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Pharmacy and Medications

Tapering Off Prednisone Safely

07/17/2008

Question:

I would like to know how to taper prednisone safely. I am on 40mg daily. I take 20mg in the morning and 20mg at night. My doctor said to start taking 30mg in the morning only. Is it safe to taper 10mg immediately, or should it be done in 5mg increments?

Answer:

Prednisone is a glucocorticoid drug.  It belongs to a family of drugs called corticosteroids or steroids.  Glucocorticoids effect metabolism and have anti-inflammatory and immunosuppressive effects.  Your body produces its own glucocorticoid, cortisol. 

When you take prednisone for long periods of time, your body stops making cortisol.   Tapering prednisone gradually allows your body to begin making cortisol again. 

Many methods of tapering 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 per day.  The 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
Former Clinical Instructor
College of Pharmacy
The Ohio State University