Posted 12/23/2007 12:44 PM (GMT -6)
Unless you are taking prednisone for only 10 days or so the taper should be very slow. Even on a short term treatment pred is tapered, not just stopped at full dosage.
The dosage appropriate for you depends on your symptoms and their severity. For a bad case of lupus or many other auto immune diseases 60 mg is typical. Tapering can take months and in some cases years. I have been taking pred for over 2 years starting at 60 mg for about 4 months but I am now down to only 5mg. Also take imuran and have tapered on that from 150mg to onoly 50mg.
When you take high doses of pred your adrenal glands stop producing cortisone (same as pred). They produce 5-10mg of it daily so your body requires it. As you taper to low dosage you adrenals will begin to produce again in most cases. Most doctors prescribe enough pred long enough to "tranquilize" your immune system and then taper. Many will start you on some other med that is more tolerable on a long term basis. Most of these meds are much slower acting than pred and some, like imuran, can take 6-9 months to become fully effective.
Here is a link about prednisone in general.
What I have discovered is that tapering is a slow process. From 60mg the taper starts with 10mg increments about every month....assuming there are no problems. Then it is reduced to about 5mg monthly to about 20-25mg. Then it is reduced at 2.5mg every 1-2 months until 10mg. Below that it is 1mg every month or two.
Some doctors prescribe alternating doses but I have read that those are less effective. There is lots of good information on the web on the subject but there is also a lot of disagreement on how to taper. Some of that is caused by the fact that each patient is unique and reacts to the meds and the taper in a different manner. In other words, there is no abosolute way to do it.
My taper has gone smoothly but my docs now want me to remain at current doses for a year before further reduction. Anything below my current doses would be sub theraputic and my docs think I need another year to see if I can get off meds entirely. Can't wait and hope it will be my Christmas present next year.
Mixed connective tissue disease (systemic lupus, scleroderma, polymyositis), Raynauds phenomena, Hypertension, Barrett's esophagus.
Meds: prednisone 5mg, 50mg imuran, Lotrel 40/5mg, maxide 37.5/25mg, folic acid, potassium, aciphex 20mg, multi vitamins.
Maintain your optimism and you can beat the odds.
"Although the world is full of suffering, it is also full of the overcoming of it." Helen Keller