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How slow to reduce prednislone Options
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Anne-P
#1 Posted : Wednesday, March 09, 2011 9:24:39 PM Quote
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Any one had to reduce their steroids slowly? I have started Humira now and I am meant to reduce down the steroids slowly but the letter from the consultant doesn't specify how slowly, other than it must may need to be very slow or I'll get some horrible side effects.

What have other people done? I'm on 15 mg a day. I am assuming I go down 2.5 mg a week/per 2 weeks, but when do I go down only 1 mg a week?

Having looked through the forum it looks like others have had to do this too, so I'm hoping someone might have some advice on what worked for them. The Humira has certainly made a difference already.

AnneSmile
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Vicky13
#2 Posted : Thursday, March 10, 2011 2:10:26 AM Quote
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Hi Anne,

Glad the Humira's working for you. I've been on and off steroids - prednisolone - for years and years for chronic kidney disease and am on it again now for my RA. In the past I was reducing from a whopping 60mg a day and reduced 10mg a week then down to 5mg and a further week of 5mg every other day. It sounds like reducing yours by 2.5mg a week seems to be sensible and your doc might even say you could do it a bit quicker.

Corticosteroids like prednisolone replace the cortisone our adrenal glands usually produce and you need to reduce slowly so your body catches on and begins producing it's own cortisone again. Adrenal failure can, in extreme circumstances, be fatal which is why we can't just stop taking steroids. Have a look at Addisons Disease on the NHS website for more adrenal info.

I recently realised I was going to run out and so lowered my dose to 5mg for the last 5 days and then had a 4 day gap before I got my new prescription which hasn't caused any problems and I went straight back onto 10mg a day again.

I hope my insomniac rambling is useful...

Vicky x
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rheumatoidymummy
#3 Posted : Thursday, March 10, 2011 8:02:25 AM Quote
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My rheumy makes me go very slowly, 1 mg a month.

So for example if I was on 5mg (like I am am at the moment) this would be how I'd do it:

Month one - 5mg a day
Month two - 5mg one day, 4 mg the next day, 5mg the next day, 4mg the next day - etc for the rest of the month
Month three - 4mg a day
Month four - 4mg one day, 3mg the next day, 4mg the next day, 3mg the next day - etc for the rest of the month
Month five - 3mg a day, etc etc

I don't know why I do it so slowly - maybe because I am on a low dose to start with and keep having trouble getting below 3mg a day?
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jeanb
#4 Posted : Thursday, March 10, 2011 2:13:08 PM Quote
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Reckon that's just about right
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LynW
#5 Posted : Thursday, March 10, 2011 7:58:19 PM Quote
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Hi Anne

As Jean says Ju's advice is spot on! It's okay on large doses above 15mg to drop to 10mg quite rapidly but on the lower doses it has to be done extremely slowly over months rather than weeks.

I can't get below 3mg and have been on that for years now. And that is where I will stay!
Lyn x
My son, Ian, completed the BUPA Great North Run on 15th September running for the National Rheumatoid Arthritis Society (NRAS). You can read his story at http://www.justgiving.com/ianlukewilson

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Anne-P
#6 Posted : Friday, March 11, 2011 5:29:11 PM Quote
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Thanks everyone for your advice. It is much appreciated.

I'll go down very slowly. I hadn't realised why it was so important before - now I'll be very careful.

Anne Smile
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