question about prednisone taper

It is a pretty drastic drop from what I can tell. I've always heard that slower is better. If it is too big of a drop you will be able to tell because he will probably not be feeling too well shortly thereafter.

That IS a drastic drop. If you are unsure in any way - you should definitely ask the doctor about it. Tell him/her that you are hesitant and would like him to explain why he believes that is the best route to go. I've been on pred for almost 20 years and I would NEVER drop 40mgs like that. Question the doc. They are not perfect.

Hey everyone. Thanks for your responses. I agree - seems pretty crazy to me. BUT - we asked several people at the hospital, all who checked with our GI and he really wants to move to 20mg. He put him on 60mg to try and reduce the inflammation and now he wants him on 20mg for "maintenance" until surgery. Scar tissue seems to be the problem, so once the abcess heals, a resection is likely the next step. (at least we said NO to the entire colon removal, and now all other opinions have been on our side - a resection is all that is necessary at this point. fingers crossed) But, yeah, I don't know. We are keeping a close eye on things, and how he feels and will not hesitate to push back and ask for a higher dose if necessary. I personally want my husband to start with at least 40 this week, but my husband really wants to give 20 a shot. We'll see - I'll tell him what you are saying. (if was this community that convinced us to get a second option on the surgery too!) I was told its more important to taper in smaller amounts when you are at a lower dose to begin with. I dont know, I question it. We have a follow up with the GI doc in less than a week so we'll be talking to him about it then for sure. I'll keep you posted.

emrose said...
 .......... I was told its more important to taper in smaller amounts when you are at a lower dose to begin with.........

That is consistent with conventional wisdom in medicine.  It's usually much easier to go from 60mgs to 20mgs than from, say, 20mgs to 0. 

Tapers are usually pretty fast down to 20mgs or so, then slower the rest of the way down.

Normal amounts produced by the body are in the 10-15mg range, so as long as the dose drop keeps him above that, he'll *hopefully* be ok.

However, like others said, he's been on 60mgs for quite a while now, and everybody responds differently to pred.

I wouldn't be suprised for him to have some fatigue and possible achiness when he drops down in the dose.  Hopefully it will be mild and tolerable, but if it does get bad, I agree with the others that you shouldn't hesitate to let the doctors know and then bump the dose back up higher.

hmmm.... It's so interesting. So hard to know what the right thing to do is with this disease... The surgery, the meds, the diet... I could over analyze and research til I'm blue in the face, but will never really know what will work best for my husband.

I appreciate all your replies. Beave - very good info. However, so are all of the experiences you have all shared. I guess I should have mentioned that the doc also put my husband on cipro and metronidazole (500mg) for 14 days. Don't know how that impact this.......

Thanks again

Personally I would never go from 60 down to 20 and if any GI told me to I'd be kicking his arse out the door...I wouldn't take that chance with a crazy drug like pred.

:)

Yeah, I have heard that about cipro. Our doctor didnt warn us about any negative side effects, nor did the pharmacist! I'm glad I do my research and check this formum! He's on the antibiotics for two weeks, and I am hopeful that it will be okay. We are just keeping a VERY CLOSE eye on his symtoms and how he is feeling. I wont hesitate to call the doctor and/or have him stop taking it.

I appreciate the info! Also - pb4 - I hear ya. I feel a little bit like kicking our GI's arse out the door myself! However, we do really like him for the most part and my husband trusts him and has built a good relationship. I am finally in a place wiht him where I feel like I am educated enough to challenge him if I feel like I should and he is totally open to that and open to hearing me out and exploring our options. Not to mention - there are a ton of great GIs at the clinic and we talk to all of them a lot.

As for the prednisone - I am sort of stuck. My husband is stubborn and he really wants to drop the dose and the doc has repeatedly told him he thinks that is the right thing to do. Like I said - keeping a VERY CLOSE eye on him and he has a follow up appt next week.

I appreciate all of your responses. They are making me nervous, but I am glad to be aware of potential problems so I we can act immediately if necessary.

Wow, that's a HUGE drop!

I have only been allowed to taper by 5mg a week when tapering. I think that he should get a second opinion on that. Or recheck with his doc, and find out his reasoning. Maybe the doc will see he made a RIDICULOUS mistake. If he insists, I would get a second opinion. I've never heard of anybody dropping that fast on the prednisone. I agree with Jen and pb4, it could be crazy dangerous with too quick a taper.

I've been on and off the 'roids for two years. I wouldn't taper that fast. It can wreck some serious havoc on the body. =(

Take care and please keep us updated.

-Em

just thought I'd post an update:

My husband did go ahead and drop to 20 because 1) he wanted to be on a lower dose and 2) because the doc said it was important to drop to 20 so he would heal from the abcess surgery.

It's been almost a week and he's doing really well. He's lost some of the energy that he got from the pred. And he has some cramping, but no more than when he was on the 60mg dose. He has just over a week left of the flagyl (sp?) and cipro.

The surgeon we talked to was thrilled he dropped the dose so much and said that hopefully he's on even less for the resection surgery late next month. however, the taper from 20 down will go MUCH slower!!

Thanks for all of your input. I owe so much to all of you, as I am just so much more educated now and my husband won't be losing his entire colon thanks to advice given here!!!!



Thanks!!!