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Prednisone Dosages

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Ulcerative Colitis
WWYD? (until Dr. gets back with me)
drop to 20mg - 0.0% - 0 votes
stay at 40mg - 85.7% - 6 votes
up to 60mg - 14.3% - 1 votes
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Posted 7/2/2011 7:55 PM (GMT 0)
I know a poll is maybe not the best way to get advice, but my Dr. never called back Friday and I am on vacation.

I am in the middle of a UC flare, going 15+ times a day with lots of blood and all loose BM's. 

Began 20mg pred for 1 week, did not work.  Then Dr. upped it to 40mg.  Today is my 6th day on 40mg and I am not seeing much relief.

Latest Dr. instructions were to take 40mg for 5 days then go down to 20mg.  However, I am not seeing any improvements.

What would you do?  Go down to 20mg?....stay at 40mg.....or go ahead and take 60mg ????  I will not be able to get back with my Dr. until Tues/Wed since it is a long holiday weekend.

Posted 7/2/2011 8:24 PM (GMT 0)
Well, I have a very little experience with Predn, but if you still have symptoms you should at least stay on 40mgs until you get in touch with doc. I do not know anything about going up on your own to 60mgs which is rather high dose (isn't it?). But I'm sure you'll get more help from other members, with more experience than myself.

Hope you'll feel better soon.
Posted 7/2/2011 8:43 PM (GMT 0)
In your position I would not drop to 20mg.

If you are getting any improvement I would stick to a well cooked chicken/veg. diet and hold at 40mg. I have read previously somewhere that anything over 40mg oral has little extra effect.

Some people are prescribed 60mg pred for a week or two but unless things are getting worse it might be best to get clearance from your doctor.
Sue
Posted 7/2/2011 10:30 PM (GMT 0)
I think it depends on if you're having side effects.

I'm on 40mg Prednisone and it took 2 weeks for my bowels to become solid and it was overnight. I was told to stay on 40mg until symptom free for a week. Had a setback due to a car accident....still at 40mg. Would have been tapering by now if it wasn't for that!
I'm experiencing no side effects so I could up it, but am slowly showing some improvements. The fun thing is now going to be going through the claim process. The accident was not my fault and claim agents can be nasty!

If your GI is not responding then I would search for a new one. I go to Mayo Clinic and they are VERY responsive there. They call me back within 2 hours. They also coordinate with your local GI, but they're the primary point of contact as they are the experts in the field. My local GI doesn't mind the coordination...it just makes it easier for her.
Posted 7/3/2011 1:59 AM (GMT 0)
Oh...if you really want to try increasing the dose, I would suggest increasing it 5mg/week based on side effects and response.

Are you taking any other anti-inflammatory treatments? I came across an article from 2005 stating that taking fish oil leads to smaller dose of steroids. http://www.gastroendonews.com/ViewArticle.aspx?d=From+the+Literature&d_id=186&i=July+2005&i_id=260&a_id=7086

Also my integrative doctor recommended BSP-201 which is supposed to be as potent as steroids without the side effects. http://bsp-201.com/
I tried ordering some but it was on back order for so long I cancelled the order. May want to make sure this won't interact with Prednisone.
Posted 7/3/2011 10:57 AM (GMT 0)
mellybelly,

There are people who need a higher initial dose of prednisone for the regimen to work out. I'm one of them.

Years back it was the norm to start with 60 mg, or even higher, depending of the case. Now the norm is 40 or even 30 mgs - the advances in the medical science.

When I started dealing with the godforsaken drug some 36 years ago, it bit within 3 days. Now it takes a week or even two to start working, and I'm talking about the high dose.

I know that some posters here will tell you that they rather would elect for colectomy than take a single pill of prednisone but, unfortunately (or fortunately) it's the drug that works in most cases.

The most important matter now is for you to reach the remission, whatever it takes. If the 40mg does not work, the 20 most probably will not either, especially if you have dealt with the drug many times previously.

The decision is yours. Hope this helps.

Good luck to you.
Posted 7/16/2011 2:15 PM (GMT 0)
I still haven't had any improvements. I was beginning to have a feeling of tightness in the chest so the Dr. said I should go down to 20mg. I am only 99lbs right now anyway. So, 40mg was probably too much.
Posted 7/16/2011 11:49 PM (GMT 0)
I wouldn't increase the dose without discussing with your doctor. In fact, I just saw my doctor on Friday and we talked about Prednisone a lot because it will be the next step for me if other meds don't work. He said he does not go above 40mg because there is no real benefit beyond that.
Posted 7/17/2011 12:15 AM (GMT 0)
One time, I higher my dosage from 40mg to 60mg without my doctor's consent :x. To say the least, it worked for me.

I wouldn't recommend you doing it, too. Like others have said, it's the side effects that could haunt you. I am not you, so what happened to me may not happen to you.

Maybe the Prednisone doesn't work for you? I don't know.

I say you should do all you can to get in contact with your doctor, which could even mean you tossing a fit to the doctor's office since the doctor did not follow-up with his/her end! Sorry to hear that you have to spend your vacation with this problem.
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