You need to slowly reduce your dose under the guidance of your doctor
If you have taken prednisone for more than a few weeks, you usually reduce the dose gradually and under the supervision of your doctor. This slow reduction is known as a taper, and helps your body restart its production of a hormone called cortisol to reduce the risk of withdrawal symptoms. Recovery often begins within weeks, but it can take months for energy, sleep, and mood to return to normal.
A taper is a planned, stepwise reduction in steroid dose over days, weeks, or months. Your doctor will adjust the pace of the taper based on how you feel and may slow or pause reductions if withdrawal symptoms or disease flares occur.
The length of the prednisone taper is often dictated by how long a person has been on prednisone and how high the doses have been. The longer the prednisone course, the longer the taper.
Why tapering matters
Prednisone acts like the natural hormone, cortisol. When taken for weeks, steroids cause the body to reduce its own cortisol output. Stopping steroids suddenly can cause a shortfall in cortisol and lead to tiredness, dizziness, nausea, low mood, or even a serious condition known as adrenal crisis. A carefully planned taper balances control of the underlying condition with time for the adrenal gland to recover.
How doctors decide on a taper
Tapers are personalized. Key factors are how long you are on steroids, your daily dose, and how active your disease has been. When steroids are used for longer periods or at higher doses, clinicians reduce the dose more slowly and may monitor symptoms or test morning cortisol levels to guide the timing.
What people commonly experience
Common withdrawal symptoms include:
- Tiredness and low energy
- Muscle or joint aches
- Poor sleep or vivid dreams
- Anxiety, low mood, or irritability
- Nausea or lightheadedness
Symptoms can worsen briefly after a dose reduction, then improve. Many people feel better over a period of two to six weeks. Some patients experience lingering fatigue or sleep disturbances that improve over time.
Managing disease flares and rebounds
As the dose falls, the underlying disease can flare. Doctors use strategies that include switching to steroid-sparing therapies, pausing or slowing the taper, or treating flare symptoms with other medications. Your prescriber will try to find the lowest effective steroid dose and consider alternatives when appropriate.
Practical tips while tapering:
- Pace yourself and know that energy may be limited for a while
- Protect sleep with a consistent bedtime routine
- Eat regular, balanced meals and drink plenty of fluids
- Rise slowly from sitting to reduce dizziness
- Keep a short diary after each dose change: note dose, sleep, energy, mood, and pain
- Use breathing exercises, short walks, or talk therapy to help with anxiety
Important: Don’t adjust your prednisone doses yourself. Make any changes in your prednisone dose in consultation with your doctor.
Seek immediate care if you feel faint, cannot keep fluids down, develop sudden severe weakness or confusion, or experience difficulty breathing. Contact your doctor immediately if symptoms are severe or if your condition flares.
Work and daily life
If fatigue or sleep problems impact your work, consider temporary adjustments such as shorter hours, flexible start times, or regular rest breaks. A note from your doctor or an occupational health professional may help.
To read more about tapering, read our article called “Why we taper”
Remember, always consult your doctor before making any changes to your medication.