how long for 40mg prednisone to work?

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Regular Member

Date Joined Jul 2009
Total Posts : 37
   Posted 7/19/2009 3:18 AM (GMT -6)   
I've been on 40mg of prednisone for almost 4 weeks now (I already take 12 asacol a day so that can't increase) and I'm a little better, but is going an average of 4.5X a day to 3.25X a day really that great? My doctor and things I've read make it sound like the prednisone should work really fast and get you back to normal. I started 30mg in Dec 08 and tapered down, but I started having problems again close to the end of the spring semester when I went below 10mg. So I went back up to 10, had problems on and off and then a month ago he put me on 20mg twice a day.

I have an appointment Tuesday and he's seriously considering 6MP and I'm really scared to start that. I've even already had the TB test just in case he wanted to start remicade.

Should I ask for a higher dose of prednisone for a while or what?

This is my first post, so sorry if I'm not doing this right. I just never thought it would get this bad. Now my doctor is classifying my UC as moderate-severe when 2-3 months ago it was just maybe moderate.

Regular Member

Date Joined Dec 2006
Total Posts : 251
   Posted 7/19/2009 3:33 AM (GMT -6)   
When I was on 40 mg for a week or so and it did not work (I was doing very poorly) I was put on Remicade. Predisone is so bad for your body I am sure your doc would not want you on it any longer than this, especially at such a high dose. I wish you the best of luck. I am sure those on the 6MP can post and tell you their experiences with it.

Female, Left-sided colitis diagnosed at age 28 in 2001
Remicade stopped a major flare for me I am now off all meds except the remicade.

Regular Member

Date Joined Jul 2009
Total Posts : 66
   Posted 7/19/2009 5:11 AM (GMT -6)   
i agree, prednisone is possibly the worst drug ever made by man. It totally screws up your adrenal gland after prolonged use.
Remicade has less side effects and works much better at suppressing your immune system. If its not working then switch to something that does work-like remicade. If your doctor tries to put you on a higher dose of prednisone tell him no thanks. You will get terrible side effects like insomnia, high blood pressure and moon face.
Age:31 Married with children.
Ulcerative Colitis cause: In 2003 I took Accutane for about 4 months, strong side effects of abdominal cramping and bloody stools.
May 2004: Diagnosed with Left sided UC -should have understood the IBD warning and should've never taken the dangerous drug
known as Accutane.
May 2004- May 2009: Prednisone, Asacol and many other med's that did not work well-Remicade was great for 16 months then suddenly stopped working.
May -June 2009: Pancolitis- chronic 2 month flare up that put me out of work and made me seriously think about surgery.
June 24th 2009: elective colectomy/ileostomy at Barnes/Washington University.
August 2009: planned rectum removal and j-pouch construction.
October-November 2009: planned Reversal.
Summary: Suffered 5 long years with severe Ulcerative Colitis, Anxiety and depression.
No more diseased colon. No more running to the bathroom 20+ times a day. No more cramping and bleeding. Satisfied with first surgery.

Veteran Member

Date Joined Aug 2008
Total Posts : 5975
   Posted 7/19/2009 2:52 PM (GMT -6)   
     I can be a spokesperson for 6MP, as I have been on it for about six years now.  Don't be afraid to go on it.  My GI doctor carefully monitors my blood.  I have monthly CBC's to make sure my white count doesn't get too low.  He likes it about 3.1.  If I may mention, I fought him tooth and nail for about a year before going on this stuff.  You will have to take the prednisone along with the 6MP for awhile, as it takes about 3 months for the 6MP to "kick in".  I am surprised that your doctor isn't decreasing your prednisone.  I started this "latest" flare right after Memorial Day.  Doc told me to go on 20 mgm of prednisone, but that just didn't cut it.  So, a few weeks later he increased it to 40 mgm and increased the 6MP from 50 to 100 mgm.  I also take nine capsules of Colazal a day, Cort enema nightly and Canasa suppository in the morning, along with probiotics, fish oil capsules, multivitamin and calcium.
     I agree with the other posts in that prednisone is not a good drug to take over long periods.  I developed osteoporosis and have to carefully monitor my BP while on it.  This time my pressure is great, 110/65.  However, last year I had to be hospitalized because my pressure shot up to 210/110 and they had a hard time controlling it.  It can also increase your blood glucose.
     I am not a candidate for Remicade, my GI doctor pushing that too, but his associate had a few fatalities related to Remicade and disagreed.  I was exposed to the TB virus back in the 60's and Remicade could activate the virus in your system.  This is in no WAY meant to scare you, but in my particular situation, it scared me.  I am also almost 63 yrs of age.
     Good luck to you.  Let me know what you decide. put your mind at ease a bit about the 6MP.  I saw a leading GI surgeon last year when I was discharged from the hospital and he said that in his over 30 yrs of practice he only has come across one patient who developed Lymphoma while on 6MP...and who is to say that patient wouldn't develop Lymphoma had he not been on the drug.  I know of several Lymphoma victims who NEVER took 6MP.
62 yr old granny. South Jersey
Diagnosed with ulcerative proctitis in 1998 in hospital
Hospitalized (2nd time) in May 2008
Meds as of June 09: Colazal (6 per day), 6MP (50 mgm), Probiotic (upped to 3 per day), Fish oil capsule, calcium, multivitamin, Cort enema nightly, Canasa in morning.  Also taking Benicar and Toprol to control high blood pressure.  Getting old is a b****.

Old Hat
Veteran Member

Date Joined Feb 2007
Total Posts : 5191
   Posted 7/19/2009 10:11 PM (GMT -6)   
Responses to meds vary among UCers! Do you have pancolitis or is the inflammation confined to the left-side or rectum only? If you've been on 40 mg. Pred + Asacol daily for 4 weeks & still have 2-3 bms daily, it seems that you're making some progress toward healing. What about diet-- are you on low-residue? Be sure to get enough calcium/vitamin D daily to keep your bones/teeth healthy while on steroids. It takes patience to subdue flares, hard to face if you're a student trying to accomplish specific goals on time, but you have to take the best possible care of yourself with regard to meds, diet, & adequate rest. / Old Hat (30 yrs with left-sided UC ... [etc.)

Veteran Member

Date Joined Feb 2009
Total Posts : 7150
   Posted 7/19/2009 10:50 PM (GMT -6)   
Ask your doctor about rectal meds...specifically, mesalamine enemas like Rowasa. They can make a BIG difference.
Status: Remission since late May 2009!
Symptoms began in November 2008, ~4 weeks after giving birth to my son.
Diagnosed with pancolitis on 1/30/09
Currently taking Apriso (4 pills ONCE!! daily), Rowasa twice weekly, Natural Factors Ultimate probiotic 12/12 Formula, and Zoloft (25 mg).

Regular Member

Date Joined Jun 2009
Total Posts : 173
   Posted 7/20/2009 12:34 PM (GMT -6)   
I agree with others--4 weeks on 40 mg right after a taper since December is probably a little too long on prednisone. You should keep an open mind about trying something else. The 6MP drugs are a piece of cake compared to the side effects pred can give you. Good luck and keep us posted.
UC since 1996 (age 20)
Mommy of 2 sweet little girls.
My life is one big flare.

Asacol, Azathioprine, Prednisone, Rowasa
First Remicade 6/22/09

Veteran Member

Date Joined Mar 2008
Total Posts : 2855
   Posted 7/20/2009 4:19 PM (GMT -6)   
I would have thought 4 times a day was a wonderful break from my usual UC, so maybe that's as good as it will get for you too unless you try one of the biologics (Remicade).

In other words, I would have tapered my prednisone once I reached at 4-5 time per day, because I would have considered myself past a flare (but I never had remission until Remicade).
49 year old female attorney, diagnosed UC/pancolitis 1985, no surgery but much suffering. Asacol maintenance for 20+ years; used prednisone & Rowasa for flares.  Probiotics (Ultimate Flora, 50 billion), salmon oil (omega-3) when I can remember. 
August 2008 sought care of naturopathic doctor. Food sensitivity test showed wheat/gluten, other intolerances; eliminated wheat/gluten from my diet.
Bad flare in March, used prednisone. Humira denied, started Remicade 4/12 and doing great~ learning what normal is~ wow

Regular Member

Date Joined Apr 2009
Total Posts : 178
   Posted 7/20/2009 7:51 PM (GMT -6)   
i was on pred for several months......mostly 20 mg or less.....strated 40mg and within a few days, total remission....go figure....i was on 40 mg for a while a couple months ago, and never reached remission.....hard to figure out

Veteran Member

Date Joined Feb 2005
Total Posts : 1373
   Posted 7/21/2009 1:13 AM (GMT -6)   
I am on the max dose right now... 60mgs of PRed.. It sucks because the insomnia is a killer.... it's like having 50 cups of coffee in your system 24/7... I have been on Pred now for almost a month, 2 weeks at 40mg with no results and 1 week at 60 and I'm finally starting to see a decrease in the blood... If I can go 3 or 4 days without blood, I'll start tapering at 5mg a week.... I don't know how long is too long before some real damage is done.. but in a way, I'm scared to go off it......
Diagnosed with U/C  (Proctitis) January 31st, 2005, IBS on July 21st, 2006 
  Status as of June 30th, 2009 :  Flaring for the last 7 or 8 months with blood, mucus PAIN.....
Meds are: Prednisone 60mg daily, 
Apriso 4 pills 1x a day.. .YEA! 
I take Xanax when needed and Ambien for sleep... Which is every day and night with all this darm PRED..
Nexium in the am for heartburn due to Prednisone..   Culturelle 2 times a day...

Regular Member

Date Joined Jul 2009
Total Posts : 37
   Posted 7/22/2009 10:55 PM (GMT -6)   
Thank you so much for all your responses! It's really encouraging and helpful to hear from others living with this.

I went to the doctor yesterday and he wants to remain at the 40mg until I'm only going 2-3 times a day. But I see him again in 3 weeks so hopefully I'll be better by then. Also, I switched from taking 12 asacol a day to 9 colazal. He said it couldn't hurt and my mom talked to a friend who actually improved after switching from asacol to colazal even though they are similar drugs so the 3 of us decided to give it a try.
I'm just trying to stay positive because I know it could be a lot worse. I mean, I went 5 times today but I haven't been bleeding since the week before I upped to 40mg.

My doctor is concerned that I might be steroid dependent or become steroid resistant just based on how it's going so far. I hope not because I want to keep my colon!

We've also decided to get a second opinion because I've only seen one doctor since I've only had this a year.

And we just heard about the Accutane recall! I took that in 04 for six months! I'm so glad you said something mikeman...we're getting that looked into. It sickens me to know that the accutane could have very well caused this.

Here's my daily med routine if y'all are interested: 1 probiotic pill when I wake up, 20mg pred, 2 echinacea, now 3 colazal when I eat breakfast

3 colazal midday

20mg pred 12 9:00

3 colazal, yaz (for cramps & stuff), 2 echinacea, and 1/2 of a folic acid tablet before bed

Regular Member

Date Joined Jul 2009
Total Posts : 37
   Posted 7/22/2009 10:56 PM (GMT -6)   
**20mg pred @ 9:00

Veteran Member

Date Joined Mar 2008
Total Posts : 2855
   Posted 7/23/2009 9:18 PM (GMT -6)   
I took Accutane in the 1980s and am sure it gave me UC.
Last year I explored joining the litigation but my medical records have all been destroyed, it's been too long.
49 year old female attorney, diagnosed UC/pancolitis 1985, no surgery but much suffering. Asacol maintenance for 20+ years; used prednisone & Rowasa for flares.  Probiotics (Ultimate Flora, 50 billion), salmon oil (omega-3) when I can remember. 
August 2008 sought care of naturopathic doctor. Food sensitivity test showed wheat/gluten, other intolerances; eliminated wheat/gluten from my diet.
Bad flare in March, used prednisone. Humira denied, started Remicade 4/12 and doing great~ learning what normal is~ wow

Veteran Member

Date Joined Sep 2007
Total Posts : 955
   Posted 7/27/2009 6:14 AM (GMT -6)   
i was on 40 mg of pred for almost 2 months before i saw any improvement in my symptoms.
just finally finished about 3 days ago.
symptoms got a little worse each time i tapered until about 15/10mg.
then i went into remission and just tapered fine after that with no issues.

but yea, took almost 2 months at 40mg.
steph - 33 - female - gold coast australia - UC since 2000
was in remission until i quit smoking 5 weeks ago  o.O  now im flaring like a solar flare!
waiting for blood test to see if i can start imuran
mesalazine granules 3g x1 a day (much nicer than a million tablets a day)
just finished 3 months of prednisolone (worked) and now back on 40mg a day (ick)
quercertin tablets, tumeric capsules, vitamin d3, enteric coated fish oil
pre-conception vitamins and minerals (cuz we trying to make a baby)
oxycontin for pain every 4 hours.  plastic bags in the loo from the involuntary puking.
i still eat what i want, when i want, if i feel like eating at all ... diet doesn't affect my UC.

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