg pills exactly in half. Once you get to the next lower dose, you might have to stay there for at least a week before moving lower again.
1 day new dose, 6 days old dose
1 day new dose, 5 days old dose
1 day new dose, 4 days old dose
1 day new dose, 3 days old dose
1 day new dose, 2 days old dose
1 day new dose, 1 day old dose
1 day old dose, 2 days new dose
1 day old dose, 3 days new dose
1 day old dose, 4 days new dose
1 day old dose, 5 days new dose
1 day old dose, 6 days new dose
Good luck,
Shawn
You can get 2.5 and 1 mg tablets
me too. Half a mg at a time is plenty and you can be very clear at exactly what dose you are comfortable or you getting into trouble. It's a wee bit slower but it's not a race! Good Luck!
It depends where you live. We can only get 1 and 5