Case study 2. End-of-use adverse reaction
A 64-year-old woman has taken prednisolone 10 mg daily for 6 months for
rheumatoid arthritis, which is now well controlled by methotrexate. She
is asked to reduce her prednisolone dose by 1mg/month with the aim of
stopping the glucocorticoids. When she is reviewed 6 months later she is
still taking prednisolone 10 mg daily. She managed to reduce the dose to
5mg daily using this regimen, but felt lethargic, nauseated and weak so
returned to her usual dose.