Predinsone at once or divided?

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B00e00n00
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Date Joined Mar 2009
Total Posts : 55
   Posted 4/3/2009 10:56 AM (GMT -6)   
Hi all,
I am on Lialda 4 tablets

starting taking Predinsone 40 mg total , 20mg twice a day (morning and evening)
My dr. is hoping to get the inflammation down so I can eat more fiber and get things moving and vary my diet.

Started on Monday Night, Now its Friday afternoon.

I don't like it's doing anything. I feel like I'm just taking Lialda! I'm not in bleeding diarrhea (I wasn't before the predinsone either), just can feel internal inflammation rectum. Stools are painful to pass usually once every day or two. and have alot of mucus My abodmen spends the whole day cramping, cold and in pain and am very fatigued of course. By body is trying constant trying to eliminate waste but is struggling. I am on a very simple diet, Fresh Homemade juice from a juicer (apple-pear-celery juice), cream of rice/soft pulverized oatmeal, sweet potato, and a food powder for UC made that helps provide nutirents.

B00e00n00
Regular Member


Date Joined Mar 2009
Total Posts : 55
   Posted 4/3/2009 10:58 AM (GMT -6)   
Forget to add: my question is do you think I should be taking predinsonse all in once dose? How long does it usually take to work? Predisone in the pass would work quickly for me almost instantly but that was over a year ago.

sweetmelody
Veteran Member


Date Joined Aug 2007
Total Posts : 650
   Posted 4/3/2009 11:29 AM (GMT -6)   
I know ya can split up Lialda, but I've always taken my prednisone all at once in the morning.... like it says. I'd ask dr about it...I'm not sure what to tell ya.
Kara, 22F Married.
Latest-Went to ER cuz I couldn't eat for 5 days and was having severe flare up after passing two kidney stones after a week of the flu. (long month)
GI tried to taper me off of pred fairly fast in hopes to keep me on Lialda and at a lower dosage of pred. to try mesalamine enemas again.  Starting the Imuran as soon as labworks done... longer pred time....yippee *rolls eyes*
Medications:Prednisone 40mg Again! (groan)Lialda 4 a day until Imuran
I am so sick of this disease!
 
 


fruitgirl
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Date Joined Feb 2009
Total Posts : 7150
   Posted 4/3/2009 11:45 AM (GMT -6)   
My doctor said the pred is more effective if it's split out through the day...something to do with our circidian rhythms or something. Anyway, when I was on 40mg, I took 10 mg 4 times a day; breakfast, lunch, dinner, and bedtime. As I decreased my dose, I dropped the latest one each time.
Symptoms began in November 2008, ~4 weeks after giving birth to my son.
Eased for ~3 weeks in December, possibly b/c of probiotic use?
Returned in January 2009 (with a vengeance), diagnosed with pancolitis on January 30.
Currently taking Asacol (400mg 4 pills 3x daily), Rowasa nightly, 40mg 30mg 20mg 15mg of Prednisone (quick taper), Culturelle probiotic, and Zoloft (25 mg).


pb4
Elite Member


Date Joined Feb 2004
Total Posts : 20577
   Posted 4/3/2009 11:51 AM (GMT -6)   
I've always been instructed to take pred all at once and first thing in the am so you don't have issues with sleeping, one main concern by splitting them is often people will forget to take their second dose of the day and with pred you don't want to messing around with mistakes like that and if you want to be able to sleep taking it first thing early am is best, I've also been told there is no benefit to splitting the dose.

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


PSA
Regular Member


Date Joined Jan 2009
Total Posts : 498
   Posted 4/3/2009 11:58 AM (GMT -6)   
Well if I am not wrong, I was always suggested by all the doctors not to take the Pred at bed time as it causes lot of damage since the Pred is not absorbed by the body as there is no physical activity at that time. All the doctors advised me to have the medicine in the morning alongwith milk instead of water. Besides this one has to take Calcium with Alpha D to reduce the side effects of osteoporaris and joint pains. Please consult your Doc regarding this but I repeat please do not take it at bed time otherwise you will have severe joint pains.
It takes about a week to 10 days to show positive result.
45 years Male Attorney
Diagnosed UC October 1989
Had two stage J Pouch Surgery Nov 2005 Take Down March 2006
Complications after surgery - Incisional Hernia and Ano Fistulas
"Faith is the bird that sings when the dawn is still dark."
"There are only two ways to live your life. One is as though nothing is a miracle. The other is as though everything is a miracl: Albert Einstein
"What you are aware of you are in control of; what you are not aware of is in control of you."
 


PSA
Regular Member


Date Joined Jan 2009
Total Posts : 498
   Posted 4/3/2009 11:58 AM (GMT -6)   
Well if I am not wrong, I was always suggested by all the doctors not to take the Pred at bed time as it causes lot of damage since the Pred is not absorbed by the body as there is no physical activity at that time. All the doctors advised me to have the medicine in the morning alongwith milk instead of water. Besides this one has to take Calcium with Alpha D to reduce the side effects of osteoporaris and joint pains. Please consult your Doc regarding this but I repeat please do not take it at bed time otherwise you will have severe joint pains.
It takes about a week to 10 days to show positive result.
45 years Male Attorney
Diagnosed UC October 1989
Had two stage J Pouch Surgery Nov 2005 Take Down March 2006
Complications after surgery - Incisional Hernia and Ano Fistulas
"Faith is the bird that sings when the dawn is still dark."
"There are only two ways to live your life. One is as though nothing is a miracle. The other is as though everything is a miracl: Albert Einstein
"What you are aware of you are in control of; what you are not aware of is in control of you."
 


fruitgirl
Veteran Member


Date Joined Feb 2009
Total Posts : 7150
   Posted 4/3/2009 12:00 PM (GMT -6)   
I took it at bedtime and never had joint pain issues. Or insomnia. So who knows. I started pred on a Monday, and by Tuesday had definite improvement. By Wednesday my symptoms had pretty much disappeared.
Symptoms began in November 2008, ~4 weeks after giving birth to my son.
Eased for ~3 weeks in December, possibly b/c of probiotic use?
Returned in January 2009 (with a vengeance), diagnosed with pancolitis on January 30.
Currently taking Asacol (400mg 4 pills 3x daily), Rowasa nightly, 40mg 30mg 20mg 15mg of Prednisone (quick taper), Culturelle probiotic, and Zoloft (25 mg).


pb4
Elite Member


Date Joined Feb 2004
Total Posts : 20577
   Posted 4/3/2009 12:08 PM (GMT -6)   
PSA.Delhi said...
Well if I am not wrong, I was always suggested by all the doctors not to take the Pred at bed time as it causes lot of damage since the Pred is not absorbed by the body as there is no physical activity at that time. All the doctors advised me to have the medicine in the morning alongwith milk instead of water. Besides this one has to take Calcium with Alpha D to reduce the side effects of osteoporaris and joint pains. Please consult your Doc regarding this but I repeat please do not take it at bed time otherwise you will have severe joint pains.
It takes about a week to 10 days to show positive result.

Correct, as I stated, taking it first thing early in the am will commonly ensure you won't have sleep problems at night.  The milk suggestion is mainly because the pills have such an awful aftertaste, but be careful if you have any lactose intolernace issues, then you'll want to be sure to use lactaid products (milk or pills) or you could take primadophilus reuteri probiotic which aids with lactose issues but back on topic, how long it takes to show progress is individual, the very first time I was on pred (18 yrs ago) by the next day I felt amazing (that was with 40mg start), but unfortunately for me pred no longer has any affect on me.
 
:)
My bum is broken....there's a big crack down the middle of it! LOL :)


B00e00n00
Regular Member


Date Joined Mar 2009
Total Posts : 55
   Posted 4/3/2009 1:23 PM (GMT -6)   
Thanks all.  I left a message with the Dr. and am waiting a call back.  Right now I've noticed a little trouble sleeping so, I have a bit of a sore throat.  I think since its not working it and its minorily starting to affect my sleep maybe a full dose at once in the morning would be better. 
 
    I am really struggling to get calories into my diet and all food (causes pain) and my muscles are cracking (though I suspect this is because I have been on such a low protein diet, calorie diet for a long time). 
 
sweetmelody, I take Lialdla all at once, it would be interesting to see how it would affect me to split it up.
 
Fruitgirl,  I'm glad its working for you I hope it will start to kick in for me too.  I'm starting to think its better to decided per person on whether to spllit up predinsone or not but like you said we are no drs. (even though I distrust some of what Dr say)
 
PSADelhi, I am taking Vit. D3, B12 (I am vegan, though i take VSL#3 probiotic) and am going to pick up some calicum citrate at the Apothecary this weekend. 
 
Pb4,  I fear your point might be right,  I am much worse off than before.  A year ago I could have a whole jar of peanut butter and go into a flare and the predinsone would nip it in the bud (same dose too I believe).  Now its been 3 1/2 days on this easy to digest diet (cream of rice, oatmeal,(I would be doing no grains but I need calories!), Ulcerative Colitis Food powder, Juice from a juicer (apple-pear-celery))  and still nothing.
 
 
I really can't function, I'm in constant pain, don't go to school, work or anything.  I don't even feel like playing computer games, I live day by day wondering how I'm going to get enough calories while reducing pain, all foods cause pain and suspend the digestion process but the ones I have now are the best I can come with for my given situation, otherwise I'd be bleeding out of control.
 
I think I am heading for 6mp or something since I have never been in remission.  The only reason I don't bleed dirrehea is because I'm so restricted all the time but I have significant fatigue and constipation, rectal burning,burning of the eyes, and parts of skin.
 
I would like to try a water fast sometime (I have tried a juice fast and it worked well at first but I think I waited till my condition got to bad to try) but right now I am too low weight (Mid 120's, I am 5'10 used to be 155-165) and too nutriently depleted.
 
Sorry some of my thoughts are repeated but I have trouble functioning with all this pain and nutrition delpeted.
 
 
   

pb4
Elite Member


Date Joined Feb 2004
Total Posts : 20577
   Posted 4/3/2009 1:35 PM (GMT -6)   
Well I sure hope the pred kicks in for you soon....usually docs will put you on a maintenance med and then on pred so the pred can offer some relief until the maintenance drugs kick in.  How long have you been on the Lialda?

Feel better soon :)


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


fruitgirl
Veteran Member


Date Joined Feb 2009
Total Posts : 7150
   Posted 4/3/2009 1:42 PM (GMT -6)   
Oh, wow, I'm sorry you are so very sick. I hope you find something that works for you soon!
Symptoms began in November 2008, ~4 weeks after giving birth to my son.
Eased for ~3 weeks in December, possibly b/c of probiotic use?
Returned in January 2009 (with a vengeance), diagnosed with pancolitis on January 30.
Currently taking Asacol (400mg 4 pills 3x daily), Rowasa nightly, 40mg 30mg 20mg 15mg of Prednisone (quick taper), Culturelle probiotic, and Zoloft (25 mg).


Howright
Regular Member


Date Joined Oct 2008
Total Posts : 86
   Posted 4/3/2009 1:46 PM (GMT -6)   

 

I don't have a bunch of noticable side effects when I take prednisone but I wouldn't want to take 20 mg before bed!! 


 
Diagnosed January 07 - but realize I've been living with minor flare-ups for 10+ years. 
 
Asacol 3 pills/3 times a day.
 


AlliUC
Regular Member


Date Joined Mar 2009
Total Posts : 50
   Posted 4/3/2009 1:52 PM (GMT -6)   
I have been taking 60 mg a day for 3 weeks. I take it all in the morning and was advised to take it by 9:00 a.m. This does still seem to keep me awake but I suspect it is better to take it all in the morning. Some nights my sleeping pills don't even help. I am glad to take it all at once because I do get forgetful when I have to take pills throughout the day at different times.
Female, 41
1996 diagnosed proctitis (during pregnancy, just months after I quit smoking)
Mar 3, 2009 diagnosed ulcerative colitis - it got my entire colon - severe

Fighting my first major flare up of UC (but I think my first UC flare up was at the end of 2006, 2 months after I quit smoking again)
60 mg prednisone (started at 30 but was doubled immediately) Mar 5/09
salofalk enemas = 5-aminosalicylic acid (mesalamine) added March 24/09 after second colonoscopy showed not enough progress ( previously managed proctitis with same stuff as suppository and then enema in 06)


B00e00n00
Regular Member


Date Joined Mar 2009
Total Posts : 55
   Posted 4/3/2009 2:02 PM (GMT -6)   
I posted a longer reply but for some reason it didnt get posted and deleted.  For me in my condition that's like writing an essay.  Here a shorter version
 
Wating for a call for the dr.
 
I am having a little trouble sleeping so maybe I should divide it up.  I
 
Fruitgirl, hope it continues to work for you and hope it will work for me soon, may we both be off the pred. soon and healthy again.
 
PSADelhi, I have muscle weakness but I think that's because of a prolonged low protein diet, low calorie diet.  I take Vit d3, B12 (vegan though take VSL#3 Probioitics) and will pick up some Calcium citrate
 
pb4, I fear you may be right, Predinsone a year ago (same dosage I belive) would stop a flare up from a whole jar of peanutbutter almost insantly,  but now 3 1/2 days on this simple diet and nothing.  
 
I'm probably heading for 6mp because I'm never in remission and the only reason I don't bleed direreha is cause I'm so restricted though I have internal inflammation for sure (I can feel the burn!) but I can't function like this.  I don't even have the energy to play a computer game really. too much pain all the time.
 
Right now I'm eating and the inflammation goes up no matter what unless I starve my self but I can't do that I'm nuturitently and low weight.  I live day to day trying to get enough calories in without falling of the edge.  I've been in pain all the time, out of school and work and all activities (stay at home all day) so long I've forgotten what it's like to live.  LIFE IS ALL PAIN, but hopefully things will be better soon.  It helps to have a community like this.
 
Sorry if my thoughts are cluttered but I have trouble funcitioning well in such pain and nutritionly depleted state.
 
 
 

B00e00n00
Regular Member


Date Joined Mar 2009
Total Posts : 55
   Posted 4/3/2009 2:25 PM (GMT -6)   
I see not that my message had already been posted.  Either the computer was acting up or my mind, wouldn't be suprised it if was the latter

B00e00n00
Regular Member


Date Joined Mar 2009
Total Posts : 55
   Posted 4/3/2009 2:38 PM (GMT -6)   
I have been on Lialda for about 2 1/2 weeks.  I have noticed an effect but not enough (though Dr said it can take 1-2 months to fully work).  I hope so, I'd rather avoid 6mp. 
 
Just got off the phone with the dr.  He said you can take it all the predinsone at once if you want and probably should if its effecting your sleep a little.
 
He told me to hold tight, ( I see him next week) sometimes the predinsone takes a while to work.  I will let everyone know what happens.
 

kops2da
Veteran Member


Date Joined Jun 2008
Total Posts : 2865
   Posted 4/3/2009 3:20 PM (GMT -6)   

Prednisone makes me want to eat all the time - munchies!

I see you eat grains, I assume juice is from raw food.  I don't know about you but I was told NOthing raw, no grains, etc.  I eat white bread, rice cereal, well cooked veggies - few - small amounts of meat (I know you are vegan) and lots of peanut butter.  I have problems with anything with high fiber, etc.

Sure hope you get results soon from the medicaton.  Prednisone worked in about 4 days for me but I have a mild to moderate case.

ElaineNY


 
Senior - New diagnosed with proctosigmoiditis - 6/2008  Cannot tolerate mesalamines, Canasa, etc. Tried, Colozal, steroid enemas, etc. - started working but severe side effects occurred.
Started on prednisone Feb.7, 2009 - tapering to 20 mg. for two more weeks and then down to 15 mg.etc.  Added 6-MP Feb. 28.
Added Anusol suppositories - March 16 - see doc in 3 months. 
Probiotic Align, Prilosec for GERD, Gas-X, vitamins, Calcium/D
Tylenol for knees and arthritis.
 
 
 


B00e00n00
Regular Member


Date Joined Mar 2009
Total Posts : 55
   Posted 4/3/2009 6:37 PM (GMT -6)   
Elaine, I hope I can gain some weight I am very low now so hopefully. Predinsone needs to work soon hopefully, its been 4 days now so maybe it will kick in soon like it will for you, though unfortunately it doesn't feel like it.

Peanutbutter would kill me though, glad you can tolerate it, enjoy it!. Juice is about the best thing that I tolerate. It is made at home in a juicer out of fresh fruit, pear,apple with celery(neutral green vegetable). I would avoid grains but I have been calorie starved for so long its the only way to get em (combined with steamed veggies. I would eat low fiber but than everything gets stuffed up even more so I try and get just enough to push things along but its so painful. Hopefully Preds work soon. I think I'm deceptively bad. Sometimes I feel like I just want to eat more than this simple diet and say to the Dr., SEE HOW BAD IT IS?!
UC since 2006

2009 UC Pancolitis though Primiarly Left Sided, Active Moderate

Current meds: Lialda 4 tab a day
Predinsone (40 mg a day) since 3/30 Not doing anything!

What does remission feel like, I don't remember!

Nip UC in the bud with diet before it nips you in the bud (or butt) for good!


kops2da
Veteran Member


Date Joined Jun 2008
Total Posts : 2865
   Posted 4/3/2009 7:51 PM (GMT -6)   

Once again good luck.  Just seems like there is something high calorie out there you can eat or drink - like older people eat to keep up their weight.  I have gained about 6 lbs. from prednisone and I eat cheese, ice cream, white bread, eggs, pasta, rice cereal and just about anything bland and low residue.  Just feels like to me you have something else going on - digestive disorder or something - does not sound like JUST UC to me. 

Just hope you find what works - first of all prednisone and then a maintenance for you.

ElaineNY


 
Senior - New diagnosed with proctosigmoiditis - 6/2008  Cannot tolerate mesalamines, Canasa, etc. Tried, Colozal, steroid enemas, etc. - started working but severe side effects occurred.
Started on prednisone Feb.7, 2009 - tapering to 20 mg. for two more weeks. Bleeding returned - no call back from doc so I upped prenisone to 25mg. on my own - 6MP - 50 mg. 4/2/2009 
Probiotic Align, Prilosec for GERD, Gas-X, vitamins, Calcium/D
Tylenol for knees and arthritis.
 
 
 


Malkavian
Veteran Member


Date Joined Mar 2009
Total Posts : 1439
   Posted 4/3/2009 10:58 PM (GMT -6)   
My pharmacist said you can do either but recommended taking it all in one does.

Also, for food try applesauce or roast chicken. My boyfriend was awesome and made me a whole chicken when I was flaring and in the process of being diagnosed, so that I could just pull what I wanted off the bone for meals, then made soup with it. You might also want to try looking into nutrient shakes-I'm pretty sure that one of the brands (boost or insure or something) is nondairy. Also, Naked brand smoothies I've found are great when I'm having trouble with solids, just make sure you don't get the ones with fiber. They have a really good banana chocolate protein shake.
21, female, diagnosed 3/6/2009
Mild ulcerative colitis from rectum to mid transverse colon
Currently in remission
Currently taking Asacol (3x/day) and Calcium/D supplements


Dr-A
Veteran Member


Date Joined Jul 2006
Total Posts : 2105
   Posted 4/4/2009 6:21 AM (GMT -6)   
Nothing worse than letting several of those pills hit the back of your tongue. When we were taught "bitter back nine" in school to remember the cranial nerve that innervated the back of the tongue, they should have used this as the example. GAG!
Proctitis DX 1999, Pancolitis DX 2008
Lialda 1 day
Immuran
Golimumab study (100mg every 4 weeks)
Vitamin E Enemas as needed
Probiotis/GreenTea/VitD+Ca/SuperDHA


PSA
Regular Member


Date Joined Jan 2009
Total Posts : 498
   Posted 4/4/2009 9:57 AM (GMT -6)   
fruitgirl said...
I took it at bedtime and never had joint pain issues. Or insomnia. So who knows. I started pred on a Monday, and by Tuesday had definite improvement. By Wednesday my symptoms had pretty much disappeared.

Hi Fruitgirl
 
I still feel one should not take it during bedtime. It is my experience which is advising you all. Pred is a silent killer or what I term it as a termite which eats up the whole body and the immunity levels go for a six. The problem in having it during bedtime used to be that I would have my joints locked and had to crawl to go to washroom. Milk is suggested to make up the deficiency of calcium. Another important aspect is have your sugar levels checked regularly, if you are on steroids/pred.
Cheers and good health to you all.
Sorry if my views are a little harsh.
 
45 years Male Attorney
Diagnosed UC October 1989
Had two stage J Pouch Surgery Nov 2005 Take Down March 2006
Complications after surgery - Incisional Hernia and Ano Fistulas
"Faith is the bird that sings when the dawn is still dark."
"There are only two ways to live your life. One is as though nothing is a miracle. The other is as though everything is a miracl: Albert Einstein
"What you are aware of you are in control of; what you are not aware of is in control of you."
 


kops2da
Veteran Member


Date Joined Jun 2008
Total Posts : 2865
   Posted 4/4/2009 10:23 AM (GMT -6)   

All our experiences here is what helps us all.  We are all different but can see what COULD happen, etc.  I take mine early morning.  Just upped to 25 mg. for two days to see if I can stop the blood/mucous mix.  Otherwise, feeling pretty good.  I like what prednisone does for my arthritis/joint pain and my skin and the extra energy but know I cannot take it the rest of my life at this level anyway - and I am OLD!  LOL

ElaineNY


 
Senior - New diagnosed with proctosigmoiditis - 6/2008  Cannot tolerate mesalamines, Canasa, etc. Tried, Colozal, steroid enemas, etc. - started working but severe side effects occurred.
Started on prednisone Feb.7, 2009 - tapering to 20 mg. for two more weeks. Bleeding returned - no call back from doc so I upped prenisone to 25mg. on my own - 6MP - 50 mg. 4/2/2009 
Probiotic Align, Prilosec for GERD, Gas-X, vitamins, Calcium/D
Tylenol for knees and arthritis.
 
 
 


PSA
Regular Member


Date Joined Jan 2009
Total Posts : 498
   Posted 4/4/2009 10:41 AM (GMT -6)   
Hi Elaine

Have you ever tried Sallaki/Boswellia for your knees and arthritis. It is very effective. Infact lots of people in Germany are also having it to cure arthritis. You may be able to get rid of Pred with Boswellia. My brother takes only Sallaki/Boswellia 400 Mg three times a day and gets into remission. He has stopped Pred for the last over 5 years now.

Pred is not good in long run. The skin becomes so tender that it can cause problems, as it did to me.
45 years Male Attorney
Diagnosed UC October 1989
Had two stage J Pouch Surgery Nov 2005 Take Down March 2006
Complications after surgery - Incisional Hernia and Ano Fistulas
"Faith is the bird that sings when the dawn is still dark."
"There are only two ways to live your life. One is as though nothing is a miracle. The other is as though everything is a miracl: Albert Einstein
"What you are aware of you are in control of; what you are not aware of is in control of you."
 

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