Drugs Q & A

How To Taper Off Prednisone (Taper Chart)

What is prednisone?

Prednisone is a prescription drug that belongs to a group of drugs called corticosteroids (often called “steroids”). Other steroid drugs include prednisolone, hydrocortisone, and methylprednisolone. Prednisone can be given in different ways, including pill, injection, and inhaled.

Prednisone is used to treat conditions such as arthritis, blood disorders, breathing problems, severe allergies, skin diseases, cancer, eye problems, and immune system disorders. It decreases your immune system’s response to various diseases to reduce symptoms such as swelling and allergic-type reactions.

How does it work?

Steroid drugs, such as prednisone, work by lowering the activity of the immune system. The immune system is your body’s defense system. Steroids work by slowing your body’s response to disease or injury. Prednisone can help lower certain immune-related symptoms, including inflammation and swelling.

How is Prednisone taken?

Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. Take this medicine with food. If you are taking this medicine once a day, take it in the morning.

The typical dosage of prednisone can range from 5 mg to 60 mg by mouth per day. This depends on your condition and how bad it is. Your provider will raise or lower your dose based on how you respond and if you have any side effects.

This medication also comes in an extended-release brand-name formulation called Rayos.

Do not take more medicine than you are told to take. Do not suddenly stop taking your medicine because you may develop a severe reaction. Your doctor will tell you how much medicine to take. If your doctor wants you to stop the medicine, the dose may be slowly lowered over time to avoid any side effects.

Can I stop taking the prednisone suddenly?

No, dose tapering is required for patients who have: received more than 40 mg of prednisone per day for more than one week, been given repeat prednisone doses in the evening, or received prednisone for more than 3 weeks. If you fall under any of these categories, your healthcare provider will give you a schedule on how to lower (or taper) the dose of the medication down. If you stop suddenly, you can cause your adrenal glands to stop working. Your adrenal glands are responsible for making your body’s natural hormones. If you are unsure when or how to stop the medication, it’s important to speak with your pharmacist or provider.

How To Taper Off Prednisone (Taper Chart)

Usual oral dose range: 5 to 60 mg/day given in a single daily dose or in 2 to 4 divided doses; Low dose: 2.5 to 10 mg/day; High dose: 1 to 1.5 mg/kg/day (usually not to exceed 80 to 100 mg/day).

The following dosing is from the commercially available tapered-dosage product (eg, dose pack containing 21 x 5 mg tablets):

Day 1: 30 mg on day 1 administered as 10 mg (2 tablets) at breakfast, 5 mg (1 tablet) at lunch, 5 mg (1 tablet) at dinner, and 10 mg (2 tablets) at bedtime.

Day 2: 25 mg on day 2 administered as 5 mg (1 tablet) at breakfast, 5 mg (1 tablet) at lunch, 5 mg (1 tablet) at dinner, and 10 mg (2 tablets) at bedtime.

Day 3: 20 mg on day 3 administered as 5 mg (1 tablet) at breakfast, 5 mg (1 tablet) at lunch, 5 mg (1 tablet) at dinner, and 5 mg (1 tablet) at bedtime.

Day 4: 15 mg on day 4 administered as 5 mg (1 tablet) at breakfast, 5 mg (1 tablet) at lunch, and 5 mg (1 tablet) at bedtime.

Day 5: 10 mg on day 5 administered as 5 mg (1 tablet) at breakfast and 5 mg (1 tablet) at bedtime.

Day 6: 5 mg on day 6 administered as 5 mg (1 tablet) at breakfast.

What are the side effects of tapering down on prednisone?

If you abruptly stop taking prednisone or taper off too quickly, you might experience prednisone withdrawal symptoms:

  • Body aches
  • Joint pain
  • Lightheadedness
  • Loss of appetite
  • Nausea
  • Severe fatigue
  • Weakness

Most people will recover fully from prednisone withdrawal once their body begins producing enough cortisol again.

The duration of symptomatic withdrawal will vary according to the dosage of prednisone that the person was taking and the length of the course of treatment.

Generally, people who were on a lower dose for a shorter period will have less severe symptoms. They may also recover from prednisone withdrawal more quickly, or they may not experience any withdrawal symptoms at all.

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Dr. Oche Otorkpa PG Cert, MPH, PhD

Dr. Oche is a seasoned Public Health specialist who holds a post graduate certificate in Pharmacology and Therapeutics, an MPH, and a PhD both from Texila American University. He is a member of the International Society of Substance Use Professionals and a Fellow of the Royal Society for Public Health in the UK. He authored two books: "The Unseen Terrorist," published by AuthorHouse UK, and "The Night Before I Killed Addiction."
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