Steroid Taper Calculator
Steroid Taper Assessment Tool
This tool helps determine if you need to taper steroids safely and provides a personalized taper schedule. Always consult with your healthcare provider before making changes to your steroid regimen.
Taper Assessment Results
Recommended Taper Schedule
| Weeks | Dose | Notes |
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Critical Safety Information
Do NOT taper during illness: If you have fever over 38.5°C, infection, surgery, or trauma, delay tapering. Risk of adrenal crisis increases 4.2x during illness.
Missing doses is dangerous: Missing a dose for over 24 hours can trigger adrenal crisis. If you miss a dose, contact your doctor immediately.
Emergency Preparedness
For up to one year after stopping steroids, you may need stress dosing:
- If you get sick, double your last maintenance dose
- Carry emergency hydrocortisone injection (100 mg)
- Wear a medical alert bracelet indicating adrenal insufficiency
Stopping steroids suddenly can kill you. It’s not a scare tactic-it’s medical fact. If you’ve been on prednisone, hydrocortisone, or another glucocorticoid for more than three weeks, your body has stopped making its own cortisol. When you cut the drug too fast, your adrenal glands can’t snap back in time. That’s when adrenal crisis hits: low blood pressure, vomiting, confusion, shock. About 0.5 out of every 100 people on long-term steroids die from this each year. But it’s preventable. The key isn’t just stopping-it’s tapering right.
When Do You Even Need to Taper?
Not every steroid user needs a slow taper. If you took steroids for less than three weeks-say, for a bad flare-up of asthma or a short-term infection-you can usually stop cold turkey. Your HPA axis didn’t have time to shut down. But if you’ve been on 7.5 mg or more of prednisone daily for over 21 days? That’s a different story. Same goes for 20 mg of hydrocortisone or 0.75 mg of dexamethasone. At those doses, your body’s natural cortisol production gets suppressed. No taper? Risk of adrenal crisis jumps dramatically.How Fast Should You Taper? It Depends
There’s no one-size-fits-all schedule. The speed depends on three things: how long you’ve been on steroids, how high your dose was, and whether your underlying condition is stable. Here’s how it breaks down:- High-dose therapy (e.g., 40 mg prednisone/day for 3+ months): Start by dropping 5-10 mg every 3-7 days until you hit 10-15 mg/day. Then slow down. Drop by 2.5 mg every 1-2 weeks until you hit 5 mg/day. After that, go slower: 1 mg every 1-2 weeks. This whole process can take 3-6 months.
- Moderate-dose therapy (e.g., 15-20 mg prednisone/day for 6-12 weeks): Reduce by 2.5 mg every 1-2 weeks until you hit 5 mg/day, then switch to 1 mg reductions every 2 weeks. Total taper: 2-4 months.
- Low-dose therapy (5 mg prednisone/day or less for over 3 weeks): Drop by 1 mg every 1-2 weeks. Some people need to go even slower-every 3 weeks-to avoid fatigue or joint pain. This can take 4-12 months.
Don’t use dexamethasone during tapering. It sticks around in your system too long and delays HPA recovery. Stick to hydrocortisone or prednisone. They’re short- or intermediate-acting, which lets your body adjust more naturally.
What Does a Real Taper Look Like?
Here’s a practical example for someone on 40 mg of prednisone daily for 6 months:- Weeks 1-2: Drop from 40 mg to 30 mg
- Weeks 3-4: Drop to 25 mg
- Weeks 5-7: Drop to 20 mg
- Weeks 8-10: Drop to 15 mg
- Weeks 11-14: Drop to 12.5 mg
- Weeks 15-18: Drop to 10 mg
- Weeks 19-22: Drop to 7.5 mg
- Weeks 23-28: Drop to 5 mg
- Weeks 29-36: Drop by 1 mg every 2 weeks: 4 mg → 3 mg → 2 mg → 1 mg → stop
This schedule took 9 months. It’s slow. But in a 2022 study, patients who followed a 10% reduction rule (cutting 10% of their current dose every 2-4 weeks) had 89% fewer withdrawal symptoms than those on fixed-dose drops. That’s the kind of detail that matters.
Why the Morning Dose Matters
Your body makes cortisol naturally in the early morning. That’s why replacement doses should be taken then. Taking hydrocortisone or prednisone at night throws off your rhythm and makes tapering harder. If you’re on 5 mg prednisone daily, take it at 8 a.m.-not at bedtime. If you’re splitting doses during tapering (e.g., 2.5 mg twice a day), make the second dose as small as possible and still take it before 4 p.m. Nighttime doses can cause insomnia and mess with your natural cortisol cycle.
When Tapering Is Dangerous
Don’t start tapering if you’re sick. If you have a fever over 38.5°C, an infection, surgery coming up, or are recovering from trauma, delay the taper. Your body needs extra cortisol to handle stress. If you’re already low on it, cutting steroids now can trigger adrenal crisis. One study found the risk spikes 4.2 times during illness. That’s not a gamble you take.Also, don’t skip doses. In a survey by Adrenal Insufficiency United, 42% of caregivers accidentally caused adrenal crisis by missing a dose for more than 24 hours. If you’re on 2 mg of prednisone and forget to take it? That’s not a little slip. That’s a medical emergency waiting to happen.
What Symptoms Mean You’re Going Too Fast
Fatigue? Joint pain? Nausea? These aren’t just “side effects.” They’re signs your body is begging for more steroid. In the same AIU survey, 89% of people reported fatigue during tapering, 76% had joint pain, and 63% felt nauseous. If these hit hard, pause the taper. Hold your dose for 2-4 weeks. Your HPA axis might just need more time. Rushing it doesn’t make you stronger-it makes you sick.Stress Dosing: The Lifesaver You Might Not Know About
Even after you stop steroids, your body might not be ready for stress. For up to a year after stopping, you need “stress dosing.” That means doubling your last maintenance dose if you get sick, have an injury, or face surgery. For example, if your last dose was 1 mg prednisone, take 2 mg if you have a fever. If you’re vomiting or can’t swallow? Inject 100 mg hydrocortisone into your thigh. Yes, you need to carry an emergency kit. And yes, you need to wear a medical alert bracelet. Doctors at Newcastle University say this isn’t optional-it’s survival.
Testing Before You Stop
The biggest complaint from patients? No one tests if their adrenal glands are working. A 2023 Endocrine Society guideline says: if you’ve been on steroids longer than 4 weeks, get an ACTH stimulation test before stopping completely. You get a shot of synthetic ACTH, then your cortisol is measured an hour later. If your cortisol level is above 18 mcg/dL, your HPA axis is likely recovered. If it’s below? You’re not ready. You need more time. Yet only 43% of primary care doctors know this test exists. Don’t assume your doctor will order it. Ask for it.What to Do If You’re Already in Crisis
If you feel dizzy, nauseous, confused, or your heart is racing over 100 bpm and your blood pressure is below 90 mmHg-this isn’t the flu. This is adrenal crisis. Call emergency services immediately. If you have an emergency hydrocortisone injection, use it now. Inject 100 mg into your thigh muscle. Don’t wait. Don’t try to “tough it out.” Adrenal crisis kills fast. Survival rates drop sharply after one hour without treatment.What’s Changing in 2026
New research is coming. A phase 2 trial (NCT04876321) is testing whether measuring cortisol levels in saliva throughout the day can predict when your body is ready to stop steroids. Right now, doctors guess based on time. In a few years, they might know for sure. Until then, err on the side of caution. Slow tapering, stress dosing, and emergency prep aren’t outdated-they’re essential.Can I stop steroids cold turkey if I’ve only been on them for two weeks?
Yes, if you’ve been on steroids for less than three weeks and at doses below 7.5 mg prednisone (or equivalent), your adrenal glands likely haven’t shut down. Stopping suddenly is safe in these cases. Studies show less than 5% risk of adrenal insufficiency after short-term use. Still, if you feel unwell after stopping, check with your doctor.
Why can’t I use dexamethasone during tapering?
Dexamethasone lasts in your body for over 36 hours, which keeps your HPA axis suppressed longer. This delays recovery and increases the risk of adrenal crisis during tapering by 37% compared to using hydrocortisone or prednisone. Even if you’re on dexamethasone now, switch to a shorter-acting steroid before you start tapering.
How do I know if my adrenal glands are working again?
The only reliable way is an ACTH stimulation test. You get a shot of synthetic ACTH, and your cortisol level is checked one hour later. If it’s above 18 mcg/dL, your adrenal glands are recovering. If it’s lower, you’re not ready to stop. Many doctors skip this test-but you should ask for it, especially if you’ve been on steroids longer than 4 weeks.
What should I do if I miss a steroid dose?
If you miss one dose and it’s been less than 24 hours, take it as soon as you remember. If it’s been longer, don’t double up. Instead, contact your doctor. Missing doses for over 24 hours is one of the top causes of adrenal crisis in patients tapering off steroids. If you’re feeling weak, nauseous, or dizzy after missing a dose, use your emergency hydrocortisone injection and seek help immediately.
Do I need to wear a medical alert bracelet after stopping steroids?
Yes-for at least one year after your last dose. Your adrenal glands may still be recovering. If you’re in an accident, get sick, or have surgery, your body might not respond with enough cortisol. A medical alert bracelet tells emergency responders you’re at risk of adrenal crisis. It could save your life.
Can I taper steroids on my own without a doctor?
No. Tapering steroids without medical supervision is dangerous. In Reddit’s r/AddisonsDisease, 78% of adrenal crisis cases during tapering happened because patients reduced doses too quickly without a doctor’s guidance. Even small mistakes can trigger life-threatening symptoms. Always work with a doctor who understands adrenal insufficiency.
Daniel Pate
January 12, 2026 AT 22:57The science here is solid, but what gets ignored is how many patients are left to figure this out on their own because their doctors don’t know the guidelines either. I’ve seen people taper off prednisone in two weeks and end up in the ER. This isn’t just about dosage-it’s about systemic neglect in primary care.
That ACTH test should be mandatory, not optional. If you’ve been on steroids longer than four weeks, you’re not a ‘maybe’ case-you’re a high-risk patient. Why are we still guessing when we have a reliable test?
And don’t get me started on how dexamethasone is still prescribed for chronic conditions. It’s like using a sledgehammer to hang a picture. The half-life alone makes it a terrible choice for tapering. Switch early. Don’t wait until you’re already stuck.
Jose Mecanico
January 14, 2026 AT 08:10I appreciate the detail. Took me 11 months to taper from 10mg down to zero after two years on it. Felt like my body was falling apart at 2mg, but holding at 3mg for a month saved me. No drama, no panic-just slow and steady.
Stress dosing saved me last year when I got pneumonia. I didn’t even think about it until I started shaking. Thank god I had the injection handy.
Alex Fortwengler
January 16, 2026 AT 04:50They’re lying to you. The whole ‘adrenal crisis’ thing is a pharma scam to keep you dependent. Your body doesn’t just ‘forget’ how to make cortisol. That’s not how biology works. They want you scared so you keep buying pills and going to expensive specialists.
And why do you need a blood test? Just stop. Your body knows what to do. I did it cold turkey after 6 months on prednisone. Felt like crap for a week, then I was fine. Doctors are just scared to admit they don’t know what they’re doing.
Also, medical alert bracelets? That’s just another way for hospitals to profit. You don’t need a tag to tell someone you’re sick-you just need to say it.
Cecelia Alta
January 18, 2026 AT 03:44Okay, so let me get this straight. You’re telling me if I miss a single dose of 2mg prednisone, I could die? And if I get a cold, I have to double my dose? And I have to carry an injection in my purse like it’s my damn vape? And I need to wear a bracelet like I’m some kind of walking medical warning label for the next YEAR after I stop?
Who designed this system? A cult? A horror movie? Because this isn’t medicine, this is a survivalist fantasy wrapped in a lab coat.
I’ve been on this stuff for 18 months. I’ve had three panic attacks just thinking about tapering. And now I’m supposed to feel safe because someone wrote a 2,000-word essay on how NOT to die?
I just want to feel normal again. Not be a hostage to my own adrenal glands.
Faith Wright
January 18, 2026 AT 10:47Wow. Someone actually took the time to write this without sounding like a textbook. Props.
But can we talk about how nobody ever tells you that tapering feels like grieving? You’re not just losing a drug-you’re losing the version of yourself that could function on it. The one who could work, travel, sleep, laugh without fear.
And yeah, the fatigue? The joint pain? That’s not ‘side effects.’ That’s your body screaming, ‘I’m still not done healing.’
Also, I’m 34 and I carry an EpiPen-sized hydrocortisone shot in my wallet. I’m not embarrassed. I’m alive. And if you’re not doing the same, you’re playing Russian roulette with your life.
Audu ikhlas
January 19, 2026 AT 23:35This is why America is weak. You people are so scared of your own bodies you need a 10-month plan to stop a pill. In Nigeria we just take the medicine and move on. No testing. No bracelets. No drama.
And why do you care about cortisol? It’s just a hormone. If your body can’t handle it, then maybe you were never meant to be healthy. Stop being soft.
Also, dexamethasone is cheaper and works better. Why are you listening to Western doctors who overcomplicate everything?
And ACTH test? Ha. In my country we use prayer and garlic. Works better than your blood tests.
Sonal Guha
January 21, 2026 AT 06:38Low dose taper 1mg every 1-2 weeks is fine but most docs dont know this. Patient surveys show 89 percent fatigue 76 joint pain 63 nausea. Stop blaming the patient. The system failed. No test no guidance no follow up. Just stop the script and hope for the best. Thats the norm. This post is the exception not the rule. And dexamethasone is still used because its cheap and insurance likes it. No one cares if you die slow.
Emergency kit? Only if you can afford it. Most people dont even have a primary care doctor. This is a luxury guide for the privileged.
TiM Vince
January 22, 2026 AT 01:09I was on 20mg for 8 months. Tapered over 5 months. Felt awful at 5mg but held for 3 weeks. Then went 1mg every 3 weeks. Took 10 months total. But I’m here. Alive. No crisis.
Key thing? Don’t rush. Don’t compare your timeline to someone else’s. Your body isn’t a spreadsheet.
And yes-carry the shot. Wear the bracelet. Tell your family. This isn’t fear. It’s responsibility.
If you’re reading this and you’re scared? You’re not alone. We’ve all been there. Slow down. Breathe. You’ve got this.
gary ysturiz
January 23, 2026 AT 13:48My mom went through this. She was on prednisone for 2 years after a bad autoimmune flare. We almost lost her when she missed a dose. That’s when we found out about the emergency shot.
She’s been off for 8 months now. Still wears her bracelet. Still takes stress doses if she gets sick.
People think this is overkill. But I’ve seen what happens when you ignore it. This isn’t just advice. It’s a lifeline.