Hi Amberhere. I asked my Rheumatologist this question some time ago. I finished my steriod taper last December. He has told me to take 15mgs of Prednisone a day Nd to call him, to continue to take that dose daily until he sees me. For his reason I always have spare steriods and especially when travelling. Hope this helps. Autumm

Amberhere. I meant to add that steriods should NEVER be stopped without tapering. It's too much of a shock to the system and can result in adrenal crisis or worse. Autumm

Hi Amberhere. First, keep in mind that DMARDs only slow down the process of disease by killing off bad B cells and T cells. DMARDs will not stop a flare from occurring. The idea is to get the disease under control with the DMARDs in a hope that active disease gets under control. Many people try to completely taper off prednisone over time and stay on the DMARD for disease maintenance. If disease is active, then it may not be possible to taper off prednisone completely for some people.

To answer your question about how to deal with a flare - I will feel weakness begin in both arms and the weakness will travel to my legs usually the next day. I will see my rheumy right away. My doctor will run a comprehensive metabolic panel blood test. Based on the results of the blood test, the doctor will determine HOW BAD the flare is occurring. The doctor will then tell me how much to go up on the prednisone. Usually when I flare, I will go up from 5.5mg to maybe 7 or 8mgs of Prednisone. Once I feel stable, like around two or more weeks later, then I will taper down by a half milligram every fourteen days. I will eventually return to my 5.5mg maintenance dosage. My doctor and I have determined that I will always stay around 5mg without a taper off completely. I am one of those who does have active disease. I do flare fairly frequently like at least twice a year.

Steroids absolutely must be tapered. You should discuss with your doctor a safe taper schedule. I originally would taper down by 1mg every fourteen days. I later learned I felt so bad that I now taper down by a half milligram every fourteen days. If I do NOT feel stable then I will sometimes go for a month or longer at a particular dosage until I feel stable to lower again. Tapering too fast when there is active disease that is not controlled will mean needing to go back up a dosage or two. My doctor always looks at my blood work to determine the need to go back up.

Be sure you ask these questions to your doctor too. Be clear with the doctor in your understanding of why s/he put you on a particular DMARD too. You should know exactly why you take these meds and how they coordinate together in your care.

I hope this helps.

I went off Prednisone over a year ago. I still take Methotrexate weekly. I don't know what a flare is because I always feel weak and not so strong. But we tapered because my CK was under 200 and I wanted off. I've gotten weaker but haven't gone back on Prednisone. My Neuro told me if I went back on, we would start at 20 mg and taper from there.

It will be a cold day in ..... before I go back on.

Hi Everybody...Meow,

I suddenly stopped taking Dexamethasone Jan 31, 2013. BAD IDEA. I didn't realize how I narrowly I dodged a dangerous bullet by doing that, but my weight was climbing towards 300 lbs and my blood sugars were over 400 at lunch. I felt I had to do something, and my Rheumy missed the boat on this one.

I totally lost my appetite and desire to even eat. Didn't want food at all. Plus, I was nauseated constantly. Even water made me heave. For about two weeks, I couldn't eat hardly anything. I was stupid and didn't include my doctor. Looking back, I think I was also severely confused and depressed. Started at 252, lost down to 206 in two weeks. Kept drinking water...I think that's what saved my kidneys. Blood sugar went back to normal. However, I soon was able to eat mashed potatoes and turkey plain, and I had a scheduled Dr appointment, so I fessed up. Rheumy was understanding, but admonished. Went on Prednisone (Dex is 26 times more potent) at that visit, and was able to eat normally (for me) once again. I Will Never Do That Again. Am thinking I'll probably be one who has to have at least 10mg of Prednisone for the rest of my life. OH Well...I can live with that dose. With Pred, my weight holds at around 210., wear size 2X in everything.

Life is still enjoyable, and Spring Is In The Air...Love hearing the birds nest-building and chirping outside my windows.

Purr,
=^.,.^=

Purr