You will need to “reduce” (gradually reduce) the dose so that the adrenal glands have time to start producing their own steroids again. Usually, people won't need to “reduce the dose” if they've been taking steroids for less than three weeks, but you should always consult your IBD team before stopping treatment. There are no established rules for reducing prednisone. The schedule will vary depending on the dose you were taking and how long you used the medication.
The decision depends largely on the health care provider's clinical experience. Prednisone and other steroids must be slowly reduced to allow the adrenal glands to readjust to the amount of cortisol they produce. A typical step-down regimen can last anywhere from days to weeks, depending on the dose of prednisone a person has used and how long they have used it. Most prednisone regimens longer than five days will need a gradual reduction.
When you stop taking any medication, it's important to listen to your doctor's instructions on how to do it in the safest way. When trying to stop taking prednisone, the recommendation is to slow down slowly to avoid withdrawal. The best way to do this is under the supervision of a medical professional, whether your doctor or you visit a treatment center designed to help people detoxify from medications. To reduce the chance of experiencing these symptoms, you should use a gradual reduction program to gradually reduce the amount of prednisone you take every day.
Your doctor will tell you how to do this, since there is no standard program for phasing out prednisone. The period of gradual reduction can vary widely, from a few days to a few weeks, depending on how long you have been taking prednisone. Never stop taking prednisone even if it decreases it, unless your doctor has told you to. Secondly, it cannot be stopped simply “all at once” because the adrenal system needs time to recover.
A prednisone warrior asks himself a question: Why would he get a 20 mg prescription directly for 5 days? When it's only 5 days, it may be fine. Doctors usually prescribe prednisone for less than 10 days with no gradual reduction. Prednisone is like cortisol, a hormone naturally produced by the adrenal glands. If you take prednisone for more than a few weeks, your adrenal glands decrease cortisol production.
A gradual reduction in the dose of prednisone gives the adrenal glands time to resume their normal function. Treatment for steroid withdrawal syndrome (SWS) involves decreasing the decrease in the dose of steroids or increasing the dose used.
