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.