Posted by pinksharkmark on March 18, 1999 at 13:40:17:
In Reply to: Re: prednisone and muscle pain : taper dosage posted by John on March 17, 1999 at 04:13:12:
Hmmmm..... from what I have seen on this board so far, and from what a neuro from Canada prescribed for me long-distance (I live in the Dominican Republic) the common ten-day regimen seems to look like this : 80 mg for 3 days, then 60 mg for 3 days, 40 mg for 2 days, 20 mg for 2 days, then nothing. Your schedule seems MUCH more shallow a curve than that. My German-trained Doctor here in the Dominican Republic was shocked at the high dosage at the beginning of the taper (80 mg), but he did admit that I was the first cluster patient he had treated. He didn't seem to think the taper schedule I prescribed was too abrupt, but I will admit I didn't ask him specifically about it. Since he was surprised at the dosage level, though, I am sure he would have said something about the tapering off being too steep if he thought that was the case.
He told me that normally with prednisone treatments for any ailment, the trick is to stay on it at the lowest possible effective dosage, and for as short a time as possible if the condition is not chronic, since prednisone tends to decrease the effectiveness of the immune system. I'd never heard the immune system comment before, or read it in any literature I have seen about prednisone. Many other side effects, yes, but nothing about immune systems.
I just finished a ten-day cycle as I described above. On the second day at 80 mg, I started to experience some relief... from three CHs a day to one first thing upon awakening in the morning, and at a reduced severity... maybe only a 5 or 6 out of 10. BUT!!!! .... by the time I got down to 40 mg a day, they were back up to three a day, and back to the 8 - 9 out of 10 range.... or a full 10 if I wasn't fast enough with the Imitrex tablets (100 mg)
Sooooooo..... I started another pred taper yesterday. This time I will try 90 for 3 days, 80 for 3, 70 for 3, 60 for 3, and then taper down at 40 for 2, 20 for 2, 10 for 2, then nothing. Does anyone have ANY comments about my proposed plan? Too long at too high a dosage? Taper too abrupt or too long? Is the case that on a ten day taper, since one is only at a relatively high dosage for a relatively short time, the taper can be more abrupt? For example, if I stayed at 80 mg for a week, would I have to taper more slowly than if I only stayed at 80 mg for 2 days? (Sort of like a scuba diver's decompression tables).
I certainly don't want to risk adrenal cortex failure with a taper that is too abrupt, but I don't wan't to stay on the prednisone for any longer than is absolutely necessary, either.
Comments?