Is there such a thing as a "safe" dosage of pred?

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ach13
Regular Member


Date Joined Jul 2007
Total Posts : 41
   Posted 11/7/2007 5:11 AM (GMT -7)   
Just wondering if there is a low enough dosage of pred that would be balancing its good effects with the bad?

I mean that the dosage is enough to provide relief/help in remission yet low enough that it would not cause any major long term harm to the body?
Ulcerative Colitis - Diagnosed: 1997 (2nd yr HS)

As of 09/11/07:
"Rebooting" my gut
Prednisone - 5mg in the morning, 2.5mg in the evening (tapering 2.5mg/week)
AMP Plus - 10 tablets a day (5 in AM, 5 in PM)
Lifetime Acidophilus - 4 capsules/day, 5 billion live bacteria per capsule
Pentasa - 3x 500mg per day (Stopped momentarily)
5' 3" - 90 lbs
location: Philippines


princesa
Veteran Member


Date Joined Aug 2007
Total Posts : 2198
   Posted 11/7/2007 8:21 AM (GMT -7)   
In my experience, a moderate dose of around 40 mg with a fairly quick taper doesn't cause obvious side effects and long-term harm. A higher dose of 60-80 mg has caused me major side effects and long-term harm in the form of bone thinning. The amount of time you're on it plays a part, too. For what it's worth, I was able to counteract the bone thinning with proper diet and exercise. My bone density is back in the normal range now.
Diagnosed with ulcerative colitis spring 1999
C-scope confirmed UC diagnosis 9/18/2007
 
Therapeutic dose sulfasalazine, back on a pred taper for first flare in years. Down to 10 mg and feeling much better.
Probiotics, l-glutamine and fish oil caps. George's aloe vera juice and Mucosaheal.
 
 


julee70
Regular Member


Date Joined Oct 2007
Total Posts : 486
   Posted 11/7/2007 8:28 AM (GMT -7)   
I think the idea of "major long term" damage is probably not something we can easily define. My understanding is that if you take a low-ish dose and taper (say, starting at 40 mg) BUT you do that once a year for 10 years... that's not so good.

I always thought the effects were cumulative... For example, I deprived my body of absorbing enough calcium for a couple years in my 20s. That can't be good for when I get older... right?

The flip side that we all consider with Pred is that it also isn't good for your colon to be inflamed without relief for years on end. I think the idea of whether it's "safe" at all and in the long term is fairly subjective. My guess is that it also effects different people differently. I'd be careful and follow Princesa's lead with checking bone density and trying to stave off the loss with diet and exercise.
-------
UC for the last ten years
Current Meds: 6MP
Past Meds: You name it; I've tried it.


suebear
Forum Moderator


Date Joined Feb 2006
Total Posts : 5698
   Posted 11/7/2007 8:43 AM (GMT -7)   
There is no safe dosage of prednisone. Even small amounts, less than 10mg, can have life long side effects even if taken for a short period of time (one month). No one can predict how it will effect you. Prednisone can be a life saver, it certainly helped me when I had a severe flare that was not responding to the other UC meds but it should be taken with caution and the patient should be well educated on the length of time they are willing to submit to the drug and have made choices for alternative options well ahead of time. Also, anyone on any dose of prednisone should be taking a calcium supplement as well as engaging in regular weight-bearing exercise. This will help reduce or eliminate possible bone loss.

Sue
dx proctitis in 1987
dx UC in 1991, was stable until 1998
1998 started prednisone, asacol, pentasa, nortriptylene, ativan, 6MP, rowasa enemas and suppositories, hydrocortisone enemas, tried the SCD diet, being a vegetarian, omega 3s, flax, pranic healing, yoga, acupuncture, probiotics
2000 lost all my B-12 stores and became anemic
2001 opted for j-pouch surgery- now living life med-free
 


Old Hat
Veteran Member


Date Joined Feb 2007
Total Posts : 5135
   Posted 11/7/2007 9:17 AM (GMT -7)   
No one should be on a higher daily dose of Pred than 60 mgs, according to my gastro, who has been subspecializing in IBD treatment for over 25 yrs. Anyone taking it should be careful to keep calcium & vitamin D intake up to help prevent bone loss, and also practice good dental hygiene because it can cause periodontal problems, too. / Old Hat (nearly 30 yrs with left-sided UC; currently on 3 Colazal daily; seem to be back in remission after July flare)

pb4
Elite Member


Date Joined Feb 2004
Total Posts : 20577
   Posted 11/7/2007 11:04 AM (GMT -7)   
There are long term side effects and short term side effects when it comes to pred...that doesn't mean everyone experiances them all BUT pred is a nasty drug when it comes to side effects and even a low dose long term can do permanant damage without even giving enough benefit for IBD symptoms.

Pred is used for many types of illnesses, another one is asthma...pred is not intended to be on long term/life long to control symptoms of diseases because even a low doses it can cause permanant health issues.

A quick taper off of pred can also defeat the purpose of the drug when it comes to treating IBD....not to mention it can have negative effects doing that...talk to your GI about this.

In my 16.5 yrs of being on and off pred which used to do me wonders no longer has any benefit for me, my body seems to have become immune to it and this can happen to anyone.

I had one family doc tell me to just stay on it indefinitely, no way would I damage the rest of my body for a slim chance of it working indefinitely for my IBD, finding alternatives is much better, which is why I put my skeptisism aside when it came to the natural route, only to my surprise to find such help from it.

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


ach13
Regular Member


Date Joined Jul 2007
Total Posts : 41
   Posted 11/8/2007 5:21 AM (GMT -7)   
Thanks for the input!

I just wanted to know the thoughts and experiences of some about it since it seems I can't get quite to a remission after tapering it for some time now- the diarrhea is my main enemy and now I'm trying to up my Pentasa dosage while I'm back on 10mg of Pred a day since it helps in the "transition" of my med dosages.
Ulcerative Colitis - Diagnosed: 1997 (2nd yr HS)

As of 09/11/07:
"Rebooting" my gut
Prednisone - 5mg in the morning, 2.5mg in the evening (tapering 2.5mg/week)
AMP Plus - 10 tablets a day (5 in AM, 5 in PM)
Lifetime Acidophilus - 4 capsules/day, 5 billion live bacteria per capsule
Pentasa - 3x 500mg per day (Stopped momentarily)
5' 3" - 90 lbs
location: Philippines


princesa
Veteran Member


Date Joined Aug 2007
Total Posts : 2198
   Posted 11/8/2007 8:14 AM (GMT -7)   
Have you tried l-glutamine to help control diarrhea?
Diagnosed with ulcerative colitis spring 1999
C-scope confirmed UC diagnosis 9/18/2007
 
Therapeutic dose sulfasalazine, back on a pred taper for first flare in years. Down to 10 mg and feeling much better.
Probiotics, l-glutamine and fish oil caps. George's aloe vera juice and Mucosaheal.
 
 

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