Prednisone tapering question (another one?)

I know this must be such a common topic I'm almost reluctant to add another one.

But I have a question.

I've been on prednisone since November and desperate to get off of it. My doctor had me start tapering a few weeks ago, 25mg to 20 for a week, which went okay, and then to 15.

15 I just remember as a "bad day", went back to 20 for another because I had events coming up where I didn't want to deal with "bad stomach".

Then I tried 17.5mg, or as close of an approximation as you can get, to taper slower. That led to a Really Bad Day, but I'm also kicking myself because the night before I innocently took of one the probiotics I had bought and barely touched, and then read that some people get diarrhea as a side effect. I should know better - don't make more than one change at a time, no matter how innocent-looking!!

But again, things going on and didn't want to risk it so I went back to 20. A couple days ago yet again trying 17.5mg to taper.

I'm again getting some stomach ickiness going on... My actual question is, when tapering prednisone, if your symptoms start coming back, does that mean you immediately have to revert and taper slower or is it something that should be given a few days for the body to adjust. At this point I don't know how I can taper any slower than just shaving a sliver off the pills.

Its frustrating.
I usually give it three or four days.
The first day is almost always a little "iffy". You might get some minor distress, but you should not have a 'really bad day" or any blood or diarrhea.
Try to watch your diet etc. in those first couple of days. Don`t add pro-biotics because I too have found they can lead to loose stool until you adjust.
If I don`t settle down after those four days, then I to go back to a dosage that relieves the symptoms.
From my experience, its o.k. to adjust 2.5 or 5mg up for a day or two and then drop down to the dosage you`re aiming for again and see what happens.
I`m on Imuran and that has helped me taper and kept me off Pred for 18 months until I had another flare last Oct. Twice I tapered down to 5mg but could`nt get below that. My doctor upped my Imuran to 75mg from 50 mg and now I`m on my last day of 2.5 Pred and seem good.
You might not want to go the Imuran route, but six months of at least 25mg of Pred is not good.

Bruising is not a side effect of tapering, but the longer you are on prednisone, the more likely you will develop side effects. I found that I would bruise easily on pred, and it would take a long time to disappear.

Do check in with your Doctor, but I don't think it is anything to worry about.

As far as tapering goes, as ben1be said, give it a few days to see if your body adjusts. I always had a "blip" for a few days when I decreased the dose.

You should be getting the levels of Imuran checked. There is a test that shows how much theraputic benefit you're getting from the medication vs. how much toxicity. If you're very low on the chart for beneficial, theraputic effects, it may be harder to taper off of prednisone. If that is not the case and you're in or above the range, and you're unable to taper off, you may need to try adding another medication to successfully taper off pred. I do think it is normal to have iffy days, especially the couple days after your initially reduce the dose. At the end of my taper, I went extremely slowly. I had a lot of trouble at 15mg and went down at 2.5mg, I didn't even wait a week or two weeks, I waited until I felt like I was capable of handling another drop. Once I got to 10mg, I went down 1mg a week and I was feeling pretty stable so I was able to do so without many symptoms arising at all between doses. I know bruising can be a sign of low blood counts which can result from Imuran. You should be getting CBCs monthly or more often depending on how long you've been on Imuran. I've heard after a while you can go to 3 months between blood work but I've never been able to get out of going every month.

Hoshi, some people take imuran without other medication for maintence. I have always been taking Asacol and Rectals with my 6mp but I have gotten to a lower dose of Asacol which is good in my opinon.

I can imagine how badly you want off prednisone. I just finished a really long course and by 10mg, I wanted off sooo bad! Don't worry, you will be off soon. Take it slow, although it feels like a long time, you're better off taking a few more weeks to get off if it helps you remain stable. I am happy you had the levels checked and the dose adjusted, this should help get you off prednisone.

Enemas are a commitment..and I would suggest mesalamine (Rowasa if you're in the US).

If you start them now...which is a good idea, you should remain on them nightly and continue until you're off the prednisone. Then continue nightly for another week...if all is good, then taper to every second night.

The mistake that many make regarding using the oral/rectal 5ASA meds is they don't like the commitment.

Prednisone won't hold you for the rest of your life regarding flare treatment. Considering how you feel now...why would you ever consider it in the future anyway?

q