maintenance low dose prednisone/Azathioprine - harmful long term?

New Topic Post Reply Printable Version
[ << Previous Thread | Next Thread >> ]

JonVT98
New Member


Date Joined Jul 2008
Total Posts : 18
   Posted 7/21/2008 11:43 AM (GMT -6)   
Hello.  I've had U.C. for about 4 yrs now.  All of the normal meds(colozal, asacol, and now lialda), seem to make my symptoms worse.  The only thing that has ever worked for me is Azathioprine(imuran) at 50 mg, and a maintenance low dose of prednisone where I take 10 mg per day.  Even with this, I still have problems in the middle of the night and the morning, but the 50 mg imuran and 10mg pred with breakfast gets me through the whole day 99% of the time without a problem.  My concern though is what preds and Imuran might do to me long term.  My doc thinks I should not really take either medication long term.  I do the blood tests, which so far have come back fine every time.  I don't want to be doing long term damage to my health, but...it took me forever to find a combination that gets me through the day...and it's so frustrating that the normal medications just don't work.  If I go off preds, the symptoms come back within a week, even when i tired to up the dosage of Imuran to 100mg.  It seems i'm stuck right now with low dose prednisone.  No crazy side effects yet, but I'm worried about my future health.  Just thought i'd get some thoughts from others that might have had some similar issues.  Thanks for any responses. 

ediekristen
Veteran Member


Date Joined Apr 2007
Total Posts : 1366
   Posted 7/21/2008 11:53 AM (GMT -6)   
Azathiprine supposedly can be used long term, but prednisone is most definitely NOT a long term or maintenance drug and can cause a wide variety of problems: according to the drug information, long-term side-effects include Cushing's syndrome, weight gain, osteoporosis, glaucoma, type II diabetes mellitus, and depression upon withdrawal. Not to mention it also causes adrenal suppression:

"Adrenal suppression occurs if prednisone is taken for longer than 7 days, a condition wherein the body is unable to synthesize natural corticosteroids and becomes dependent on the prednisone taken by the patient. For this reason, prednisone should not be stopped abruptly if taken for longer than seven days; rather the dosage must be reduced slowly. This reduction may be over a few days if the course of prednisone was short, but may take weeks or months if the patient had been on long-term treatment. Abrupt withdrawal may lead to an Addisonian crisis, which may be life-threatening."

Female, 23, Ulcerative colitis (pancolitis) since 1999; GERD; gastritis; osteopenia in femur head & lumbar region of the spine from long term prednisone use. 

Currently unmedicated and flaring :(
Waiting for my appointment with the new GI on July 18th. Insurance finally kicked in, hooray!

 
 
 


ErinD
Regular Member


Date Joined Jul 2008
Total Posts : 94
   Posted 7/21/2008 11:57 AM (GMT -6)   

Hi John,

I am like you, i have UC and i do my best when i am on prednisone.  However as we all know it is not good to be on it for a long time.  I have a hard time tapering past 10mg myself without starting up a flare.  Asacol only made things worse for me as well.  My doctor recently took me off the Asacol and is having me try to taper down from 20mg of pred while also taking 9mg daily of Entocort.  Each week he is having me taper the pred 5mg until i am off of it and just taking the Entocort daily.  He said that you can be on Entocort for a lot longer as it is safer than the prednisone, yet also a steroid.  If this doesnt work he is going to look into either 6-MP or Remicade. 


JonVT98
New Member


Date Joined Jul 2008
Total Posts : 18
   Posted 7/21/2008 1:07 PM (GMT -6)   
Hi. Thanks for the responses. Yea, I have tried all those 5-asa drugs. I can't even remember some of the names cuz it was a long time ago. None of them work. Even if I take 5mg prednisone, it makes a HUGE difference. So, I am stuck. Oh...my dr. said Entocort would not work with U.C. cuz the medication doesn't make it to the colon. I have the left-sided U.C. I don't know if he's right or not, because I'm new to this site and have been reading some of the posts, and it seems some people here that have U.C. are on Entocort. Should I challenge my doc on this? He immediately dismissed the idea when i brought it up. I'd love to find something with a little less harsh side effects, because after 4 years of trying medication after medication, Imuran and low dose prednisone is the ONLY thing that works. And even with that..i'm not in full remission. Very mild symptoms..but no remission. I'm just tired of trying medication that makes me feel worse.

JonVT98
New Member


Date Joined Jul 2008
Total Posts : 18
   Posted 7/21/2008 2:31 PM (GMT -6)   
Thanks. I think what i may try to do is up my Azathioprine from 50 mg to 100 mg, and try my best to rid myself of the prednisone. I'm not sure if that will happen, but...this Lialda is giving me horrible abdominal pains and nausea and I often feel like I want to vomit. Especially when my stomach is empty in the morning. Gosh mornings are rough on this stuff. I may post a separate thread on the side effects of lialda, cuz my doc seems to think that the side effects i'm experiencing with Lialda are actually being caused by being in a bad flair-up. I don't agree with him, cuz I felt worse within a few days after taking that stuff. Yea, maybe I need to get a second opinion from another doctor. I hate to give up on it so quickly, but I feel horrible. His intentions are good in trying to get me off the preds...but none of these 5-asa meds are working for me at all, and I actually end up having to increase my pred. dosage every time I try one. Kinda counter-productive.

seconder
Veteran Member


Date Joined Jun 2008
Total Posts : 599
   Posted 7/21/2008 6:47 PM (GMT -6)   
I don't know your age, but my GI recommends his younger patients try to avoid Imuran etc. The evidence is controversial, but there seems to be an correlation between immunodialators and some bad side effects.

Your problems with Lialda sound a lot like my problems with Asacol (same medication) and once I switched to sulfasalazine, those side effects went away.

JonVT98
New Member


Date Joined Jul 2008
Total Posts : 18
   Posted 7/21/2008 7:12 PM (GMT -6)   
Hi.  I'm 32 yrs old.  Unfortunately Imuran was about the last of the meds(along with prednisone) that worked.  None of them ever did. I tried all the mesalmine drugs, as well as all the sulfasalizine drugs over the past 4 and a half years since i was first diagnosed with U.C. in 2004. 6MP didn't do it for me either.  Finally Imuran along with low dose preds got me mostly into remission.  Only problem now is..if I cut off the preds..i'm back in a flair up within a week.  I only take 50 mg imuran and I am probably going to incease that to 100 mg and then try to completely ween myself off the preds.  I am just very frustrated that the typical medication has NEVER worked for me.  Everyone one of those 5-asa drugs put me into one hell of a flair up.  So, i guess i'll put up with the blood tests every  3 months on the Imuran and pray that nothing horrilbe happens.

rob_uk
Regular Member


Date Joined Jul 2007
Total Posts : 32
   Posted 7/22/2008 10:29 AM (GMT -6)   

hi jon, have you tried prednisone enemas? i think that the side effects are not as bad as with the tablets.

i'm the same its very frustrating.

 i've been on 100 mg azathioprine for about 12 years now, i think its pretty safe long term as long as you have regular blood tests.

prednisone is definately bad long term though.


JonVT98
New Member


Date Joined Jul 2008
Total Posts : 18
   Posted 7/22/2008 11:05 AM (GMT -6)   
Thanks for the reply. Yea, I am only on 50 mg Azathioprine, but i'm going to start 100mg soon. Maybe that will allow me to totally kick the preds. At least for awhile. I can get to where I only take 5mg preds. Such a low dose! and it makes such a difference! Hopefully a dose that low isn't going to create too many issues down the road, cuz...with nothing else working, I feel like i'm stuck with this combo of meds. What kind of prednisone enemas do you use? Entocort? I'm going to create a separeate thread..but anyone who reads this..let me know what vitamins you take, or supplements that might help to counter act the side effects of low dose prednisone. I'm just nervous that even 5mg of preds long term is going to do some horrible damage. I guess the good thing for now is...when i'm just taking those meds, I have no side effects, pass all my blood tests, and I feel pretty good.

tennisfan4
New Member


Date Joined Dec 2007
Total Posts : 4
   Posted Today 5:31 PM (GMT -6)   
John,
Your situation sounds a lot like mine, although I was taking 200 mg Azathioprine until recently and it didn't appear to be doing much of anything, so I stopped. I have been stuck on anywhere from 5 to 20 mg of Pred for the past year and a half, so my docs are pushing me toward surgery. I had actually scheduled surgery for the end of June but I was feeling fine and only on 5 mg pred, so I decided to cancel it. Sure enough, two days later I had a ridiculous flare...so I'm pretty sure I'm going to have the surgery sooner rather than later...In the meantime, I take 1200 mg of calcium plus vitamin D per day to hopefully combat the calcium loss from the steroids. I agree it's ridiculously frustrating, especially when I don't feel THAT sick so I don't know if I want to have surgery yet...Good luck!!

rob_uk
Regular Member


Date Joined Jul 2007
Total Posts : 32
   Posted 7/25/2008 11:33 AM (GMT -6)   
the enemas i've had are called predsol

jars05
Regular Member


Date Joined May 2003
Total Posts : 247
   Posted 7/25/2008 9:28 PM (GMT -6)   
What the hell is an Addisonian crisis?
Age: 30
Sex: Yes please!
Location: Missouri
Diagnosed with UC in 1997.
Medications: 100 mg Azathioprine a day, Blech 40mg Prednisone
Supplements: calcium, and multivitamin
No. of colonoscopies: 5
Last scope: 6/7/08-everything looked ok.
 
 


ChiCubs7
Regular Member


Date Joined Jul 2008
Total Posts : 24
   Posted 7/25/2008 9:39 PM (GMT -6)   
A condition where one's cortisol is very low.

www.nlm.nih.gov/medlineplus/ency/article/000357.htm
Ken

Seborrheic Dermatitis diagnosed Jul 08
Left Sided Ulcerative Colitis diagnosed Jan 08
Minimal Change Disease diagnosed Feb 06

New Topic Post Reply Printable Version
Forum Information
Currently it is Friday, July 25, 2014 10:55 AM (GMT -6)
There are a total of 2,179,318 posts in 242,335 threads.
View Active Threads


Who's Online
This forum has 153595 registered members. Please welcome our newest member, jmr2007.
432 Guest(s), 23 Registered Member(s) are currently online.  Details
teacher9075, bobogol, rowingmom, JackLegofAllTrades, BnotAfraid, jason411, Inspiredby3, not creative, Brudisdog, My Anxiety Life, John T, BillyBob@388, Mommanoesbest3391, w0hll, UCHater, Akkami, Mississippi Jane, AubreyBear, Mako24, Squirm, UCandMe, iPoop, minnietoty


Follow HealingWell.com on Facebook  Follow HealingWell.com on Twitter  Follow HealingWell.com on Pinterest  Follow HealingWell.com on YouTube
Advertisement
Advertisement

©1996-2014 HealingWell.com LLC  All rights reserved.

Advertise | Privacy Policy & Disclaimer