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Doctor insights on: Prednisone Taper Scedule

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Dr. Thomas Namey
2,560 doctors shared insights

Prednisone (Definition)

Prednisone is a synthetic cortisone. The body makes cortisone, a natural hormone made in adrenal glands. The body converts it to Hydrocortisone to become active. 25 mg of cortisone has about same effect as 5 mgm prednisone. The average person would produce 3-6 mg of pred daily. So why use a substitute? The synthetic has more anti-inflammatory effect; but has less effect ...Read more


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Is it possible to struggle with prednisone taper while on dmard? Does it make the taper less painful or is it supposed to make the taper a breeze?

Is it possible to struggle with prednisone taper while on dmard? Does it make the taper less painful or is it supposed to make the taper a breeze?

Should be possible: If the dmard is as effective as intended then a slow taper of Prednisone should be successful. The inability to taper Prednisone to low levels indicates that that current dmard therapy needs to be modified. ...Read more

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I've been on prednisone taper but had to increase dose due to withdrawal symptoms. At higher does symptoms are re-occurring. Cause for concern?

I've been on prednisone taper but had to increase dose due to withdrawal symptoms.  At higher does symptoms are re-occurring.  Cause for concern?

Yes: Regardless of the reason you were taking Prednisone in the first place, chronic use of Prednisone is not recommended as it is known to cause glaucoma, insomnia, low bone density to only name a few things. Taper slowly if you need, but taper off the steroids over time. The longer you have been on it, the slower the taper needs to be. ...Read more

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I just got off a prednisone taper 5 days for asthma. I have had increased anxiety during the week is this fairly common with a prednisone dose?

I just got off a prednisone taper 5 days for asthma. I have had increased anxiety during the week is this fairly common with a prednisone dose?

Emotional response: It is not super rare to have an emotional response to prednisone and anxiety is possible. If due to medication, however, this should resolve soon after stopping the drug. ...Read more

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On prednisone taper for connective tissue disease. Have both good & bad days on 5 mg/day. 4 mg not tolerated. Might alternating 5 mg an 4 mg help?

Taper steroids grad: If significantly symptomatic on 5 mgm pred, may not br ready for taper. Talk to you doctor about a disease modifying agent (dmard).
Tapering on divided dose (2-3 times daily) works best. Can go from 5 mgm to 4 1/2: 2.5 in the am and 2.0 mgm in evening. The 2.5 mgm dose is half a 5 mg tablet. Sometimes a shift to methyl-prednisone (medrol) works better since its more durable (longer 1/2 llife). ...Read more

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Iga low, IG subclass 2&4 very low, total IG low, subclass 1&3 low normal. Could prednisone taper 1wk before labs or zonisamide cause these results?

No: A few days or weeks of Prednisone will not effect immunoglobulin levels. Neither will zonisamide. If you are having infections, you should have a more complete evaluation of your immune system. ...Read more

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I just finished taking a prednisone taper and antibiotic yesterday (8/9/17) and I would like to drink this Saturday (8/12/16), is this safe to do?

I just finished taking a prednisone taper  and antibiotic yesterday (8/9/17) and I would like to drink this Saturday (8/12/16), is this safe to do?

OK in moderation: A lot of people have come to believe alcohol and antibiotics don't mix. With rare exceptions, it's an urban myth: alcohol in moderation is OK with antibiotics and will not interfere with infection cure. Same with prednisone, except that both prednisone and alcohol can irritate the stomach. Taking antacids or drinking only with food might be helpful. If in doubt, check with your doctor. ...Read more

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How long after ending a 12 day prednisone taper will it take for all side effects , eg water retention, to go away?

How long after ending a 12 day prednisone taper will it take for all side effects , eg water retention, to go away?

1-2 weeks: A lot depends on the dosing of prednsone you were taking. Usually water retention effect going away in 1-2 weeks.
Some of the other side effects such as stretch marks, hormonal changes etc may take longer. ...Read more

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Taking a 16 day prednisone taper. 40mg x4, 30mg x4, 20mg x4, 10mg x4. On an insulin pump. How should I adjust my temporary basal rate?

Taking a 16 day prednisone taper. 40mg x4, 30mg x4, 20mg x4, 10mg x4. On an insulin pump. How should I adjust my temporary basal rate?

Basal rate.: Tough call!
Start by increasing you 24 hour insulin by about 5% and check your blood sugar 2 or 3 times a day. If that does not control your blood sugar properly keep changing the dose at the above rate till your results are OK.
You may have a high blood sugar for a few days but this should not have any major concern until you finish your prednisone dosing and you gradually decrease your insulin. ...Read more

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Any tip make a prednisone taper below 5 mg less taxing? I'm REALY struggling & it's affecting my job. I told my doctor & he just said keep tapering.

Any tip make a prednisone taper below 5 mg less taxing? I'm REALY struggling & it's affecting my job. I told my doctor & he just said keep tapering.

Prednisone Taper: Unfortunately, some of us don't really listen or understand what our patients are telling us. Look Doc, I can't function at all with my prednisone under 5 mg. I don't know how long or why you are on prednisone. If you can't make him listen and it is affecting you like that, then maybe you need a second opinion. That's how I would handle it. ...Read more

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My lupus rheumMD has me working w/endocrineMD 2help w/prednisone taper below 5mg even tho adrenal fxn is normal.Foggy,achy,stiff. Endo or rheum issue?

My lupus rheumMD has me working w/endocrineMD 2help w/prednisone taper below 5mg even tho adrenal fxn is normal.Foggy,achy,stiff. Endo or rheum issue?

Lupus? osteoporosis?: Steroids can cause severe calcium demineralization of the bones hence if you are able to tolerate the steroid taper it is good. You should be taking calcium with Vit D supplements I assume, prescribed by ur PCP/Rheumatologist. Achiness and stiffness though could be from Lupus, pl. see whether calcium supplemets if you are not on so far, are helping you in the future. Get your Vit D level checked . ...Read more

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I have a sinus infection for the past four days and I started 800mg augmenten today with my flownase but need to add my prednisone taper. ?

I have a sinus infection for the past four days and I started 800mg augmenten today with my flownase but need to add my prednisone taper. ?

Why taper?: With Flonase and Augmentin, (amoxicillin and clavulanate) plus avoiding all fragrances, aerosols, heating and cooking oils that irritate respiratory tract membranes, and a little time, you may not need oral steroids. Wait awhile first. Why risk the steroid weight gain if you don't need it? If there is another reason for your desire for steroids, let us know. I almost never prescribe oral steroids for a simple sinus infection ...Read more

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Acth test normal.why did i get spacy, confused,blurry vision, salt cravings w/prednisone taper from 6 to 5 mg .Sx improved w/increasing salt,h20. ?

Acth test normal.why did i get spacy, confused,blurry vision, salt cravings    w/prednisone taper from 6 to 5 mg .Sx improved w/increasing salt,h20.  ?

Wrong test: Hi. Neither measuring ACTH nor doing an ACTH stimulation test is a test for adrenal sufficiency during a prednisone taper (I'm not sure what you're referring to by "ACTH test"). In no case would the pred taper make you mineralocorticoid (aldosterone-the salt hormone) deficient. If your taper is going too fast based on clinical grounds, it has to be slowed down - there are no lab tests for that. ...Read more

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How to help 2ndary adrenal insuff during prednisone taper.Down to 5mg & feel foggy,exhausted,& thirsty all the time.Home remedies,diet?Will it go away

Call Doctor now: It appears that you are not producing enough cortisone to support your body function. Suggest that you go back to the dose of prednisone which did not cause these symptoms immediately until you can get hold of your doctor. Adrenal insufficiency is a serious issue and t everyone's adrenal function recovers at a different rate. ...Read more

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What can I do to keep my immune system up. I have Sarcoid of the liver and RA. I have 2 infections since being on prednisone taper for first time.

What can I do to keep my immune system up. I have Sarcoid of the liver and RA. I have 2 infections since being on prednisone taper for first time.

Immunosuppression: Having two chronic diseases, one is autoimmune, both need prednisone and other meds that cause immunosuppression, having two infections is not uncommon, at any rate you may want to wear a mask while in crowded places, you need to avoid anyhow, stay at a distance from people with colds, don't change diapers for kids who recently received oral polio vaccination, rest, fresh air, fluids,balanced diet ...Read more

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Have lupus.Struggling with prednisone taper below 5mg (fog,muscle aches,stiff).Adrenal fxn normal.RheumMD referred me to endo to help w/ taper.Common?

Prednisone: If it's necessary to stay on 5 mgs of prednisone daily to suppress your lupus activity, this is considered a mild dose with little adverse side effects. However the least amount of prednisone needed, the better. In view of your lupus, I feel that the rheumatologist is better qualified to determine the proper prednisone dose to minimize the lupus activity and damage. ...Read more

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On prednisone taper below 6 mg, can withdrawal symptoms simply be mini flare up of my lupus symptoms (pleuritic chest pain, muscles aches, etc)or no?

On prednisone taper below 6 mg, can withdrawal symptoms simply be mini flare up of my lupus symptoms (pleuritic chest pain, muscles aches, etc)or no?

Yes: Withdrawal from steroid treatment may take several "tries" before its successful! Don't be discouraged!

Hope this helps!
Dr Z ...Read more

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Have lupus.Struggling w/ prednisone taper below 5mg(head fog, pleuritic chest pain,body aches).MD said it's withdrawal symptoms & best to push thru sx.True?

Rheumatologist: Prednisone dose of 5 mgs or less is a low dose and since you're having pleuritic pain and other discomfort,your lupus may not be controlled. A rheumatologist is best qualified to evaluate and treat you. ...Read more

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Can you develop osteonecrosis /avascular necrosis by being on 40mg prednisone taper over 8 mo period? Sle. Hip/knee pain severe. Off 2mo now worse.

Can you develop osteonecrosis /avascular necrosis by being on 40mg prednisone taper over 8 mo period? Sle. Hip/knee pain severe. Off 2mo now worse.

Yes, use of Steroids: Can result in avn. See an orthopod to have it diagnosed and staged, so treatment could be started.
Good luck. ...Read more

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85% neutrophils and 9.9% lymphocytes and 12.9 WBC (normal range 4.0-10.0) I have rheumatoid arthritis, and was recently on a prednisone taper.

85% neutrophils and 9.9% lymphocytes and 12.9 WBC (normal range 4.0-10.0) I have rheumatoid arthritis, and was recently on a prednisone taper.

Steroid effect: Can cause increased neutrophils, and decreased lymphocytes, will take its time, no need to worry ...Read more

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How long will I withdraw off iv prednisone after having 5 doses and no taper down?

Probably won't: Adrenal insufficiency (steroid withdrawl) is usually only an issue after long term therapy. Doses less than 60 mg for 5 days or less don't usually require a taper. ...Read more

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I just got off 5 days of prednisone 20mg no taper off and I'm experiencing withdrawals what can I do?

Withdrawal : It is very unusual to get withdrawal on a five day course of steroids. I suggest you do nothing and just wait it out as it should rapidly disappear ...Read more

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Is it possible to feel symptoms return (or withdrawal) in a 1/2 mg taper from 5.5 mg to 5 mg after several days? I've been on prednisone for 1 yr?

Withdrawal: After being on prednisone for a year it is very difficult to come off of the steroid without experiencing withdrawal pains of some sort ...Read more

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Recov from pnemonia.What's standard for tapering down from prednisone? Had 60mg for abt 2 weeks, 50mg week3, 40mg week4. Today Dr says stop pills.

Mgt: That should be fine, another option is to continue for one more week and to lower the dose from 40 mg every day to then discontinue it. If you notice any symptoms off the Prednisone, please let your physician know. ...Read more

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