Pharmacy and Medications

Suggestions for Tapering Off of Prednisone

06/20/2008

Question:

I have been taking 7mg of Prednisone for more than 5 years. During this 5 years I have gained more than 60 pounds. I would like to discontinue taking Prednisone all-together. What is a good plan?

Answer:

Prednisone causes the body to retain sodium which can result in fluid retention and weight gain. Prednisone may also increase the appetite leading to more calories being consumed. Eating a low salt diet, decreasing calories and fat, and having several small meals a day can help to minimize the fluid and weight gain. These side effects should go away once the dose of prednisone is reduced to less than 10 milligrams a day.

Any weight gained during prednisone therapy will not automatically be lost as the drug is stopped. You will have to work to take off the pounds by reducing your calorie intake and adding physical activity as you are able.

Daily prednisone use can reduce the body's own hormone production. Tapering prednisone gradually allows the body's hormone production to start up again.

Many methods of tapering the prednisone are used by doctors. Generally, the dose is reduced by 2.5mg every 1 to 2 weeks until 5mg per day is reached. Hydrocortisone 20mg per day may be substituted for prednisone 5mg. Hydrocortisone is a steroid of shorter duration and will continue the gradual tapering. The hydrocortisone may also be tapered at 2.5mg every 1 to 2 weeks until 10mg per day is reached.

Work with your doctor on the best schedule for you based on your medical problems as well as the length of time you have taken prednisone.

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Response by:

Carmen M. Hadley, RPh, CSPI
Clinical Instructor
Central Ohio Poison Center
Nationwide Children’s Hospital
College of Pharmacy
The Ohio State University