Maybe this is a silly question...

[katarzena]

...but we often discuss about how important it is to taper prednisone extremely slowly to avoid the shock and flare up. But what when you're on IV prednisone with rituximab every 4 weeks, and you taper off completely of prednisone ands after that receive rituximab (with 100 mg prednisone - in my case)..? Isn't organism suppose to find that a shock to? (hopefully not) but it is still a huge amount of prednisone and after that, second day - no prednisone at all.

[Jack]

The problems with Pred are caused by long term use, although long term might only mean a few weeks for some. This is because it causes the adrenal glands to slowly get lazy and shut down and they can take some time to get going again. In some cases (my own ) the adrenals are in such poor shape that they will never function properly again. If you take a big shot of Pred every now and again, this effect does not have time to happen.

[Sangye]

Jack's got it right. Getting IV pred during a rtx infusion isn't considered "being on pred" so there's no tapering necessary.

You need to take at least 3 weeks of 20mg pred daily to cause the adrenals to shut down and be dependent on the pred.