Another prednisone Question (sorry)

After a non-stop 4 month flare, I am thinking about starting Prednisone.  My GI wrote the prescription last month for me to fill if I need it.

 

I just spoke with him and he said I could start at 20 milligrams a day.

 

My question for you guys is:  Will this be enough to help me and will this cause unwanted side effects from your experience on this low dose?

 

I know this topic has been discussed may times but I wanted to be specific.

 

Thanks

Bluechipguy

It would all depend on your body.

Have you used pred in the past? If so, what was your highest dose? How long did it take to work?

There will always be side effects of prednisone use :( What they are and how bad they are will depend on your body.

What other meds and supplements are you taking? What are the symptoms of your flare?

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Pan-colitis and GERD diagnosed May 2003

 

Asacol 12 per day,  Azathioprine 75mg, Rowasa and Canasa as needed

Aciphex, Effexor XR, BCP, Rhinocort nasal spray

Culturelle, Biotin, Folic Acid, Forvia, Calcium, and B12

 

Osteopenia (hip and spine) from prednisone use.  Started Azathioprine because I was steroid dependent.

 

Co-Mod for the UC forum

Keep HealingWell running smoothly:  www.healingwell.com/donate

I have never taked Pred before.  I am currently on 9 Colazal.  My current flare consists of every morning movements, usually about 3-5 minimum, sometimes worse than others.  My past flares I usually got a break from the symptoms 2 to 3 mornings a week, or even better.  This has been an everyday occurence for the last 4 months or so.

bluechipguy

Since you have never used pred before, your side effects may not be as severe. I found that mine got worse with each time I had to use pred. I also found that each time I had to use it, I had to use it at a higher dose for longer periods of time for it to do anything. It was like a built up a tolerance to it - which might be why I ended up being steroid dependent... hmmm...

Do you use a probiotic? They replace the good bugs in your guts that are killed or removed with D and antibiotics. If you're willing to "hang in there" for a few more days, you might try them. If you do, start with a smaller dose (CFUs in the low millions) and build yourself up.

If you decide to try the pred. I think 20 would be a good spot for you to start. It's not awfully high, and since you've never used it before, a low dose may be all you need :)

Another option would be to try rectal meds. I know - eeewwwww! But, they work! I think they're better than the dreded pred! Have you ever used Canasa? It's the 5ASA suppository - will help inflammation in the rectum. Rowasa is the enema form (in the US) of the 5ASAs - it will reach farther up. Or, if your doc is stuck on steroids - Colcort is the steroid enema. Using the steroid in the enema, you won't absorb as much into your blood stream; therefore, not as many side effects.

Okay - that was probably more info than you wanted ;-)

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Pan-colitis and GERD diagnosed May 2003

 

Asacol 12 per day,  Azathioprine 75mg, Rowasa and Canasa as needed

Aciphex, Effexor XR, BCP, Rhinocort nasal spray

Culturelle, Biotin, Folic Acid, Forvia, Calcium, and B12

 

Osteopenia (hip and spine) from prednisone use.  Started Azathioprine because I was steroid dependent.

 

Co-Mod for the UC forum

Keep HealingWell running smoothly:  www.healingwell.com/donate

Read up on VSL#3. My sister says it works for her. It has actual medical studies backing it. Might be something to consider trying.

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Dakota,

I have used both the Cort Enemas and the Canasa.  The Cort Enemasa worked very well for me last year whenever I had a flare. Since Jan, however, they stopped working as I have used them a few times for 2 to 3 weeks periods.

I know pred isn't ideal, but it seems to me there is a quality of life issue here and I have to pick my poison.  Maybe 20mg of pred will be enough to help me with minor effects.

bluechipguy

bluechipguy, I feel you! I did not want to take pred, either, but I am on the max Lialda and was still cramping, bleeding, etc. from a recent flare. I don't like it, wish I didn't have to be on it, hate the side effects, but have stopped having urgency, bleeding and cramping within a days time. I am on 40 mg of pred. I don't know how the amount is determined: weight, severity of flare, past usage?? I did learn the hard way "trying to be doctor" as my mom says. I was given the prescription a week prior to actually taking it on Sunday after a terrible Saturday of bleeding like I did when first diagnosed and then "decided" I would take myself to 20 on Monday and paid the price with symptoms coming back. I am back on 40 with no more flare symptoms. Keep us posted!

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No, pred is not ideal. Sometimes it is a must though. I understand that! I was hoping you could avoid it though.

The 20 mg might be enough to "jump start" you. I wish you the best of luck!!! Feel better soon :)

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Pan-colitis and GERD diagnosed May 2003

 

Asacol 12 per day,  Azathioprine 75mg, Rowasa and Canasa as needed

Aciphex, Effexor XR, BCP, Rhinocort nasal spray

Culturelle, Biotin, Folic Acid, Forvia, Calcium, and B12

 

Osteopenia (hip and spine) from prednisone use.  Started Azathioprine because I was steroid dependent.

 

Co-Mod for the UC forum

Keep HealingWell running smoothly:  www.healingwell.com/donate

thanks guys for the support.  I don't have bleeding...expect maybe a tiny bit every once in a while and my GI says pred is reserved for the worst cases, but nobody can tell me if I have symptoms everyday and what I am doing ins't working that I have "mild UC".  I know what a flare is and one that last 4 months with no let up...is bad..even though I was scoped 2 months ago and was still considered mild UC

I am going to ponder it more over the weekend and start on Sunday or Monday if need be.

thanks again

bluechipguy

If you start the prednisone be absolutely sure to take the calcium with vitamin D for your bones. If your insurance allows maybe get a bone scan now for a baseline. If your insurance allows for them yearly as ours does then take another one then for a comparison.

My hubby was on the pred off and on for a year or so and tapering again. We had a bone scan done and it showed the osteopenia of the spine - mild - even with the calcium (although he wasn't as religious about taking it before -- he does now) but he needs Fosamax once a week.

I understand the bone mass can improve with the fosamax and weight bearing exercise (which he has not been able to do yet - I stress even walking as much as he can).

There is a certain vitamin that is supposed to be good for bones....Vitamin A???? If you start the prednisone, even though it is a dose on the lower side fortunately and hopefully that will do it for you I think the calcium supplements are important. Talk to your doctor.

We like the caramel calcium chews...kind of like having a piece of candy instead of another "horse" pill as we call them. The publix brand we buy is identical to Viactin brand and less

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60 yr old male~Colitis 1st diagnosed Jan '05-cleared up within a few wks. Flared again in May '06 ... left sided UC now, fully involved and trying to get in remission. Acute inflammation-pancolitis-tenesmus rectal pain-granulation is showing some healing started. Osteopena of spine from prednisone DX 8/07  July 07 good days & bad days 75mg Imuran 40  mg prednisone (tapering 8/07) 12 Asacol, Lidocaine Hydrochloride Jelly 2%,multi vitamin, iron 3X day, DanActive, chewable calcium, Prilosec 20mg, enalapril 10mg, glipizide 5 mg, zocor 20 mg, baby aspirin, (Fentanyl pain patch 50mg 72 hrs  Morphine Sulf 15 mg twice daily)Colocourt enemas at night. Fosamax and mthly B12 shots folic acid 1mg

personally, 20 mg wouldn't do anything for me. but, if your doctor recommends it, i would start with that. pred is NOT something you would want to take more than needed.

hope you feel better
james

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James

21 yrs old, diagnosed severe pan ulcerative colitis 2 Mar 2007
Asacol (mesalamine) 400 mg x 12 daily
Remicade <--first infusion on 3 May 2007, second on 17 May 2007
Imuran (azathioprine) 50 mg x 2 daily
Ferrous Sulfate 325 mg x 2 daily <--battling some anemia right now
Aleve 2x daily (yeah, controversial, I know, but the doctor's haven't found anything else that works :/ )

I have been on prednisone several times in the past couple of years -- like you I have mild to moderate UC.  Now I am taking Entocort, which is also a steroid but doesn't enter the system until it is in the large intestine.  I have not had the side effects like I did with Prednisone (moonface, insomnia, weight-gain, etc).  I don't know why the doctors use prednisone first and this second (I plan to ask my dr next month when I go for my check-up) but it may be something to discuss with your doctor. 

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- 45 year old; female

jwogie,

how much pred were you taking that gave you those side effects?  Was it a larger dosage?

bluechipguy

The most I've taken is I believe 40 mg/day.