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Thread: Fatigue and Prednisone reduction

  1. #11
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    I would think that alternating pred doses would make determining a flare difficult.
    A straight slow taper makes more sense, but that is just my opinion.

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    Quote Originally Posted by mrtmeo View Post
    I would think that alternating pred doses would make determining a flare difficult.
    A straight slow taper makes more sense, but that is just my opinion.
    I think the idea is that over the two days of alternating, it averages out to a solid amount, and that having a day of reduced dosage, or in some cases no dosage, would sort of "kick start" the adrenals. But that would mainly apply at the lower dosages, when a person had actually been on the medium to higher doses for long enough for the adrenals to have shut down. At the initial higher doses like 40-60mg., I don't really see the point, or that alternating 40 and 60 would be much different overall than just going to a straight 50mg. At that point, the person would still be too sick to think about flaring, since they are already flaring. As for the alternating at the lower doses like 15mg or lower, I think some people on here have successfully gotten off pred that way. I'm a little afraid to try it myself, because I know my adrenals are toast, and I'd be worried about how I'd feel on the low or no dose day. But I might try a moderated version of it and have seen some interesting taper schedules of this kind on here in the past.
    Anne, dx'ed April 2011

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    Quote Originally Posted by annekat View Post
    I think the idea is that over the two days of alternating, it averages out to a solid amount, and that having a day of reduced dosage, or in some cases no dosage, would sort of "kick start" the adrenals. But that would mainly apply at the lower dosages, when a person had actually been on the medium to higher doses for long enough for the adrenals to have shut down. At the initial higher doses like 40-60mg., I don't really see the point, or that alternating 40 and 60 would be much different overall than just going to a straight 50mg. At that point, the person would still be too sick to think about flaring, since they are already flaring. As for the alternating at the lower doses like 15mg or lower, I think some people on here have successfully gotten off pred that way. I'm a little afraid to try it myself, because I know my adrenals are toast, and I'd be worried about how I'd feel on the low or no dose day. But I might try a moderated version of it and have seen some interesting taper schedules of this kind on here in the past.
    I would think an alternating taper would only confuse the adrenals.
    The body likes a gradual reduction in dose when tapering off benzodiazepines, for example, so that it can gradually upregulate the missing item in the body.
    I don't know what the half life of pred is, but I would guess it is not that much different to other drugs.

    Titration works very well with tapering many drugs because the body gets used to the slow lowering of the drug and upregulates the necessary receptors and chemicals.
    The body is always trying to reach homeostasis (balance).

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    Like many of the others, I reduced slowly from 50mg down to the 20mg I am on now, but I tend to blame the cyclophosphamide for the tiredness and lethargy. Some days are good and I make the most of them, when tiredI rest as there is little choice. However I am retired and have few obligations that I can't postpone, so not so demanding on me. Yes "spoons" are a great reminder in balancing our activities whatever they may be.

    Terry

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    Quote Originally Posted by mrtmeo View Post
    I would think that alternating pred doses would make determining a flare difficult.
    A straight slow taper makes more sense, but that is just my opinion.
    It is a pretty standard rheumatological practice to alternate days when tapering down prednisone. I did it from 5 for a month and then to 5 every other day for a a month. I was told all major studies have proven that taper just as effective as the 2.5 every day.
    MikeG-2012

    "You never know how strong you are until being strong is the only choice you have"


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