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how long for 40mg prednisone to work?

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Posted 7/19/2009 8:18 AM (GMT 0)
I've been on 40mg of prednisone for almost 4 weeks now (I already take 12 asacol a day so that can't increase) and I'm a little better, but is going an average of 4.5X a day to 3.25X a day really that great? My doctor and things I've read make it sound like the prednisone should work really fast and get you back to normal. I started 30mg in Dec 08 and tapered down, but I started having problems again close to the end of the spring semester when I went below 10mg. So I went back up to 10, had problems on and off and then a month ago he put me on 20mg twice a day.

I have an appointment Tuesday and he's seriously considering 6MP and I'm really scared to start that. I've even already had the TB test just in case he wanted to start remicade.

Should I ask for a higher dose of prednisone for a while or what?

This is my first post, so sorry if I'm not doing this right. I just never thought it would get this bad. Now my doctor is classifying my UC as moderate-severe when 2-3 months ago it was just maybe moderate.
Posted 7/19/2009 8:33 AM (GMT 0)
When I was on 40 mg for a week or so and it did not work (I was doing very poorly) I was put on Remicade. Predisone is so bad for your body I am sure your doc would not want you on it any longer than this, especially at such a high dose. I wish you the best of luck. I am sure those on the 6MP can post and tell you their experiences with it.


Melissa
Posted 7/19/2009 10:11 AM (GMT 0)
i agree, prednisone is possibly the worst drug ever made by man. It totally screws up your adrenal gland after prolonged use.
Remicade has less side effects and works much better at suppressing your immune system. If its not working then switch to something that does work-like remicade. If your doctor tries to put you on a higher dose of prednisone tell him no thanks. You will get terrible side effects like insomnia, high blood pressure and moon face.
Posted 7/19/2009 7:52 PM (GMT 0)
     I can be a spokesperson for 6MP, as I have been on it for about six years now.  Don't be afraid to go on it.  My GI doctor carefully monitors my blood.  I have monthly CBC's to make sure my white count doesn't get too low.  He likes it about 3.1.  If I may mention, I fought him tooth and nail for about a year before going on this stuff.  You will have to take the prednisone along with the 6MP for awhile, as it takes about 3 months for the 6MP to "kick in".  I am surprised that your doctor isn't decreasing your prednisone.  I started this "latest" flare right after Memorial Day.  Doc told me to go on 20 mgm of prednisone, but that just didn't cut it.  So, a few weeks later he increased it to 40 mgm and increased the 6MP from 50 to 100 mgm.  I also take nine capsules of Colazal a day, Cort enema nightly and Canasa suppository in the morning, along with probiotics, fish oil capsules, multivitamin and calcium.

     I agree with the other posts in that prednisone is not a good drug to take over long periods.  I developed osteoporosis and have to carefully monitor my BP while on it.  This time my pressure is great, 110/65.  However, last year I had to be hospitalized because my pressure shot up to 210/110 and they had a hard time controlling it.  It can also increase your blood glucose.

     I am not a candidate for Remicade, my GI doctor pushing that too, but his associate had a few fatalities related to Remicade and disagreed.  I was exposed to the TB virus back in the 60's and Remicade could activate the virus in your system.  This is in no WAY meant to scare you, but in my particular situation, it scared me.  I am also almost 63 yrs of age.

     Good luck to you.  Let me know what you decide.  Oh...to put your mind at ease a bit about the 6MP.  I saw a leading GI surgeon last year when I was discharged from the hospital and he said that in his over 30 yrs of practice he only has come across one patient who developed Lymphoma while on 6MP...and who is to say that patient wouldn't develop Lymphoma had he not been on the drug.  I know of several Lymphoma victims who NEVER took 6MP.

Posted 7/20/2009 3:11 AM (GMT 0)
Responses to meds vary among UCers! Do you have pancolitis or is the inflammation confined to the left-side or rectum only? If you've been on 40 mg. Pred + Asacol daily for 4 weeks & still have 2-3 bms daily, it seems that you're making some progress toward healing. What about diet-- are you on low-residue? Be sure to get enough calcium/vitamin D daily to keep your bones/teeth healthy while on steroids. It takes patience to subdue flares, hard to face if you're a student trying to accomplish specific goals on time, but you have to take the best possible care of yourself with regard to meds, diet, & adequate rest. / Old Hat (30 yrs with left-sided UC ... [etc.)
Posted 7/20/2009 3:50 AM (GMT 0)
Ask your doctor about rectal meds...specifically, mesalamine enemas like Rowasa. They can make a BIG difference.
Posted 7/20/2009 5:34 PM (GMT 0)
I agree with others--4 weeks on 40 mg right after a taper since December is probably a little too long on prednisone. You should keep an open mind about trying something else. The 6MP drugs are a piece of cake compared to the side effects pred can give you. Good luck and keep us posted.
Posted 7/20/2009 9:19 PM (GMT 0)
I would have thought 4 times a day was a wonderful break from my usual UC, so maybe that's as good as it will get for you too unless you try one of the biologics (Remicade).

In other words, I would have tapered my prednisone once I reached at 4-5 time per day, because I would have considered myself past a flare (but I never had remission until Remicade).
Posted 7/21/2009 12:51 AM (GMT 0)
i was on pred for several months......mostly 20 mg or less.....strated 40mg and within a few days, total remission....go figure....i was on 40 mg for a while a couple months ago, and never reached remission.....hard to figure out
Posted 7/21/2009 6:13 AM (GMT 0)
I am on the max dose right now... 60mgs of PRed.. It sucks because the insomnia is a killer.... it's like having 50 cups of coffee in your system 24/7... I have been on Pred now for almost a month, 2 weeks at 40mg with no results and 1 week at 60 and I'm finally starting to see a decrease in the blood... If I can go 3 or 4 days without blood, I'll start tapering at 5mg a week.... I don't know how long is too long before some real damage is done.. but in a way, I'm scared to go off it......
Posted 7/23/2009 3:55 AM (GMT 0)
Thank you so much for all your responses! It's really encouraging and helpful to hear from others living with this.

I went to the doctor yesterday and he wants to remain at the 40mg until I'm only going 2-3 times a day. But I see him again in 3 weeks so hopefully I'll be better by then. Also, I switched from taking 12 asacol a day to 9 colazal. He said it couldn't hurt and my mom talked to a friend who actually improved after switching from asacol to colazal even though they are similar drugs so the 3 of us decided to give it a try.
I'm just trying to stay positive because I know it could be a lot worse. I mean, I went 5 times today but I haven't been bleeding since the week before I upped to 40mg.

My doctor is concerned that I might be steroid dependent or become steroid resistant just based on how it's going so far. I hope not because I want to keep my colon!

We've also decided to get a second opinion because I've only seen one doctor since I've only had this a year.

And we just heard about the Accutane recall! I took that in 04 for six months! I'm so glad you said something mikeman...we're getting that looked into. It sickens me to know that the accutane could have very well caused this.

Here's my daily med routine if y'all are interested: 1 probiotic pill when I wake up, 20mg pred, 2 echinacea, now 3 colazal when I eat breakfast

3 colazal midday

20mg pred 12 9:00

3 colazal, yaz (for cramps & stuff), 2 echinacea, and 1/2 of a folic acid tablet before bed
Posted 7/23/2009 3:56 AM (GMT 0)
**20mg pred @ 9:00
Posted 7/24/2009 2:18 AM (GMT 0)
I took Accutane in the 1980s and am sure it gave me UC.
Last year I explored joining the litigation but my medical records have all been destroyed, it's been too long.
Posted 7/27/2009 11:14 AM (GMT 0)
i was on 40 mg of pred for almost 2 months before i saw any improvement in my symptoms.
just finally finished about 3 days ago.
symptoms got a little worse each time i tapered until about 15/10mg.
then i went into remission and just tapered fine after that with no issues.

but yea, took almost 2 months at 40mg.
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