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At that time, a slow steroid taper is initiated if the initial prednisone dosage was 15 or 20 mg per day. The gradual increase is followed by the transition into steady state when the maximum daily dosage is reduced to 10 mg per day. This may be done either at the initiation of a prednisone dosage reduction or every 7 days to reduce the risk of long term steroid-induced gynecomastia, but for most individuals a 3 or 5 month transition is needed. Once a dosage is set, the most effective dose during a steroid taper may be 4 mg per day to increase bone mineral density, but any steroid taper, and any steroid dosage will be a compromise between the benefits of the previously selected dosage and the risks of the steroid-induced bone loss. Most individuals in this population will respond negatively to a lower dosage. Also, individuals who are susceptible to developing cystic fibrosis, cystic fibrosis syndrome (CF) or osteoporosis are commonly at higher risk of bone loss from use of prednisone and will be most beneficial to use higher dosages during a prednisone taper. In addition, at least with prednisone, individuals at risk of developing anabolic steroid abuse are typically on a dosage less than that recommended for individuals for whom it is effective. Individuals who are on a steroid dosage recommended by the doctor to promote muscle growth but not necessarily for bone, tend to feel the taper to be too harsh and will not use to excess. Thus, in this population a dose more than what the recommendation would normally be to promote muscle growth is advised. While we are not advocating that anyone stop use of prednisone, we feel that it is important to remember that there is a tradeoff between the benefits of using the medication and the risks of steroid-induced bone loss. Therefore, as with any drug, it is important to weigh the benefits versus the risks of the drug. Although the risks of chronic steroid use are usually greater than the benefits, there is less of an opportunity for abuse of the drug when the dosage is lower and the dosage is taper based, which are both examples of optimal dosage and taper strategy. Finally, just because a medication can be used safely on an individual as long as a dosage is set, doesn't mean that all steroid medication is safe to use with the same dosage every day, particularly if a person's weight increase isn't the primary concern in the daily course and steroid taper does not prevent that. The most important thing to take away is that prednisone, like every other type of medication, is not Similar articles:
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