They should but you will have to reduce the dose extremely slowly,
especially as you get very low. Most people in the non-stressed state make
the equivalent of about 5 mg per day of prednisone in adrenal hormones
(mostly cortisol). It goes up quite a bit if they are stressed (sick,
injured, mentally stressed). I find that if the steroids are no longer
needed for the disease that it is usually easy to taper the prednisone to
about 5-10 mg and then from there you have to go very slowly.

Sometimes if just dropping the daily dose slowly isn't going well it helps
to use "alternate day dosing". You keep the dose beyond which you are stuck
constant on alternate days and reduce the dose on the other alternate day
until you are just taking the dose every other day and then reduce from
there (i.e. 5,5,5,4,5,3,5,2,5,1,5,0,5,0,4,0,3,0,2,0,1,0,0,0 - but much more
stretched out). I've seen some rheumatologists get to 10mg of prednisone and
then drop the dose 1mg per month taking a year or so to get the people off.
This is probably the extreme end.

Some people think that hydrocortisone more naturally mimics the body's
cortisol. I'm not sure I have seen any evidence of the difference. It is
about 1/4 as potent as prednisone so the 15 mg of prednisone is equivalent
to about 60mg of hydrocortisone. This difference does make it easier to
adjust the dose in small increments.

All of this is great if you are doing well and can reduce the dose. The
problem is that until you have been off of exogenous steroids for several
months up to a year your adrenals will not respond to a new stress
appropriately so you may need a burst of steroids ("stress dose steroids")
whenever you have a significant illness, surgery, etc.

Hi,

I am also on prednisolone (40 mg up to 80 mg depending how I am doing).
These Orodispersible pills are 20 mg ones... way better than those I had to
mix with water.

I take these pills for a really long time, but on a regular basis at least
for the last 10 years (except 2 years on hydrocortisone).

Day after day, I also take fluticasone propionate (500 mcg) and salmeterol
(50 mcg) twice a day 2 inhalations, in France it is called Seretide Diskus,
international I think it is also named Advair-Accuhaler.

A few years ago, we made some tests with my pneumologist.
Deal was to test if there was some difference between prednisone and
hydrocortisone.

In my case, the pneumologist found out my body responded way better to
hydrocortisone than to prednisone, and this was a first in his long carreer.

We managed to swith from daily prednisone to hydrocortinsone, one 80 mg
injection 3 to 4 times a year.
The great feeling to live again normally... and no side effects (stomach)
were the results.

Now, we moved to another part of France, and the new pneumologist told me he
is not allowed to prescribe hydrocortisone, which is not approved for asthma
(because of the french state-controlled health insurance) !

So, i am back to 40 to 80 mg prednisone, a.s.o, with a really bad quality of
life !

Within the next weeks, I'll be enrolled to test omalizumab (Xolair) at the
hospital (it isn't yet officially available in France), and I hope it will
help.

Someone already have experienced Xolair ?

Best regards
Roland.