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Trouble dropping PRED from 30mg-25mg

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Ulcerative Colitis
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Posted 3/24/2011 4:50 PM (GMT 0)
Anyone have trouble tapering Pred down from 30mg? On 30mg, I feel great - super great! I'm solid and only going once a day! I have tried 3 times now to drop to 25mg (even tried 27.5 for a few days) and the next morning...D again. Just once, but it's definitely D. I'm frustrated... any advice? Or can this be the case for the first few days of a taper and then it will become solid again? Does this happen with anyone else as they decrease Pred??
Posted 3/24/2011 5:19 PM (GMT 0)
I found that I'd have a little bit of trouble for a day or 2 after I decreased my dosage. Then everything would settle back to the way it was.

I didn't have any real problems, but I don't think I would have decreased again if things didn't settle down first.
Posted 3/24/2011 6:16 PM (GMT 0)
Just had the exact same problem in February ... and have had it in the past. My tough times usually start 2-3 days after a cutdown. What I found was that I literally had to go down 1mg at a time (with the 1mg pills) till I was able to get past that threshold. Also - if you've become really dependent on the pred your taper may have to take longer (longer periods between cutdowns). I've been able to get to 17.5mgs (from a high of 70mgs a few months ago). Once you get past a that threshold of going from 30mgs to 25mgs you may be able to go back to a 5mg cutdown. For me, once I get to 30mgs I cutdown in 2.5mg increments and then when I can get to 15mgs I have had to go down in 1mg increments.
Posted 3/24/2011 7:47 PM (GMT 0)
I had to go down from 15mg at 1mg increments too. I went from 7.5 or so at .5mg! I had to start 6mp and that helped me to reduce the dose without having symptoms return. What are you taking to prevent the flare up from returning? I couldn't get off pred with just Asacol and rectal meds, I think 6mp was necessary for me at the time.
Posted 3/24/2011 8:03 PM (GMT 0)
When I was tapering I always had a few rough days. So, I always waited until I was stable for a couple of days at least to drop again. You can also try doing 27.5! GL! :o)
Posted 3/24/2011 9:16 PM (GMT 0)

notsosicklygirl said...
I had to go down from 15mg at 1mg increments too. I went from 7.5 or so at .5mg! I had to start 6mp and that helped me to reduce the dose without having symptoms return. What are you taking to prevent the flare up from returning? I couldn't get off pred with just Asacol and rectal meds, I think 6mp was necessary for me at the time.

Boy do I know that .5mg cutdown ... Doctors don't believe, but I got stuck at 2mg a number of years back. I've done Immuran in the past, never 6mp. For me It's kinda strange because what I've found my two best weapons are Tylenol-3 and metamucil. The T-3 pretty much shuts everything down and gives my colon a chance to rest and the metamucil allows things to pass smoothly when they need to. I also try to follow a low flatulent diet. The less gas pushing things through the better. Asacol and rectaal meds do help tremendously though. Many people can't handle or don't want to handle any type of narcotic. I find T-3 to be mild enough I have few side effects. But everybody is different.

 

Posted 3/24/2011 9:57 PM (GMT 0)
What is 6mp?
Posted 3/24/2011 10:15 PM (GMT 0)
It's a immunosupressent. The generic is called mercaptopurine. It is similar to Imuran, not sure if you've heard of Imuran. Usually if a patient can't get off prednisone they start you on one of these medications. Some doctors go straight to Remicade I've heard but mine gave me the option and I went for 6mp. I am also on Asacol and Canasa.

Tiger - interesting info on the tylenol 3, how is this different from regular tylenol? I don't think I've heard of it.
Posted 3/24/2011 10:21 PM (GMT 0)
It's a drug that suppresses the overactive immune system characteristic of UCers that leads to inflammation. The other option a lot of us are on are taking constant anti-inflammatories through oral, rectal and suppository means.
Posted 3/24/2011 10:23 PM (GMT 0)
Taper very slowly and if pred is the only thing you're on for this, you'll definitely run into problems. You need an arsenal of back-up maintenance meds that take over as you taper off pred
Posted 3/24/2011 11:51 PM (GMT 0)

KeepTheFaith31 said...
Anyone have trouble tapering Pred down from 30mg? On 30mg, I feel great - super great! I'm solid and only going once a day! I have tried 3 times now to drop to 25mg (even tried 27.5 for a few days) and the next morning...D again. Just once, but it's definitely D. I'm frustrated... any advice? Or can this be the case for the first few days of a taper and then it will become solid again? Does this happen with anyone else as they decrease Pred??

Yes. No bleeding at 30 mgs. Bleeding would come back in full every time I tried to reduce the dosage to 25 mgs. It didn't seem to matter if I was at 25 mgs for a couple of days or a couple of weeks. I was pred dependent.

I did fecal transplantation and went immediately into remission.

I hope you find something that works for you.
Posted 3/25/2011 4:58 PM (GMT 0)

notsosicklygirl said...
Tiger - interesting info on the tylenol 3, how is this different from regular tylenol? I don't think I've heard of it.

 

It's Tylenol with Codeine so it has to be prescribed. It has 300mg of Tylenol and 30mgs of Codeine. It is a fairly mild narcotic. In Canada they sell Tylenol with Codeine over the counter at I believe 7.5mgs of Codeine per tablet. The only problem is they also have to include caffeine in the pills, so they can actually make things worse. I've used Lomotil in the past and it works very well, but I found it made me more groggy than the T-3. Once I get into a remissive state I then try to go back to straight Immodium. But when I'm flaring nothing gets me back to regular like T-3 and it really helps deal with the associated problems of prednisone taper (my current taper from 70mgs has been a nightmare of body and joint pain ... down to 15mgs now and I can almost see the lightat the end ... not to jinx myself).

 

I also really like what Dr-A says about Immodium ... It is one of the lesser evils of all the drugs we have to take ... and for many people can be used with great success.

Posted 3/28/2011 6:43 PM (GMT 0)
I know where you're at. I'm at 10mg (down from 40 but never reached remission) and I'm worse than ever.

Everyone's posts have been a real revelation though. I'm starting to think I may need to switch doctor. He's never prescribed anything like Imuran or the likes. I'm now trying to get my hands on some Rowasa enemas which are not sold in Guatemala.
Posted 3/28/2011 7:00 PM (GMT 0)
can you add a steriod enema for a couple days when trying to taper...just thinking out loud.....
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