What's the best way to sneak out cortisone?

introduction

Cortisone preparations are among the drugs that have to be tapered off. This means that they must not be discontinued suddenly. The dose must be reduced slowly. The reason for this is that the body's own cortisone production in the adrenal cortex is suppressed by an external application of cortisone for more than 10 days. The adrenal cortex needs some time to completely take over the body's own cortisone production. Abrupt discontinuation of cortisone preparations could lead to a lack of cortisone in the body. This could have serious consequences. It is therefore important to taper off cortisone supplements.

Read more on the topic: Effects of cortisone or side effects of cortisone

Is there a fixed scheme for this?

There are recommended, fixed schemes which differ only slightly from each other. These schemes can and should be individually adapted to the patient. Some authors recommend tapering off cortisone preparations after an application period of 10 days or more. Other authors describe that taking cortisone preparations for less than 3 weeks does not lead to a suppression of the body's own adrenal cortex. In addition, they assume that a dose of, for example, prednisone of a maximum of 5 mg per day does not require tapering off. Accordingly, the cortisone treatment could be discontinued without testing the adrenal cortex. According to these authors, an impairment of the adrenal cortex is possible from an intake of 7.5-20 mg prednisone per day for more than 3 weeks. As a result, the treatment must be tapered off. Testing of the adrenal cortex may be advisable. In these cases, the function of the adrenal cortex should always be tested before an operation. The dose of cortisone would have to be adjusted accordingly. Treatment with cortisone preparations for about 1.5 or 3 weeks (depending on the author) with more than 20 mg of prednisone per day is assumed to be a restriction of the adrenal cells. The same applies to any so-called Cushing's syndrome. The duration and dose of the external cortisone administration are not decisive here. In these cases, cortisone therapy must be tapered off. Here, too, testing of the adrenal cortex is possible and an absolute must before an operation.

In which steps should you sneak out?

Some authors describe a general rule that cortisone supplements should be reduced every 3 - 5 days or in 2.5 mg increments. There are other dose-related recommendations. In the case of daily doses of cortisone greater than 20 mg, a reduction of 5 - 10 mg daily, every 1 - 2 weeks is recommended. With daily doses of 20-10 mg cortisone, a reduction of 2.5 mg daily, every 1-2 weeks, may be advisable. With cortisone quantities of 10-5 mg per day, a reduction of 1.0 mg daily every 1 to 2 weeks is suggested. For daily doses below 5 mg per day, a reduction of 0.5 mg daily, every 1 - 2 weeks, can be effective. In certain cases, testing of the adrenal cortex is useful.

Read more on the topic: Dosage of prednisolone

Why should you skip the evening tablets at the beginning?

The body's natural cortisone level is highest in the morning and lowest in the evening. The more the cortisone administration adapts to the body's cortisone release, the less the drug affects the adrenal cortex. Therefore, it makes sense to skip the evening tablets at the beginning - of course in consultation with the attending physician.

What happens to the pain when I sneak out?

If cortisone preparations are tapered off, previously existing symptoms such as pain can reappear. The more abruptly the cortisone preparation is discontinued, the higher the probability that a so-called rebound phenomenon will occur. This means that pain can reappear, possibly intensified. The more carefully the cortisone preparation is tapered, the lower the risk of increased pain. If necessary, pain-relieving measures or medication can make tapering off the cortisone more pleasant. Individual advice and treatment from a doctor is needed to reduce the incidence of pain.

Are there any differences when tapering the various cortisone preparations?

The tapering off of the various cortisone preparations can have different effects. Since there are cortisone preparations in different effective concentrations, the strength is different. Correspondingly, the suppressive effect on the adrenal cortex is also different. In addition, every body reacts individually to medication of any kind. The given schemes are only an aid. An individual consultation with the doctor when tapering off any cortisone preparations can reduce uncertainties and side effects.

Read more about the topics:

  • Cortisone tablets
  • Cortisone ointments
  • Cortisone spray