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Prednisone dosing schedule

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Ulcerative Colitis
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Posted 4/7/2022 5:51 AM (GMT -8)
Hi all,

Started up on 40mg of Prednisone 3 days ago due to a flare from what I think was caused by all the stress from early stage breast cancer (surgery now radiation to my breast). My radiation oncologist said it's not common but by body's way of responding to the inflammatory response in my breast could be to increase inflammation in my whole body.

I haven't been on 40mg of Prednisone in about 13 years, Other than being on 20mg last year after the covid vaccine gave me a short flare but I was tapered off in about a month or so. My GI now wants me to stay on 40mg for another 7 days then down to 30mg for 5 days then report back to him.

How long do you guys normally get put on this high of a dose? I am struggling hard as I am SO tired from the radiation yet cannot sleep due to the Prednisone. I hate this drug and rarely in my 28 years of having UC needed this high of a dose. I fear this flare won't have a chance of going away till my radiation is done either, and I have another 12 treatments (so a bit more than 2 weeks). But if I can't sleep for those 2 weeks I don't know how I will survive as the fatigue from radiation will only get worse as time goes on. If I could get back on my nightly enemas hopefully that could help get me off Prednisone as well.
Posted 4/7/2022 8:32 AM (GMT -8)
I usually do a split dose of pred -- half in the morning and half in the evening. That actually helped me sleep because single dose was wearing off by bed time and I had to get up every few hours to run to the toilet. Usually at 40 mg I am on for 1-2 weeks depending on symptoms before I start tapering. and then I taper 5mg every 5-10 days (I've had different tapers).

Maybe you could try Uceris instead if the flare continues. It's not systemic so it won't affect you like pred and you can be on it longer -- I think the longest I was on it was 4 months one time.
Posted 4/7/2022 9:18 AM (GMT -8)
I actually started with Uceris for 2 weeks but then last weekend had a lot of blood all of a sudden. So my GI switched me to Prednisone. I'm going to try to start taking my mesalamine enemas every night again. It's been hard to lie on my left side after breast surgery but it's getting better even for an hour. Maybe that will help me taper the Prednisone
Posted 4/7/2022 1:57 PM (GMT -8)
I usually lay on my back to administer the enema -- easier for me rather than reaching around behind -- and then lay on my side for at least 20 minutes. Just a tip in case that would be more comfortable to do the enemas. I've also heard of people who administer them on the toilet and try to lay down for a few minutes though I read of one person who was doing that and then going to work without the laying down part. It may not be ideal, but just getting the med in there will help.
Posted 4/9/2022 6:18 AM (GMT -8)
40 mg for 2 wks, 30 mg for 1 wk, 20 for 1 wk, 10 for1 wk, then off. That was my go-to. Try Benadryl for sleep if it helps you. Sorry you're going through this.
Posted 4/14/2022 3:13 PM (GMT -8)
I am currently tapering and at 25mg/day prednisone. I started at 40mg/day, and have been on high dose for about 4 years now. Asacol, imuran, entyvio, stelara, humira have all failed. I am currently getting inflectra and entyvio infusions, and taking imuran 200mg/day. Log story, and last effort with these biologics before trying Xeljanz.
The prednisone is a love/hate relationship for sure. I don't sleep well either, but my flare is stopped in its tracks. I have dealt with some pretty serious anxiety episodes, and probably close to psychosis a few times.
A normal taper for me has been to decrease by 5mg/day weekly.

Deacon
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