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Suggest Treatment For Headache While On Prednisone

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Posted on Wed, 10 Feb 2016
Question: I was started on prednisone 20 mg. for 30 days; then doctor increased me to 60 mg. for 30 more days; then lowered to 40 mg. for two weeks, and now have been on 30 mg for 10 days. Can I start tapering by 5mg every week now? The diagnosis was polymalgia rheumatica. I developed headaches, but cause turned out to be not temporal arteritis, but compression in my neck due to past whiplash. I am seeing a rheumatologist, but 3 doctors have given me different opinions about the tapering schedule. Thank you!
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Answered by Dr. Indranil Ghosh (48 minutes later)
Brief Answer:
various tapering schedules are used

Detailed Answer:
Hi
Thanks for your query.

I understand your concerns. Steroids, if used for >3 weeks need to be reduced slowly before stopping completely. Reasons are twofold. First, if stopped abruptly there may be adrenal insufficiency and second, the disease for which it was given can flare up.

So exact schedule also depends upon the disease being treated. In your case, as the disease is not autoimmune and due to previous neck trauma, role of steroids is limited. Hence I would suggest a rapid taper. 5-10 mg reduction every week seems fine to me. Various doctors give differing opinion as there is no established standard way of doing this.

Hope this helps.
regards
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Indranil Ghosh

Oncologist

Practicing since :2004

Answered : 1712 Questions

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Suggest Treatment For Headache While On Prednisone

Brief Answer: various tapering schedules are used Detailed Answer: Hi Thanks for your query. I understand your concerns. Steroids, if used for >3 weeks need to be reduced slowly before stopping completely. Reasons are twofold. First, if stopped abruptly there may be adrenal insufficiency and second, the disease for which it was given can flare up. So exact schedule also depends upon the disease being treated. In your case, as the disease is not autoimmune and due to previous neck trauma, role of steroids is limited. Hence I would suggest a rapid taper. 5-10 mg reduction every week seems fine to me. Various doctors give differing opinion as there is no established standard way of doing this. Hope this helps. regards