May 29, 2023


Prednisone taper trap are you stuck in the prednisone taper trap i know i was stuck in the prednisone taper trap you might be wondering what is the protozoan taper trap i’m dr megan the prednisone pharmacist and i took prednisone for a long time and the taper trap is the reason why we need to taper but what is tapering i’ll explain that in this video and i will

Show you how to use a prednisone taper chart and you can even print one off my website really easily i’ll show you how through this video so prednisone was a miracle for me i took prednisone and it allowed me to not bleed to death from a condition called itp my immune system was attacking my own platelets and i could have bled to death if i didn’t take prednisone

So what my doctors would do is give me a high dose say 40 milligrams and my platelets would be down here at five or something really super low and so as they kept me on a higher dose my platelets would go up and so they would try to decrease my dose of prednisone and then my platelets would go down and then they would taper my prednisone down so that i didn’t

Have so many side effects and then my platelets would go down and then they’d try a little bit lower and then my platelets would crash and so i was stuck in this taper trap they would do it again they’d go back up to 40 milligrams and try to get me back down and back down and my platelets would go up and then they would crash and then they’d have to go back

Up and i just went on this roller coaster doses from 40 down down down down and then my platelets falling high then low low crash roller coaster so the taper trap is when you are stuck when you can’t get any lower for me that was often somewhere around 15 milligrams where my platelets might stay high but i was suffering so many side effects and so for other

People it might be that their rheumatoid arthritis they can actually use their hands but and the side effects aren’t too bad but if they get any lower than that then the side effects come back or the they’re not able to use their hands it’s it’s just a really tough situation so i’m going to tell you the story of a guy named matt that’s what we’re going to call

Him it’s not really his name but we’ll call him that because i want to protect his privacy so matt is a really important person he owns a business where he supervises 30 people and he can’t just be sick he needs to be there to run his business so when he came down with a sinus problem where he’s tried everything from nose sprays to nasal flushes to prednisone

And the last resort is surgery he can’t take two weeks to have a surgery so he’s taking prednisone as the alternative to keep him able to breathe at night if he doesn’t take it he gets so congested that he can’t sleep so the prednisone for most people like me it doesn’t let me sleep because it causes racing thoughts but for him the prednisone caused decongestion

So he could actually breathe so with matt it’s this really tough situation he has to be on pretty high doses to get all of that decongestion but it’s causing moon face and weight gain and all sorts of other side effects and i had to go through this with him where is the dose that you find the best balance of being able to breathe not having too much congestion

But not too many side effects and it’s a really tough spot to find for every person it’s different for me it was around 15 milligrams for him it might be around 25 milligrams for a lot of people with rheumatoid arthritis it’s often closer to 5 milligrams or 10 milligrams it it’s really dependent on your condition your body the level of inflammation that you have

Tapering is so essential but i based on the research i’ve done it’s not really a science like they’ve tried to do studies to find a a perfect tapering schedule and they couldn’t find one and so it’s more of an art than a science and fun fact of the day tapering is the number one reason people contact me for a side effect consultation as the protozoan pharmacist

Because it’s so hard to do it’s so hard to have a doctor who has the time to be able to help you find what deuce dose to take when and so there are websites that can help you navigate this that will you can link to it in my article or you can use a taper chart so a taper chart let me show you you can download this exact taper chart off my website and you go

Throughout my website i’ve got a whole bunch of different strategies you can use there’s this short term one there’s long term there’s even slower there’s one that takes a year and a half it’s really dependent on you and your condition where the withdrawal syndrome kicks in and what is withdrawal syndrome so withdrawal syndrome is where your body is going through

Withdrawals from prednisone and it feels awful and it’s really hard to diagnose because it looks like everything else it looks like the flu you might get a fever you might feel totally exhausted fatigued achy like muscle aches joint aches like you would if you had the flu you got run over the bus by a bus um you might get sweats you might get all sorts of really

Weird non-specific symptoms that could even be confused for covid it’s just crazy so when that withdrawal kicks in that’s your your adrenal system has to recover from taking prednisone your adrenal hypothalamic pituitary adrenal system your hpa axis has to kick back in so that you start making cortisol again your body has been not making cortisol while you’ve

Been taking prednisone it’s been replacing it and so you have to be able to allow your pituitary gland your hypothalamus and your adrenal gland to get that system re-engaged so it can actually start excreting cortisol and then the rest of your body has to get out of prednisone withdrawal it’s a really unique patient specific art of finding that balance that

Speed that you can go down in doses so knowing that we’re trying to balance protozoan withdrawal and your condition those are the two things we’re trying to find a balance when is your condition going to get out of whack or when is your prednisone withdrawal gonna kick in and that is the taper trap is when you can’t go any lower and you have to go super slow

Or go through pure misery of adrenal withdrawal syndrome and i i don’t it’s never there’s never a good answer okay like i can help you find the the best balance but there’s never a black and white like this is for sure what you should do it’s always a okay let’s find the lightest gray that we can find it’s really a tough thing so based on this i give you a

Whole bunch of things on my website and then you can print it out and by when you print it out you can just go here to the printer button and i’ll just do it right now why not print it out and while that’s loading we can keep looking at this one and then i’ve got it so that there’s the days of the week and what dose you should take so if your doctor said okay

I’m gonna taper you down from 40 milligrams here’s one way to do it now i want to make it perfectly clear that i am not replacing your doctor i am not your medical provider i am all the legal things this is just an example you can follow okay this is not medical advice this is just a service i’m trying to provide because i get asked so often and i think it’s

Really important that people have something that they can use and so this is an option but your doctor and you need to work together to find the very best solution i am not replacing your doctor so based on that here’s an option of what you and your doctor could work on you could print this out and say hey doctor what do you think and they can approve it so

What you would do is print it out so now i’ve got it over here i could push print and you can print any number of pages so i don’t really need this first page i really want to just do i’m going to be starting at 40 milligrams and i’m going to do a short term maybe or maybe i want to do this long term or maybe i’m going to do this really super long term slow one

So i’m going to just do this short term one and i can just print um what’s it let’s see this is page two so i can just print page two whichever page you need and now it’s gonna come off my printer and while it’s coming off my printer i’ll keep going through this with you can you hear my printer kicking in all right so here it is the prednisone taper chart and

That’s kind of loud sorry i’m gonna grab it here it is brennan’s on taper chart so once you have it you can use it you can put your prednisone bottle right next to it and mark it off so for example if you had been given 40 milligrams and your doctor said okay take 40 milligrams every day for a week so then you start on month sunday and you just go okay i took my

Sunday dose and i always recommend to take it first thing in the morning with some food but you don’t have to and then on monday morning you can say okay i did monday and then you get through that week and then you start another dose down to 30 milligrams that’s a typical one 40 30 20 10 5. so you could do that you could follow this plan but maybe you get to 10

Milligrams and you’re like i can’t i can’t drop to five i’ve i can feel that withdrawal kicking in or i can feel my condition coming back those are the two things withdrawal kicking in or condition coming back and so you can’t go that fast you can’t drop fifty percent in one week from ten down to five that’s just too dramatic for you so you could try this one

This is a longer term taper so it’s just dropping about 20 per week and so you’d go down boom boom and you can do a week of each of these doses now we’re at one milligram per week dropping here that’s definitely doable here is that taken instead of per week we’re talking per month so you do each of these for a week so month one you’re doing 20 milligrams month

Two you’re doing 17.5 milligrams and so you just go all the way across week one week two week three and week four so if you don’t want to do it for 14 months or maybe you’ve already gotten down to 10 milligrams and you don’t need to start at 20 milligrams well then just ignore this part and just start at 10 milligrams make this work for you this is just to make

It as easy as possible for you to remember what dose to take and when then um we have the alternate day strategy and so this one is if you are super sensitive if you cannot drop even one milligram a week so then here’s a suggestion you could go ten nine ten nine taking ten milligrams on one day nine on the next and then the following week you hold that dr

Lower dose at nine milligrams and then the next week you would do eight nine eight nine eight nine and then the next week you could hold it at eight milligrams and maybe you have to hold it longer than one week that’s fine you could hold it for two or three weeks at that lower dose just slow and steady wins the race when it comes to tapering so then you would

Just keep following this plan seven eight seven eight and then seven and then seven six seven six seven six and then six and then six five six five six five and then five and then five four five four and then four milligrams and you just keep dropping keep dropping until you get to one milligrams and then congratulations three cheers for you you’re finally off

Prednisone so i’ve shown you in this video how to taper prednisone using a taper chart and what to look for your condition coming back or withdrawal syndrome kicking in and you can follow any of these taper charts that you work out with your doctor as the best for you signing off as dr megan your prednisone pharmacist i’m committed to helping you thrive while

On prednisone not just survive the side effects you

Transcribed from video
The Taper Trap – How to Taper Prednisone (Taper Chart) By Dr. Megan – Prednisone PharmacistliveBroadcastDetails{isLiveNowfalsestartTimestamp2021-03-19T140015+0000endTimestamp2021-03-19T141734+0000}