prednisone dosage for uc

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heatmiser
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Date Joined May 2003
Total Posts : 1669
   Posted 9/1/2009 11:58 PM (GMT -6)   
How much prednisone do you typically take? I've heard of up to 60mg but how common is that? I'm at 40mg now and still having symptoms but my dr wants me to go on imuran rather than upping the prednisone again. I can't figure out why we wouldn't try more pred before starting something new and unknown to me.

tums
Regular Member


Date Joined Apr 2008
Total Posts : 128
   Posted 9/2/2009 4:02 AM (GMT -6)   

I have always started on 40mg but has taken 2-3 weeks before I notice any improvement.  My cousins pred was increased to 60mg on her first flare up and she started imuran on her first flare up.  I managed to get through 7 years and 7 flares before I caved in to imuran.  I am now battling a flare after 16mths remission so looking at going back on the pred. 

My brother is a general medicine doctor and also a UC sufferer although he has now had surgery.  I remember asking him about increasing pred when on one occassion I had been on 40mg for couple weeks and noticing no difference but he said orally taking anymore that 40mg he felt did not make any difference and he had several occassions when he had them intravenously (sp?).  But in my experience they just take a long time for me to start working typically 2 - 3 weeks.



33 year old female
UC diagnosed 2001
Asacol 6 per day
Azathioprine 100mg started 4/08
 

Post Edited (tums) : 9/4/2009 6:39:24 AM (GMT-6)


pam222
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Date Joined Jun 2009
Total Posts : 985
   Posted 9/2/2009 5:55 AM (GMT -6)   
I've been anywhere from 10-60. I started at 10 and every time I have tapered, I have been put on a higher dose, as it made symptoms worse. I was on 60mg for about a month and got down to nothing and then had to go back up to 30 this last time. I am at 20 now and am not tapering but I do not want to be on a dose higher than that
26 year old female
Diagnosed with unspecified UC 11/08 by flex. sig. as I was pregnant at the time and did not want to be put under for a colonoscopy
Breastfeeding my baby boy (born 4/8/09)
20mg Prednisone, 2 Asacol 3x/day, Prenatal vitamin, and Ferrous Sulfate 2x/day
3 infusions of Remicade with no success
8/09 colonoscopy shows that the whole colon is affected
Waiting on pathology report to make sure I don't have Crohn's before proceeding with surgery


suebear
Forum Moderator


Date Joined Feb 2006
Total Posts : 5402
   Posted 9/2/2009 9:09 AM (GMT -6)   
Taking imuran is far safer than upping your dose of prednisone. Prednisone is not a maintenance drug for UC. I would follow the advice of your doctor, however, if you are unable to work due to your symptoms then get an appt with your GI to discuss other options.

Sue
dx proctitis in 1987
dx UC in 1991, was stable until 1998

1998 started prednisone, asacol, pentasa, nortriptylene, ativan, 6MP, rowasa enemas and suppositories, hydrocortisone enemas, tried the SCD diet, being a vegetarian, omega 3s, flax, pranic healing, yoga, acupuncture, probiotics

2000 lost all my B-12 stores and became anemic

2001 opted for j-pouch surgery- now living life med-free


ucisnotforme
Regular Member


Date Joined Aug 2009
Total Posts : 37
   Posted 9/3/2009 8:31 AM (GMT -6)   
tums- i'm like you, it takes 2-3 weeks to see a difference with pred, and often a month or more for me before i achieve remission. for me, it works better if i take it all in the morning, or split it morning/afternoon, and not take it at night. the imuran is going to take a long while to work- months, not weeks.

my guess is your doctor wants you off the pred because pred has some lousy side effects when you take a lot of it for a long time. imuran won't do this quickly, though.

i normally am prescribed 40 mg of pred, and taper down like this- 40 for two weeks, 30 for two weeks, 20 for two weeks, 10, then 5...

pan colitis diagnosed in 2003

6 mp 50 mg/day
asacol 4800 mg/day
metamucil nightly
lots of live culture yogurt


AmyWaffle
Regular Member


Date Joined Jun 2009
Total Posts : 173
   Posted 9/3/2009 11:14 AM (GMT -6)   
I was just put on a course of pred starting at 80 mg, but that was a last-ditch surgery avoidance route. It has worked like a charm. I am so thankful for Prednisone. Now to get off of it successfully!
UC since 1996 (age 20)
Mommy of 2 sweet little girls.

Asacol (12/day)
Azathioprine (175 mg)
Prednisone (60 mg)
Rowasa nightly
Immodium daily
First Remicade 6/22/09 [discontinued 8/12/09, not helping]


wodin
Regular Member


Date Joined Jul 2009
Total Posts : 491
   Posted 9/3/2009 4:06 PM (GMT -6)   
My last serious flare I stared at 40 MG and was feeling some relief after just a few days. This time I stared on 9 MG of Entecort for a couple of weeks with no relief then my Doc went straight to 60 mg of Pred. I have been at that dose for a week and a half now, and am beginning to see a little relief.
I still have blood and mucus in the mornings, and pinkish mucus at night, but have some fairly productive BMs during the day, a couple of hours after taking my pred.
Male age 65
First Diagnosed Feb 2007
Significant flare June-July '07 treated with Prednisone
Asocol X 6 per day
Largely in remission with some minor flares treated with Entocort
Currently in flare X 3 weeks
VIEW IMAGE


Christine1946
Veteran Member


Date Joined Aug 2008
Total Posts : 5472
   Posted 9/3/2009 4:20 PM (GMT -6)   
     Been on prednisone off and on since being diagnosed in 98.  The doctor tried started me at 30 mgm with this present flare (started right after Memorial Day), but 30 did nothing, so he increased the dose to 40 mgm with a 5 mgm taper per week.  At the present time, I am still on 5 mgm of prednisone.  I would like to know how people can take only 1 or 2 mgm of prednisone since my pill is 10 mgm with a divider.
     I will tell you what prednisone has given me....osteoporosis, high blood pressure and with this present flare...borderline diabetes.  My doctor calls it the best/worse drug.  I am back on the 6 MP 50 mgm.
 
Diagnosed with ulcerative proctitis in 1998 in hospital
Hospitalized (2nd time) in May 2008 for ten days.
Remission Nov 08 thru May of 09.
Slowly coming out of flare.  Meds: Colazal (6 per day), prednisone 10 mgm and tapering weekly, Cort enema nightly, Canasa in morning, Benicar 20 mg for BP, flaxseed oil 3 x a day, fishoil 2 x a day, probiotic 3 x a day, calcium with D 1x a day and multivitamin.
Doctor had me on 100 mgm of 6MP which drastically lowered my white count.  Now off the 6MP pending results of repeat white count. UGH.


heatmiser
Veteran Member


Date Joined May 2003
Total Posts : 1669
   Posted 9/3/2009 7:38 PM (GMT -6)   
Thanks for all the replies. I guess I will try my luck with imuran. Just had my initial blood work done. I just hope it helps. Thankfully at this point I am functional and making it through work, although I have run low fevers and haven't felt my best. It could be worse I know.

pb4
Elite Member


Date Joined Feb 2004
Total Posts : 17880
   Posted 9/3/2009 8:05 PM (GMT -6)   
My GI's have always started me on 40mg for 2 weeks straight before tappering down 5mg weekly (then by 1/2mg when I'm down to 3 weeks left on it, they like to taper me slowly)...once I had my GP put me on 30mg for 2 weeks and then tapering, my GI laughed and said why bother with 30, if you're gonna go on pred the best minimum to start at is 40.

The 30 never did do a thing for me either, so GI was right yet again.

:)
My bum is broken....there's a big crack down the middle of it! LOL :)


Nutz
Regular Member


Date Joined Jul 2009
Total Posts : 149
   Posted 9/3/2009 10:09 PM (GMT -6)   
For me, the Prednisone usually works within a week. My doc just recently put me on 30mg which was working well but then my flare became worse a few weeks later. I upped my Pred to 40mg with minimal relief so my doctor admitted me into the hospital to receive IV steroids. I was there for 5 days (4 of which on IV steroids) and it did the trick. I am now taking 40mg orally and will taper to 30mg after 2 weeks. If you are not getting any better on 40mg, I suggest the IV steroids because they throw you into remission. It would also be a good time to start Imuran because it takes 2-3 months to kick in. Are you taking any of the 5ASA's for maintenance?? Might be a good idea so you can get off of the Pred as well.
Nutz
Diagnosed with Ulcerative Proctitis 1999, changed to Ulcerative Colitis 2002.  Currently taking 6MP 50mg, Prednisone 30mg, Lialda 2 tabs/day, Colocort enemas, Canasa suppositories


heatmiser
Veteran Member


Date Joined May 2003
Total Posts : 1669
   Posted 9/5/2009 10:29 PM (GMT -6)   
Yes, I take colazal for maintenance. I haven't heard about the iv prednisone. I don't know that I'm flaring bad enough for that since I'm able to work right now. What kind of dosage do they give you for that? Are the side effects more pronounced because it's an iv?

burnabygirl
Regular Member


Date Joined Jun 2008
Total Posts : 205
   Posted 9/6/2009 7:44 PM (GMT -6)   
Nutz said...
I upped my Pred to 40mg with minimal relief so my doctor admitted me into the hospital to receive IV steroids. I was there for 5 days (4 of which on IV steroids) and it did the trick. I am now taking 40mg orally and will taper to 30mg after 2 weeks.


My doctor was also considering to admit me to the hospital for IV steroids 2 weeks after I'd taken 35 mg Prednisone with little improvement. And now I have been on 35 mg Pred for 4 weeks and I'm feeling better. I can't taper yet, not until I go less than 6 times/day, as suggested by my doctor.
How did you feel having IV steroids in a hospital?
Ulcerative proctitis diagnosed in July 2006. Medications: Salofalk enema nightly.
Remission from Nov 2006 to Oct 2007. Then a bad cold and a bad flare for 1 year till Nov 2008.
Pancolitis diagnosed in April 2008. Current medications: Salofalk enema, Salofalk suppositories, Salofalk tablets 1000mg x 3/day, Entocort enema
Supplements: Calcium with Vitamin D, Vitamin B Complex, Vitamin C and psyllium capsules (Metamucil).

Present status: Flaring since July 2009; on 35 mg Prednisone

Post Edited (burnabygirl) : 9/6/2009 9:49:58 PM (GMT-6)


Christine1946
Veteran Member


Date Joined Aug 2008
Total Posts : 5472
   Posted 9/6/2009 9:15 PM (GMT -6)   
      Heatmiser....I was on IV steroids in the hospital last year too.  I believe it was 60 mgm and yes, the side effects, at least in my case, were worse.  They had to give me insulin because my blood glucose shot up to 180.  However, with this flare I am gradually coming out of now, my blood sugar went to 237!!!  I've been on prednisone since June 11th.  I started at 30 mgm on the doctor's advice.  It did nothing, so he increased it to 40 mgm with a 5 mgm per week taper.  Presently, I am taking 5 mgm one day and skipping the next, etc..  I also take a Cort enema every other night now too.  I cut my Colazal down to six per day instead of nine.  For the past two weeks my blood sugar has been normal.  My family doctor gave me an Accu-Chek monitor but you can purchase one at your local drug store.  Because of all the times I have been on prednisone, I know while on it I have to closely monitor my blood pressure too. sad
 
Diagnosed with ulcerative proctitis in 1998 in hospital
Hospitalized (2nd time) in May 2008 for ten days.
Remission Nov 08 thru May of 09.
Slowly coming out of flare.  Meds: Colazal (6 per day), prednisone 10 mgm and tapering weekly, Cort enema nightly, Canasa in morning, Benicar 20 mg for BP, flaxseed oil 3 x a day, fishoil 2 x a day, probiotic 3 x a day, calcium with D 1x a day and multivitamin.
Doctor had me on 100 mgm of 6MP which drastically lowered my white count.  Now off the 6MP pending results of repeat white count. UGH.

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