Question on Pred doasages

  Question for some of you on your Rheumy's dosages. I have found for my pulmonologist he likes 40-60 mgs of steriods, the GI likes 20-40 depending on disease activity and the Rhuemy like to hover at 10 mgs on a long term basis as in months and months while the previous 2 like to taper quicker. What do guys seem to take for a dose on long term basis and are you on aconel or any of those for your bones? Does it work well for you?

i have never actually seen a rheumy before, my nephrologists have always been ok with me just see them for both my kidneys and lupus and they have been great about maintaining both, both my docs and i agree that 5mg is good between flares, i have avscular necrosis in both knees and maybe in my hips and ankles due to the long term steriod use, ( i have been on prednisone for 11 1/2 yrs ranging from 5-80mg), so we try to taper as quick as my body allows when i am in a flare. i am also taking a calcium + D supplement because i had another dexa scan a year or so ago and it was show osteopenia, so i am close to osteoperosis but i am not there yet and hopefully the calcium supplements are working, i was taking fosamax but it was doing awful things to my GI tract and since i was only showing osteopenia my doc said a calcium would be ok.

I take a maintenance dose of 5mg a day but right now I.m on 10mg and started on 160 when I gt sick. I do have osteoporosis. I have had it for several years now. I was taking fosamax but I started having jaw problems and my doctor change me to evista. What are you seeing a pulm. for? my pulm was the one that decided to keep me on 5mg pred. he called it a quality of life but somtimes it takes more like 10 or 15 for my quality of life.

hugs

carol

Unless you are taking prednisone for only 10 days or so the taper should be very slow.  Even on a short term treatment pred is tapered, not just stopped at full dosage.

The dosage appropriate for you depends on your symptoms and their severity.  For a bad case of lupus or many other auto immune diseases 60 mg is typical.  Tapering can take months and in some cases years.  I have been taking pred for over 2 years starting at 60 mg for about 4 months but I am now down to only 5mg.  Also take imuran and have tapered on that from 150mg to onoly 50mg.

When you take high doses of pred your adrenal glands stop producing cortisone (same as pred).  They produce 5-10mg of it daily so your body requires it.  As you taper to low dosage you adrenals will begin to produce again in most cases.  Most doctors prescribe enough pred long enough to "tranquilize" your immune system and then taper.  Many will start you on some other med that is more tolerable on a long term basis.  Most of these meds are much slower acting than pred and some, like imuran, can take 6-9 months to become fully effective.

Here is a link about prednisone in general.

http://www.gihealth.com/html/education/drugs/prednisone.html

What I have discovered is that tapering is a slow process.  From 60mg the taper starts with 10mg increments about every month....assuming there are no problems.  Then it is reduced to about 5mg monthly to about 20-25mg.  Then it is reduced at 2.5mg every 1-2 months until 10mg.  Below that it is 1mg every month or two. 

Some doctors prescribe alternating doses but I have read that those are less effective.   There is lots of good information on the web on the subject but there is also a lot of disagreement on how to taper.  Some of that is caused by the fact that each patient is unique and reacts to the meds and the taper in a different manner.  In other words, there is no abosolute way to do it. 

My taper has gone smoothly but my docs now want me to remain at current doses for a year before further reduction.  Anything below my current doses would be sub theraputic and my docs think I need another year to see if I can get off meds entirely.  Can't wait and hope it will be my Christmas present next year.

Bill