How Long on Prednisone Before Tapering?

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Regular Member

Date Joined Oct 2016
Total Posts : 40
   Posted 10/5/2017 4:14 PM (GMT -7)   
Hi all,

I've been flaring since the beginning of July. I started 40 mgs of Pred about 2 weeks ago after a recent colonoscopy showed severe inflammation in the rectum (the rest of my colon looked perfect).

This is my first time taking Prednisone and luckily, so far it's been pretty uneventful side effects-wise. It has definitely helped my symptoms - I'm now having pretty normal bowel movement 2-3 times a day, no more cramping, and only a tiny bit of blood. My doc just told me to start tapering off at 5mgs a week. I'm very happy that she's the kind of Dr. that wants me on Pred for as short a course as possible but I'm wondering if this seems too soon? I'm very worried about sliding back into a flare. From what I've read here, it seems that every GI has a different approach to tapering, but wondering what your thoughts are in my situation...

Thank you!
36 year old female, Diagnosed with ulcerative procitis 9/16. Currently in second flare, 4 Lialda a day, Hydrocort/Mesalamine enemas. Diet - gluten free and vegetarian, Culturelle probiotic, Turmeric drops, L-Glutamine powder, multi-vitamin, liquid iron.

Forum Moderator

Date Joined Aug 2012
Total Posts : 11047
   Posted 10/5/2017 4:51 PM (GMT -7)   
Seems about right to me. That's 10 weeks total on pred. You've either healed and are fine without pred or need stronger doses and/or more maintenance meds to get off of pred. Reduce and findout. No sense in delaying the inevitable...
Moderator Ulcerative Colitis
, 39, UC Proctosigmoiditis
Rx: Remicade @5mgs/kg/6wks; daily 75mgs 6MP, 4.8g generic-Lialda, and rowasa

That walk we do, due to post-public-restroom-embarassment, from our awful poop-spolsion in the bowl that flushing alone won't fully hide. Quiet, sly, and as near of a direct-path to the exit as possible...

Regular Member

Date Joined Oct 2016
Total Posts : 40
   Posted 10/5/2017 4:53 PM (GMT -7)   
iPoop, you are always there with a quick and to the point answer for me. Thank you!
36 year old female, diagnosed with Proctosigmoiditis 9/16. Currently in second flare since 7/17, on 4 Lialda a day, Hydrocort/Mesalamine enemas daily and 40 mgs Prednisone. Diet - gluten free and vegetarian, Culturelle probiotic, Turmeric drops, L-Glutamine powder, multi-vitamin, liquid iron.

Regular Member

Date Joined May 2016
Total Posts : 122
   Posted 10/5/2017 6:06 PM (GMT -7)   
I recently started prednisone for the first time and my dose started at 40mg to wean by 5mg per week. My doc said he only prescribes prednisone once a year as a rescue drug and will not prescribe more than that.


diagnosed April 2016 s/p a c diff infection age 53
very mild proctitis 5cm-20cm per sig scope in December-
currently on Rowasa enema or Canasa in Pm, balsalazide 2/ 2x day , cannot tolerate Lialda

past meds- tried cortifoam and canasa for 8-9 weeks since December but its Rowasa recently started that actually worked
felt amazing on just Canasa last summer till flare in October

New Member

Date Joined Sep 2017
Total Posts : 19
   Posted 10/6/2017 4:59 AM (GMT -7)   
I just had my first flare and was given 40 MG a day. I've been on that dose since 9/13. Unfortunately, my flare was so severe by that time (took 3 weeks to get a GI appointment) that I ended up being emitted to the hospital for a 6 day stay. I'm still on 40 MG a day. Saw my GI Tuesday. Started my new med regime (mesalamine enemy before bed, oral mesalamine 2 pills 4 times a day, 40 MG prednisone a day, and Xanax to help me sleep). I'm supposed to start tapering off in 2 weeks, going down 10 MG every other week. So that will put me at about 5 weeks on 40 MG and 6 weeks of tapering.

Anyway. I'm feeling much better. Pretty much back to normal. Hope to stay that way as I taper off the prednisone. I'm new to all this and I'm concerned about the long term side affects too (heard to many people say they had hip replacements) but I guess you gotta do what you gotta do to get the flare under control.

If you're feeling better it seems like you should start tapering to see what happens. From what I've seen on some of the threads here you want to get off prednisone as quick as possible. The only reason I'm on 40 MG for 5 weeks is because of how bad mine got and I wasn't able to start maintenance drugs (mesalamine from both ends) until this week. GI wants me on those for two weeks before starting the taper which seems legit. Your tapering seems in line with what my GI has me doing.

Sorry if this would be considered hijacking your thread but this made me start to wonder how common hip replacement from prednisone is and what other long term side affects are there?

Glad you're feeling better County! Hope it stays that way as you taper!
~37 year old male
~Diagnosed with pancolitis September 24, 2017, after a 6 day hospital visit from my first flair up
~Currently on prednisone (40mg/day), mesalamine enemy (4g before bed), oral mesalamine (1g 4x/day)
~Allergic to flagyl

Regular Member

Date Joined Jul 2016
Total Posts : 368
   Posted 10/6/2017 11:28 AM (GMT -7)   
As soon as my CRP and ESR get down to reasonable levels, I start tapering. Those low readings don't mean inflammation is gone, but it does mean your body is no longer in crisis. In my case, I can handle non-life threatening inflammation in other ways that don't require pred.

For example, at the peak of my current flare my CRP was 208. After 3 weeks on prednisone at 30mg it went down to 5 and that's when I immediately started tapering at 5mg per week.

If your prognosis is unclear then reduce prednisone by 5mg per week and look for changes in symptoms. If you get worse then you probably still need immune suppression to rescue you. If you stay the same or improve, you're probably OK.

I usually rapid taper prednisone by 10mg per week, and then when I get down to 20mg/day I reduce by 5mg per week. Below 10mg is when you have to be the most careful about relapsing.

Pred is really bad for the body but our disease is worse. If you can get off pred without suffering an aggravation then I'd do it ASAP.
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