Prednisone and Asacol Questions

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Regular Member

Date Joined Apr 2007
Total Posts : 23
   Posted 2/18/2008 7:39 PM (GMT -7)   
I have mild crohns and am just starting  5 weeks of prednisone 40mg a day to start, reduced by 10mg each week along with Asacol 400mg x 3 for an undetermined amount of time. This is the first time I have had to take any kind of meds. Here are my questions
Is 5 weeks the usual  amount of time to be on prednisone the first time?
Will being on Prednisone this length of time cause the puffy face?
Why does prednisone make some people tired and others wired?
Do any of you who have started  both of these meds at the same time, had alot of side affects and how does one know which med would be causing the side effects if you are on them at the same time?
And finally, I feel so blessed to know there is a place I can come to where there are people who are willing to give advice, encourage me and help me thru my journey. tongue

Veteran Member

Date Joined Apr 2006
Total Posts : 1885
   Posted 2/18/2008 8:36 PM (GMT -7)   
It is not unusual to be on pred for five weeks. However, many people take 40 mg for one or two weeks and then start tapering down.
Why are you on prednisone? Was it to stop a bad flare?

Cookie's Wife
Regular Member

Date Joined Aug 2005
Total Posts : 299
   Posted 2/19/2008 12:56 PM (GMT -7)   
I was just admitted in the hopsital about a month ago for 7 days.  While in the hospital my GI started me in Asacol and of course the dreaded Prednisone.  I started at 40 mg. of Prednisone and was allowed to taper after being discharged.  I had just finished tapering from 40 mg. when I was admitted.  I'm now down to 20 mg.
I'm just starting to get the puffy face.  For me that usually goes away a couple weeks after I'm done.  And since I was also on it prior to this last time I don't know if that's why I'm getting the puffy face only after 5 weeks.  Staying away from extra salt can help with the puffiness.  Prednisone usually makes me wired and gives me the munchies.  I haven't heard of too many people tired unless they are still flaring.
I can't recall any side effects from the Asacol that stood out but I was just getting out of the hospital and a really bad flare so my whole body was out of whack.  My GI said it takes about 3 weeks for Asacol to really begin to work.  I've been on it for 5 weeks and I'm just now starting to feel "normal'.  I'm also in bi-weekly Humira injections that I started in November. 
Hope that helps!
Good luck!
If God brings you to it, He will bring you through it

Regular Member

Date Joined Jul 2007
Total Posts : 56
   Posted 2/19/2008 1:34 PM (GMT -7)   
I was put on Asacol and Prednisone at the same time. I have been on Asacol since July and have no physical side effects. You will notice that after a while of being on this med your urine will stain your toilet seat a sort of burgandy/brown so that's something to look forward to :)

As for the Prednisone, I had a whole bunch a symptoms from that but I was on higher dosages and took 5 months to taper. By the way, I had significantly less symptoms at 40MG and lower so you hopefully will have too much to worry about.

Everybody reacts to Prednisone a little differently, I never experienced much weight gain or puffy face but did have significant psychological side effects (insomnia, panic attacks, crazy mood swings).

Good luck...hopefully, the Asacol will be all you need to keep you healthy.
Dx with Crohn's Colitis July 2007
37 yr old working Mom with two beautiful little girls (2 and 4)
Prednisone (fingers crossed), 75 mg Mercaptopurine (6MP), 4.8g Asacol, lorazepam (1 MG), Vicadin, Imitrex and Ambien as needed
Other stuff: probiotics and folic acid

Regular Member

Date Joined Aug 2005
Total Posts : 32
   Posted 2/19/2008 1:43 PM (GMT -7)   
Prednisone tapers really vary by person. From what I've expereienced, 5-10mg/wk is normal.

I ran into problems tapering too quickly. As soon as I'd taper off, I'd be right back on. I ended up doing 5mg every other week and that finally got me off of it. Including the taper, I was on pred for almost 6 months.

As for the Asacol, I never saw too many side effects (other than the stained toilet) LOL.

Be prepared to see the casings of the asacol in the BM. They usually don't dissolve.

Good luck with the treatment.

Regular Member

Date Joined Oct 2005
Total Posts : 168
   Posted 2/19/2008 1:54 PM (GMT -7)   
I was on both Pred and Asacol at the same time. I didn't have any side effects with the Asacol, but the Pred was another story.

I started to get moon face a couple of weeks after I started Pred. It also gave me the munchies bad! which of course, in turn, caused weight gain. I was on Pred for 3-4 months though, not 5 weeks. That seems kind of light.

Sorry about the Pred, I really am. I've had 3 rounds of it during the last 2 years and it made my life miserable. But some people do much better than I did.


Regular Member

Date Joined Feb 2008
Total Posts : 493
   Posted 2/19/2008 3:59 PM (GMT -7)   
I was on asacol and prednisone combo for a while. Had no side effects from the asacol except that the casing would get stuck on my anal skin tag and hemmies! YIKES! Prednisone was always a miracle worker for me--felt better instantly. However, I'd get the moonface instantly and it wouldn't go away until I was under 10mg, bad dreams, hunger, and crazy mood swings. I also experienced headaches in the back of my head and lots of sweating. I too go with very low salt, plenty of walking/exercise and low caffeine. I also learned how to wake myself out of the really crazy dreams. Many of the low immune system problems I'd have due to the flare up would clear instantly with prednisone--pimples, skin rash, fistula irritations, back pain, weakness. While it's a crazy drug, I'm thankful it's pulled me out of some scary spots.
23 years with moderate Crohn's/colitis; fistulizing crohn's; pentasa

New Member

Date Joined Aug 2008
Total Posts : 2
   Posted 8/28/2008 10:50 PM (GMT -7)   
hello sharon i was diagnosis with chron 2 weeks ago I have to take 30mg predisone 1200mg asacol daily,but i want to start gradually until i reach this dose and see if i can reach remission with less dose.
It will be wonderful to stay in contact to see the benefits or disadvantages of this combination.

Veteran Member

Date Joined Apr 2008
Total Posts : 1753
   Posted 8/29/2008 5:07 AM (GMT -7)   
Asacol(three pills twice a day) and Prednisone(40 mg for two weeks then tapered down 10 mg per week) were the first combination of medication that I took after being diagnosed. I saw no side effects from the asacol. I'm not even sure what it DID do aside from leaving its shell in BM's. It really felt ineffective.

As for the prednisone, I am still taking it now. It worked really well initially to the point where I felt absolutely normal. It still helps now just to a lesser extent due to the severity of my case. So far I do have the puffy face. It made me wired at first, and it felt like I had the equivalent of restless leg syndrome in my arms at night. Now I just get tired a little earlier though I suppose that's more to do with being out all day at school than the prednisone itself. It also has made me want to eat constantly. I can't complain too much..I feel a little self conscious sometimes with the weight gain distribution(I'm still rather thin BUT I don't like where the fat pouches are) and the moon face sometimes, but it's infinitely better than the alternative, and I'm so grateful that, in spite of the side effects, there is something that can give me at least a semi-normal way of life. :)

Anyway, good luck with your own prednisone/asacol experience. I hope it works for you!
20 years old, Diagnosed with severe Crohn's and colitis in May of 2008.
Currently taking:
Prednisone, pentasa, alinia, bentyl, prilosec, tandem plus, and the occasional ultracet
Surgery for ectopic pregnancy(very possibly due to Crohn's inflammation) in July of 2008.
Due to start Imuran September 17 depending on blood results.

Regular Member

Date Joined Jul 2008
Total Posts : 97
   Posted 8/29/2008 10:13 AM (GMT -7)   
I just started my asacol and pred on 05/30/08. I haven't had any side effects. I started on 40mg of pred, I just got weaned down another 10mg to 20(weaned last month from40 to 30) next month when I go back my dr said he would then wean me 2.5 mg every two weeks. so will still have 8 wks or so on the pred if my body allows. I also take 6-MP and Remicade, In the beginning I felt great lots of energy up until mid July, not sure what happened, but now just tired again and that started before the taper. My moon face didn't come until about a month and a half after starting the pred and I've gained 20lbs!!! I can eat a cow! I do have the red casings in my stools from the asacol also. Have had two "episodes" of joint pain in my knees waking me up in the middle of the night. Not sure if that is related to the pred or not.

Tannie 26 yrs
dx May 08 taking 30mg Prednisone,trying to taper, 100mg 6-mp, Asacol 6 twice a day, Remicade. 

Veteran Member

Date Joined Mar 2006
Total Posts : 2739
   Posted 8/29/2008 12:19 PM (GMT -7)   
I never had side effects from the Asacol, I think it's generally well tolerated (of course everyone is so different there).

I was on Pred at 40 mg for a few weeks before I started a slow taper. It took me 4 months to get off of it all together. But a lot of people are on shorter rounds of it, I think that's pretty common. In the first several weeks I had a super appetite, and lots and lots of energy. I ended up gaining 20 pounds from being on it those 4 months. Most of that gained during the first month. I always thought I'd be able to control what I ate, but nah, it's an unbelievable urge to eat! I really never got a big moon face, a little puffy, but nothing like others have talked about getting. I've been off of it 2 weeks now and no puffiness at all.
Diagnosed with Crohn's Disease 2/06 after sever GI bleed. Has been suffering since 1998. History of rectal fistula and gallbladder removal. Just finished tapering off Prednisone *YEAH*, Asacol, Questran, Toprol XL (for high blood pressure).

New Member

Date Joined Feb 2009
Total Posts : 1
   Posted 2/8/2009 12:37 PM (GMT -7)   
Diagnosed with moderate to severe colitis this past new years. Was put on prednisone (40mg/day) and asacol (9 pills a day). I am still tapering off at 5mg less every 10 days.

Initially this stuff had me extremely energetic, mind racing, very sweaty during sleep. Appetite was strongly affected. I gained about 12 pounds in 2 weeks.

My cheeks got a little puffy and fat is definitely migrating toward my stomach. The prednisone is also causing breakouts now of acne on my chest, shoulders, face and neck.

After about 2 weeks of being on the prednisone, I also began to have extremely bad join pain occasionally. The first episode occurred in both knees and ankles. I was literally unable to walk at all, even to the bathroom to get my morning dosage. I had to crawl to the bathroom to get the pills, then crawl to the kitchen to eat something. On later occasions it would just be the knees, or just one knee, but equally painful. The prednisone only seemed to help subside this pain if I took it with food. One of the times my left knee was in a LOT of pain and woke me up at about 5:45 AM. I took the morning dose and tried to lay back down but the pain continued for 3 hours. Finally I ate something and it went away about 20 minutes later.

This medicine is pretty frustrating to be honest. I'm starting to experience the mood swings others have described. I'm normally not one to fly off the handle but I'm finding that I have a short fuse lately. If this is the only choice for treating what I have then I'm thankful to have it, but I wouldn't hesitate to try something else with fewer side effects, even if I had to take it for longer and it cost more money. I don't like being at the mercy of a pill.

Elite Member

Date Joined Apr 2005
Total Posts : 14995
   Posted 2/8/2009 3:49 PM (GMT -7)   
I take Asacol as my maintainence med and have never had any side effects from it other than seeing the shells in my stools. The Pred, everyone is different with this med. I generally get a bigger appetite and more energy. I consider Pred a necessary evil with this disease. I think these meds should get you feeling better soon. With the Asacol I have never had the brown urine that others have spoken of. I guess thats an individual thing, just like this disease. Good luck and welcome to Healingwell.
Gail*Nanners* Co-Moderator for Anxiety/Panic Forum
Been living with Crohn's Disease for 33 years. Currently on Asacol, Prilosec, Estrace, Prinivil, Diltiazem, Percoset prn for pain, Zofran, Phenergan, Probiotics, and Calcium and Xanax as needed. Resections in 2002 and 2005. Also diagnosed with Fibromyalgia and Osteoarthritis and Anxiety. Currently my Crohns is in remission.
*Every tomorrow has two handles.  We can take hold of it by the handle of anxiety, or by the handle of faith"*

New Member

Date Joined Feb 2009
Total Posts : 2
   Posted 2/9/2009 5:47 AM (GMT -7)   
I have been on Pred 40mg for 6 months now - the side effect of being on it this long are terrible - i have been on it before - i would always say make sure you taper off them correctly - you can get them in 2.5mgs too - it might be worth getting those and reducing 2.5 every 4 days - i find that much easier on the gut and side effects! :)
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