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marta
09-24-2010, 05:08 AM
Hi gang,
How long can you take pred before you can cold turkey stop without having to wean? My dad was just put on it for kidney problems and I'm wondering how long he can take it before stopping abruptly without causing any damage. Thanks o'wise ones!!!

Jack
09-24-2010, 05:38 AM
Not sure what the official guide lines are, but I would think anything more than a week must raise the possibility of reduced adrenal function and introduce the need to taper the dose before stopping. After a period of months, stopping may become problematical even with tapering. A great deal probably depends on the dose too.

pberggren1
09-24-2010, 05:41 AM
I started back on Pred at 50mg for 2 weeks back in January and quit cold turkey.

Jack
09-24-2010, 05:43 AM
Sounds a bit scary to me, but I've never been in that situation so have not investigated. ;)

marta
09-24-2010, 07:07 AM
I've heard a couple of weeks and then saw something online for a month, but that makes the hairs on the back of my neck stand up. I know that the body can go into shock if it's too long, and it can KILL ya.

Gracias Amigos.

pwc51
09-24-2010, 07:33 AM
Can't advise on initial period - what I can say is that I have been on Pred for 14 months - starting at 60mg and reducing to 7.5mg a few months back. I have stabilised there and have now been given a 7 week program to reduce that to 5mg - tortuously slow when at this level!

marta
09-24-2010, 07:35 AM
No kidding that's torterous. I'm reducing 2.5mg every two to four weeks (it's up to me - if that's not the most hillarious thing ever) I know that the super slow stuff comes after 10mg.

pberggren1
09-24-2010, 08:46 AM
No kidding that's torterous. I'm reducing 2.5mg every two to four weeks (it's up to me - if that's not the most hillarious thing ever) I know that the super slow stuff comes after 10mg.

I would not say that is hillarious Marta because I would suspect Your doctor gave that choice to you based on how you feel one day to the next and one week to the next. I would say that if you feel you can do it faster I would go the fast rout, but like you said when getting to 10mg I would reduce by 1 or 2mg every month. Every doctor is going to have a different opion on this but most are goint to be on the same page that you have to taper slowly after being on the higher doses for 2 months or more.

I was going to ask my doc today about this but I forgot. Sorry Marta - we had a long visit, almost an hour, and we got talking about so many different things and he likes to explain everything in great detail.

Sangye
09-24-2010, 09:50 AM
A JHU endocrinologist told me that adrenal suppression occurs after taking a minimum of 20mg pred for at least 3 weeks.

pberggren1
09-24-2010, 10:37 AM
A JHU endocrinologist told me that adrenal suppression occurs after taking a minimum of 20mg pred for at least 3 weeks.

Quit speaking Greek. What is an endocrinologist?:unsure:

Doug
09-24-2010, 11:27 AM
The Endocrine System: What is an Endocrinologist? (http://www.hormone.org/Public/endocrinologist.cfm)

Sangye
09-24-2010, 11:58 AM
Phil, do you know how to Google? :w00t:

marta
09-24-2010, 01:35 PM
:lol::lol::lol::lol:

pberggren1
09-24-2010, 04:05 PM
Phil, do you know how to Google? :w00t:

Yes, but it is better to ask you.

Psyborg
09-27-2010, 06:26 AM
I'm in the process of tapering down to twenty (-5 per week from 40 to 20). I'm down to 30 now and finding that I'm having some pain in my knees, wrist, and the side of my hand (one of the weird places i got pain originally). Is this just a normal part of tapering, or do I need to be concerned? It's not nearly as bad as it was before, but obviously anything reminiscent makes me a bit nervous. I do feel a bit better today (third day at 30) so I thought maybe I'm going to feel a bit of an issue at each drop off maybe? Honestly after the taper from 40 to 35 I actually felt better, so this is a little disappointing.

Jack
09-27-2010, 06:46 AM
It might be worth pausing for a week or two at the dose you are now on to see if things improve.

elephant
09-27-2010, 08:48 AM
I agree with Jack. Slow and steady...

misskay
09-27-2010, 09:13 AM
Pysborg... I'm in the same boat. Been tapering from 80mg. Am now on day 4 at 20 mg. I've had the same issues with returning pain. It isn't near as bad as originally, but worse than I want. Have been tapering at the rate of 5 mg every 2 weeks, but am sure we will now go at much smaller increments since we've hit the 'magic' 20mg point. Have been feeling generally crappy the past 3 weeks or so. Almost as bad as before DX... NOT a happy camper.

Sangye
09-27-2010, 10:15 AM
Psyborg, if I read that right you're staying at each new dose for 1-2 weeks? That's a good idea. If it's pred pain, it'll ease up after a few days at the new dose.

Misskay, when's the last time you had blood work or saw your rheumy? You need someone to evaluate if it's just normal pred-tapering bleh or Wegs stirring up. If I remember correctly you were at 80mg for quite awhile. It's likely that you're going to feel lousy getting to lower doses.

Psyborg
09-27-2010, 10:52 AM
Pysborg... I'm in the same boat. Been tapering from 80mg. Am now on day 4 at 20 mg. I've had the same issues with returning pain. It isn't near as bad as originally, but worse than I want. Have been tapering at the rate of 5 mg every 2 weeks, but am sure we will now go at much smaller increments since we've hit the 'magic' 20mg point. Have been feeling generally crappy the past 3 weeks or so. Almost as bad as before DX... NOT a happy camper.

Sorry to hear that, hopefully you'll feel better soon.

Sangye, for 40 down to 20 I am supposed to be 1 week at each reduced dose. If I feel worse tomorrow I'll contact my Dr again. I *think* it's pred pain but it feels very similar to the original pain, if lower intensity.

Hopeful
09-27-2010, 11:33 AM
Psyborg, though I haven't been on massive doses of Pred, I was at 25 mg for 6 months. I think everyone has that magic threshhold where reducing at your regular rate makes the wg symptoms reappear, albeit not as bad as before diagnosis. Mine was when I reached 15 mg. After a week at 15, the doc upped it to 17.5 for a few weeks until I stabilised, then I went down 1 mg per week or two (doc let me decide) until I reached 10mg where I now reside. Thanks everyone else for the warning on weaning off the rest of the way!

elephant
09-27-2010, 11:52 AM
Hi Hopeful...I was wondering how long are you staying on 10 mg? Are you on any other medicines like cellcept, methotrexate, ect....just curious.

marta
09-27-2010, 01:47 PM
I'm in the process of tapering down to twenty (-5 per week from 40 to 20). I'm down to 30 now and finding that I'm having some pain in my knees, wrist, and the side of my hand (one of the weird places i got pain originally). Is this just a normal part of tapering, or do I need to be concerned? It's not nearly as bad as it was before, but obviously anything reminiscent makes me a bit nervous. I do feel a bit better today (third day at 30) so I thought maybe I'm going to feel a bit of an issue at each drop off maybe? Honestly after the taper from 40 to 35 I actually felt better, so this is a little disappointing.

Psyborg, I say it again, you and I (and Miskey) seem to be on parallel paths. That's how I felt when I went to twenty. My regular doc told me to up the dose to 35 for three days and then go back down. My rheumy told me to split upt the pred in two and see if that makes a difference. I didn't do either because by the time I got to them (or they got back to me) the symptoms had stabalized and are now gone - the symptoms stuck around for a week and a half or so - then started to mellow out slowly. I've been told after 20mg to go down 2.5mg every two to four weeks - up to me based on how I feel - and held at 20mg for three weeks. I'm starting my second week of 17.5 today. I think, barring any unforeseen yuckiness, I'm going to drop 2.5 next Sunday.

I'm totally doing what Jack is talking about in his post, and, touch wood, it's working. I don't want to jinx myself.


It might be worth pausing for a week or two at the dose you are now on to see if things improve.

elephant
09-27-2010, 08:24 PM
That is how I tapered starting with 20 of prednisone....every two weeks...tapered down to 2.5...So it went like this 17.5, 15, 12.5,10. The tapering below 10 has been a struggle. It has been trial and error...now I am tapering ( starting at 10 of pred) 1/2 mg every four weeks. Remember everyone is different...some of you will be able to taper 1 mg every month...you just don't know!

marta
09-28-2010, 03:13 AM
I was thinking about this yesterday when I was trying to cut my crumbly little 5mg pills in half. How on God's green earth do you cut them to 1mg or even better to .5mg - I don't get it. I heard - I might be wrong - that they only make them in 50mg and 5mg. You'd think that since pred is used by so many people for so many things and needs to be tapered always - almost always - they would manufacture smaller increments.:predrage:

Sangye
09-28-2010, 04:00 AM
ROTFL-- Marta, pred comes in 1mg, 5mg, 10mg and 20mg. (I've never seen 50mg, but maybe it exists). It really should come in 0.5mg since so many people have to cut 1mg in fourths.

elephant
09-28-2010, 04:22 AM
I have two big bottles filled with 1mg...then I break them in half. Sometimes I don't cut them perfectly..:(:ohmy::rolleyes1:

pberggren1
09-28-2010, 04:53 AM
ROTFL-- Marta, pred comes in 1mg, 5mg, 10mg and 20mg. (I've never seen 50mg, but maybe it exists). It really should come in 0.5mg since so many people have to cut 1mg in fourths.

In the boonies, where I am, Pred comes in 50, 5, and 1.

Psyborg
09-28-2010, 05:17 AM
I've got some 2.5mg pills too. I've heard that cutting pills isn't a great thing to do as the medication is not necessarily evenly distributed through the pill (I think most of the pill is filler?). Not sure if that's just to sell me more pills though :)

elephant
09-28-2010, 05:20 AM
I should ask a pharmacist that question. I cut my atenenol( tenormin) daily in half. :ohmy:

Jack
09-28-2010, 06:06 AM
You can buy pill cutters so I would guess that it must be OK to divide them up. I've certainly done it plenty of times.

Sangye
09-28-2010, 06:17 AM
Psyborg, I've never heard that. Most pills come scored so they can easily be cut in half. I don't think the manufacturers would do that if it weren't okay.

Sometimes I've obsessed over a pill that didn't break exactly in half, but when I really look at the miniscule amount of the dose that was added or lost, I see it's just silly.

Jack
09-28-2010, 06:20 AM
Sometimes I've obsessed over a pill that didn't break exactly in half,
Get a grip Sangye! :smile1:

Sangye
09-28-2010, 07:20 AM
LOL-- I should say that I obsess about it when the dose is really low-- ie, cutting a 1mg pill in half or fourths....

marta
09-28-2010, 07:56 AM
You guys!!! Everytime I come on this forum, I'm guaranteed a laugh - at least one laugh (usually more).

Psyborg
09-28-2010, 08:12 AM
I decided to look it up and it appears that this might be the manufacturers making the suggestion (accept in a few cases where exact dosage is extremely critical). Interesting, as I couldn't remember where I heard that in the first place :p

drz
09-28-2010, 08:16 AM
I just went from 25 to 20 so that seems to be a common number today. I get meds in 10 mg tabs and 2.5 mg at present. I have pill cutter next step might be a 10 and three 2.5 pills. Do they come in 5 mg size?

I had some slight pain in arches when i went to 25 but it went away in a few days. Lots of cramps in legs but that may not be related to tapering.

Sangye
09-28-2010, 09:18 AM
Psyborg, I'm really skeptical. Every doctor tells you to cut pills in half, and it's on the bottle label if it's the indicated dose. I can't imagine they'd encourage it if it were a real problem.

Hopeful
09-28-2010, 09:35 AM
Hi Hopeful...I was wondering how long are you staying on 10 mg? Are you on any other medicines like cellcept, methotrexate, ect....just curious.

I've been on 10 mg since January 25th. I was on Aza at the time and not making progress towards remission. Got a new doctor (immunologist) in June and was put on mtx. Mtx is working and I feel as if I'm approaching remission, so I'd love to get off the Pred!

elephant
09-28-2010, 10:01 AM
That is wonderful that Methotrexate is working for you. I am sure once your in remission your doc will be decreasing the prednisone.

Psyborg
09-28-2010, 10:41 AM
Psyborg, I'm really skeptical. Every doctor tells you to cut pills in half, and it's on the bottle label if it's the indicated dose. I can't imagine they'd encourage it if it were a real problem.

I'm guessing you are right.

jola57
09-28-2010, 12:29 PM
I guess in the olden days the mixing of pills made it so that the medication might not have been uniformly placedaround thee pill and so if you cut up the pill in 1/2 , both halves might not be equal in strength. These days with the way they produce the pills I think that worry has been taken away.

freakyschizogirl
10-10-2010, 06:16 AM
I have info on this.
I did Med training as part of my job. It is safe and OK to cut pills.
They do have a lot of filers in them but generally speaking the active ingredient should be evenly distributed.

Pill cutters are the best thing to cut them with tho.

DuaneHart
10-12-2010, 11:54 AM
I started at 60mg pred a year and a half ago and have been trying to get off it ever since. Last spring I made it to 10mg when my uncerative colitis came out of remission after 13 years. They increased the dose again and have been decreasing slowely. I am now down to 9mg and decreasing by 1mg every four weeks. I am still taking methotrexate (just started the injectable form and tolerate it much better) and have had 3 infusions of Remicade. I am actually feeling the best that I have in 2+ years so hopefully things are on the right track! I think that the slow, slow taper is the key.

elephant
10-12-2010, 11:58 AM
I am taking it slow too. I am down to 6 1/2 mg of pred and I stay on that for four weeks and then move down to 6 mg November 1 and then stay on that for 4 weeks. I am hoping to get off it completely.

Sangye
10-12-2010, 12:01 PM
Elephant, is the Bactrim keeping your sinuses okay?

elephant
10-12-2010, 10:12 PM
I suggested to the Rhuemy in August that we need to double up on the Bactrim ( trial and error) , I was taking Bactrim 400/80 every other day. So now I am on Bactrim DS every other day and I feel better. My sinuses are not perfect, but improved. Hopefully this will last. Thanks for asking.

Sangye
10-13-2010, 12:02 AM
That's awesome. Much better to take more Bactrim and less pred.

misskay
10-13-2010, 02:52 AM
I was taken down to 15mg of Pred this past weekend... and am scheduled to drop to 10mg in another 10 days... some joint pain has returned and my knees and elbows are a little swollen, but so far so good... *crosses fingers*

Also, told to doc I wasn't going to take the Celebrex he gave me due to the risks involved... he suggested Mobic. But since they are basically the same thing, I declined the offer... guess I'll just grin and bear it. :unsure:

Sangye
10-13-2010, 03:21 AM
Misskay, the drop from 15mg to 10mg pred might be too big, especially if you're already having joint problems. I'm glad the drop is 10 days away-- that'll give you time to adjust and see if the pain and swelling clear up on their own.

elephant
10-13-2010, 03:55 AM
Misskay , when I was on prednisone 15 mg the Rheumy tapered me to 12.5 mg first, and I stayed on that for two weeks...then went to 10 mg and stayed there for 4 weeks. After 10 mg of prednisone the taper is much slower.

misskay
10-13-2010, 04:15 AM
Seems like a pretty big drop to me also, but he wants me on as low a dose as we can or off it completely as soon as possible. Told me that if the symptoms got any worse, original symptoms returned or if anything new cropped up when we drop to 10mg... to immediately go back to 15mg and call him asap. Guess I'll just wait and see... so far I'm uncomfrtable... but can still manage. It's only been a few days... so hoping for the best.

jola57
10-13-2010, 03:01 PM
Misskay, do watch out for any out of norm feeling. i dropped too fast last year and flared badly enough to go back on cyclo for a year. I got down to 5.5 mg by skipping by 1.5 every 2 weeks. This time I went down by 1mg from 10mg on, every month and a half, and now I am at 4mg. From now on its 1/2mg every 2 months. I am not taking any chances. I go up 1mg if I realy feel out of sorts.