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Method to prednisone taper? Morning/ night?

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Posted 1/14/2017 10:25 PM (GMT 0)
After a series of unfortunate oral surgery events that delayed my prednisone taper, I'm finally really tapering. I've ve been tapered down to 30mg for 7 days now down from 40mg for four months. I don't feel very much different other than maybe a little more tired than usual, and a little increased general gut activity. I'm supposed to taper down to 20mg starting tomorrow.

My question is, is there a method to what time of day you decrease the dose? Morning vs night? I used to take two pills in the morning and two pills at night, and when I started the taper I decided to eliminate one of my morning pills because I'd heard that's when your body normally makes more cortisone. Should I eliminate one of my night pills next or eliminate the other morning pill?
Posted 1/14/2017 11:29 PM (GMT 0)
I never took pred later than 3 pm because it kept me awake. I started at 30 mg and stayed there for 3 weeks, then took 3 weeks to taper to 20, three more weeks to taper to 10 and three weeks to taper to nothing. I got rid of my later dose first and morning dose last.
Posted 1/15/2017 11:56 AM (GMT 0)
Did you notice a difference in withdrawal or symptoms related to time of day?

I think I'm going to continue forward and eliminate my other morning pill, since I've not had much issue doing it that way so far.
Posted 1/15/2017 12:39 PM (GMT 0)
I don't believe it really matters whether you reduce the am or pm pill. It's true that our cortisol levels would normally be highest in the early am (as high cortisol levels normally wakes us up) and falls as the day progresses. So you can try to emulate that and see if it helps any.

I don't believe time of day has any impact on withdrawal symptoms. It's more about percentage of the drop that triggers them (the bigger percent drop the more withdrawal).
Posted 1/15/2017 2:44 PM (GMT 0)
IPoop -as far as withdrawal symptoms go (UC symptoms, not adrenal insufficiency), if you start to feel them again, will they even out if you stay the course and give your body time to adjust to the taper? Or would you need to re-increase the dose and taper more slowly in order to get them to stop?
Posted 1/15/2017 2:52 PM (GMT 0)
My husband always eliminated the afternoon pill first when tapering because it affected his sleep so badly. My understanding is that because prednisone is in your system for longer than a steroid such as hydrocortisone, it doesn't really matter.

His situation is different than yours because he has been on prednisone for years. He was never able to get below about 20 mg and then UC symptoms would come back. So then he would go back up to 20. Now that he is on Xeljanz and in remission, he was able to get bellow 20 mg. Sometimes you slow down the taper once you get to 10 mg or 5 mg depending on whether you experience withdrawal symptoms (adrenal insufficiency related). Husband was so sick from the withdrawal that he had to go back up to 10 and is now going down 1 mg every 8 weeks and is seeing an endocrinologist. Probably when he gets down to 5 mg, he will switch to hydrocortisone which is in your system shorter than prednisone and you take it twice a day to mimic natural cortisol production.
Posted 1/15/2017 3:53 PM (GMT 0)
I decided to eliminate the evening pill after all. I figured I didn't want to shock my system too much by completely depriving it of Pred in the morning. Hoping everything continues to go smoothly. I had a few days of general increased gut activity and one day where I had urgency, but it seems like the gut activity has calmed down now.

Is that normal on a taper?
Posted 1/15/2017 5:12 PM (GMT 0)
I always have 2-3 days where I feel withdrawal (aches, tiredness) after a drop and yes my bms might be temporarily worse (looser or more frequent). It levels out, you go back to your normal shortly with a successful drop. It's unsuccessful when you don't go back to your normal.

Tapers are hardest below 10 mgs as the percentage drops are highest. My body fits and fusses much worse than at high dose drops (which I might not even feel any withdrawal from at all).

Going from 5mgs to 2.5 myself in a day and not looking forward to it...
Posted 1/15/2017 5:51 PM (GMT 0)
Oh boy, fun times! I'm FINALLY starting on Remicade this coming Friday (so excited omg). My doc decided to start tapering the Pred 2 weeks beforehand because I've been on it way longer than originally intended at this point (stupid teeth had to be taken care of before Remicade..) and my leg/ face/ everything swelling situation is getting ridiculous and I just need to get off this devil drug. So I'm really hoping my UC symptoms hold off until the Remi kicks in..

I know it takes some people a while to start feeling the Remi, but I really hope I'm one of those that starts feeling it after a week, lol.

Doc wants me to taper from 20mg to 10mg a week from today, but since I'm only just starting the Remicade then, I might insist on holding at 20 for a week or so to give the Remi a chance to kick in. 20mg is low enough that I'd feel comfortable that I'm making 'progress' with the taper.

Just want this swelling to go away ugggh.

Post Edited (Canaveral) : 1/15/2017 11:00:55 AM (GMT-7)

Posted 1/15/2017 7:55 PM (GMT 0)
I'd stay at 20 mgs until you start seeing improvement on remi. I saw my first improvement a week after the 2nd infusion. A much bigger improvement a week after the third. And I reached remission over time.

I've sat next to people who say their gut settled down during the infusion and they feel better right away. No sensation for me.
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