Table of ContentsView AllTable of ContentsHow to TaperWhat to ExpectWhy Tapering Is NeededWithdrawalAlternatives
Table of ContentsView All
View All
Table of Contents
How to Taper
What to Expect
Why Tapering Is Needed
Withdrawal
Alternatives
A prednisone taper gradually reduces your corticosteroid dose over days, weeks, or months to prevent prednisone withdrawal. Stopping prednisone abruptly can lead to adrenal insufficiency, which causes severe fatigue, body aches, and nausea.
Your healthcare provider will likely recommend a prednisone taper if you have taken it for more than two weeks.
Verywell / Emily Roberts
How to Taper Off Prednisone
There are no set rules for tapering off prednisone. The schedule will differ based on your dose and how long you used the medication. The decision depends largely on the healthcare provider’s clinical experience.
1:29Click Play to Learn How to Taper Off Prednisone
1:29
Click Play to Learn How to Taper Off Prednisone
When people first decrease the prednisone dose, it is common to feel achy or fatigued.These symptoms usually get better within two to seven days. If withdrawal symptoms continue beyond a week, talk to your healthcare provider.
Sometimes, your healthcare provider may temporarily increase the dose and taper more slowly. Even so, some people may still experience symptoms.
One way to deal with this is with a technique calledalternate-day tapering. For example, instead of lowering the dose from 4 mg to 3 mg, for instance, a healthcare provider may prescribe 4 mg one day and 3 mg the next day, alternating back and forth for one week.
If that’s successful, you may be prescribed 4 mg one day and 2 mg the next, and so on, until you are eventually alternating between 4 mg one day and no dose the next. The healthcare provider would then gradually taper the 4-mg dose.
When to Call Your Healthcare ProviderTapering may not always prevent withdrawal symptoms. There is no way to predict who will experience withdrawal and to what degree. If your symptoms are severe or last longer than seven days, call your healthcare provider, who can adjust the dose and tapering schedule.
When to Call Your Healthcare Provider
Tapering may not always prevent withdrawal symptoms. There is no way to predict who will experience withdrawal and to what degree. If your symptoms are severe or last longer than seven days, call your healthcare provider, who can adjust the dose and tapering schedule.
Why Prednisone Tapering Is Necessary
Like cortisol, prednisone tempers the body’simmune systemto better cope with mental and/or physical stress. This includes a steep and immediate reduction of inflammation so that it can respond physically.
In addition to the stress response and the regulation of inflammation, cortisol serves other important functions, including the regulation ofglucose(blood sugar), metabolism (the conversion of calories to energy), and lipolysis (the breaking down of fats).
Prednisone is extremely effective in mimicking the effects of cortisol. However, when prednisone is taken for more than a few weeks, the adrenal glands make less and less natural cortisol. As a result, you would need to give the adrenal glands time to “ramp up” the production of cortisol when treatment is stopped. This can take longer than you think.
If you don’t give the adrenal glands time to “catch up,” the body will have a severe deficit of cortisol and experience a cascade of symptoms recognized as prednisone withdrawal.
How to Avoid Prednisone Withdrawal
Prednisone Withdrawal Symptoms
Symptoms of prednisone withdrawal can range from mild to severe. Typical prednisone withdrawal symptoms include:
People on long-term prednisone therapy have the greatest risk for withdrawal symptoms. However, it can occasionally affect people who have taken the drug for a short time.
Alternatives to Prednisone
Some healthcare providers will opt for a different corticosteroid than prednisone. These medications can have the same benefits but with fewer side effects.
By way of example, a 5-mg dose of prednisone is equal to the following doses of these other corticosteroid drugs:
Even so, not all corticosteroids are appropriate for all medical conditions. At the same time, all medications have side effects, which can make some less appropriate for you as an individual.
If you are concerned about prednisone, tell your healthcare provider and ask if there are any reasonable alternatives.
Summary
Prednisone is a corticosteroid used to treat inflammation. It mimics the stress hormone cortisol. When taken for extended periods, prednisone interferes with the body’s natural production of cortisol.
As a result, it is not recommended to stop prednisone abruptly. Doing so can cause body aches, fatigue, fever, and other uncomfortable withdrawal symptoms.
To minimize or prevent withdrawal, your healthcare provider will instruct you on how to taper the dose gradually. Be sure to follow your healthcare provider’s instructions. You may still experience symptoms for a few days when first starting, but these will generally subside.
7 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Prete A, Bancos I.Glucocorticoid induced adrenal insufficiency.BMJ. 2021;374:n1380. doi:10.1136/bmj.n1380American College of Rheumatology.Prednisone (Deltasone).Priya G, Laway BA, Ayyagari M, Gupta M, Bhat GHK, Dutta D.The glucocorticoid taper: A primer for the clinicians.Indian J Endocrinol Metab. 2024;28(4):350-362. doi:10.4103/ijem.ijem_410_23Komminoth M, Donath MY, Hepprich M, et al; TOASST study group.Glucocorticoid withdrawal and glucocorticoid-induced adrenal insufficiency: Study protocol of the randomized controlled TOASST (Taper Or Abrupt Steroid STop) multicenter trial.PLoS One. 2023;18(4):e0281585. doi:10.1371/journal.pone.0281585U.S. National Library of Medicine: MedlinePlus.Prednisone.Stone S, Malanga GA, Capella T.Corticosteroids: Review of the history, the effectiveness, and adverse effects in the treatment of joint pain.Pain Physician. 2021;24(S1):S233-S246MDCalc.Steroid conversion calculator.
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Prete A, Bancos I.Glucocorticoid induced adrenal insufficiency.BMJ. 2021;374:n1380. doi:10.1136/bmj.n1380American College of Rheumatology.Prednisone (Deltasone).Priya G, Laway BA, Ayyagari M, Gupta M, Bhat GHK, Dutta D.The glucocorticoid taper: A primer for the clinicians.Indian J Endocrinol Metab. 2024;28(4):350-362. doi:10.4103/ijem.ijem_410_23Komminoth M, Donath MY, Hepprich M, et al; TOASST study group.Glucocorticoid withdrawal and glucocorticoid-induced adrenal insufficiency: Study protocol of the randomized controlled TOASST (Taper Or Abrupt Steroid STop) multicenter trial.PLoS One. 2023;18(4):e0281585. doi:10.1371/journal.pone.0281585U.S. National Library of Medicine: MedlinePlus.Prednisone.Stone S, Malanga GA, Capella T.Corticosteroids: Review of the history, the effectiveness, and adverse effects in the treatment of joint pain.Pain Physician. 2021;24(S1):S233-S246MDCalc.Steroid conversion calculator.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Prete A, Bancos I.Glucocorticoid induced adrenal insufficiency.BMJ. 2021;374:n1380. doi:10.1136/bmj.n1380American College of Rheumatology.Prednisone (Deltasone).Priya G, Laway BA, Ayyagari M, Gupta M, Bhat GHK, Dutta D.The glucocorticoid taper: A primer for the clinicians.Indian J Endocrinol Metab. 2024;28(4):350-362. doi:10.4103/ijem.ijem_410_23Komminoth M, Donath MY, Hepprich M, et al; TOASST study group.Glucocorticoid withdrawal and glucocorticoid-induced adrenal insufficiency: Study protocol of the randomized controlled TOASST (Taper Or Abrupt Steroid STop) multicenter trial.PLoS One. 2023;18(4):e0281585. doi:10.1371/journal.pone.0281585U.S. National Library of Medicine: MedlinePlus.Prednisone.Stone S, Malanga GA, Capella T.Corticosteroids: Review of the history, the effectiveness, and adverse effects in the treatment of joint pain.Pain Physician. 2021;24(S1):S233-S246MDCalc.Steroid conversion calculator.
Prete A, Bancos I.Glucocorticoid induced adrenal insufficiency.BMJ. 2021;374:n1380. doi:10.1136/bmj.n1380
American College of Rheumatology.Prednisone (Deltasone).
Priya G, Laway BA, Ayyagari M, Gupta M, Bhat GHK, Dutta D.The glucocorticoid taper: A primer for the clinicians.Indian J Endocrinol Metab. 2024;28(4):350-362. doi:10.4103/ijem.ijem_410_23
Komminoth M, Donath MY, Hepprich M, et al; TOASST study group.Glucocorticoid withdrawal and glucocorticoid-induced adrenal insufficiency: Study protocol of the randomized controlled TOASST (Taper Or Abrupt Steroid STop) multicenter trial.PLoS One. 2023;18(4):e0281585. doi:10.1371/journal.pone.0281585
U.S. National Library of Medicine: MedlinePlus.Prednisone.
Stone S, Malanga GA, Capella T.Corticosteroids: Review of the history, the effectiveness, and adverse effects in the treatment of joint pain.Pain Physician. 2021;24(S1):S233-S246
MDCalc.Steroid conversion calculator.
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