Need some pred advice

I started taking prednisone 4 week ago 40mg per day and tapering off by 5mg each week. I saw immediate relief. I felt 100% better after the first day and it stayed that way for 4 full weeks. But Thursday I dropped to 20mg and bam like a switch I was back to bad stomach pains and constant D. My doctor is not in the office until Wednesday so I don't know what to do. Do I raise my dose back up myself? Or do I just deal with this for the next two days and wait it out? What normally happens in this situation? It is very frustrating because I felt like I was on the road to remission and then it slaps you in the face all of a sudden. Anyways, any advice would be appreciated.

Thanks

Same thing happened to me and probably a lot of others.

My GI had me go back up to the dose just before problems started and stay on that dose for another week then try to taper down 5mg again and repeat until I was able to taper all the way down to zero.

You should contact your GI though for his info, that's what you pay them for.

wow that is a pretty dramatic taper. 40 straight to 20. All of my tapers were done at a much slower rate. Dropping that fast can definitely make your symptoms returne. So yes for now, I'd go back up to 40 until you can speak directly with your doctor.

Labyrinth said...
Are you on any rectal meds as well? I think the only reason i had a successful taper was due to taking nightly Mesalazine enemas the whole way through and once id finished pred.

No rectal meds. My dr doesn't exactly like suggestions. And he is the only one in my area.

Have you even TRIED to ask you GI about rectal meds? I mean, you do need to be proactive, and if you stand up to him a little bit, he might listen. Go in armed with some good info. Not just that you heard on here that rectal meds might work, but with some research articles. I can dig them up for you if you want.

And if he won't RX them, make an appointment with your PCP and see if you can get them that way.

I'd go back up to 30 and see if that calms things down and stay there til you see/talk to your doctor. You may need to taper more slowly. I know that when I got down to around 25 on my taper I had to start tapering by 1 mg every few days instead of 5mg per week in order for things to stay calmed down. Everyone is different, 5mg can be too quick a taper for some. Also, a doctor who doesn't listen to his or her patient is not a good doctor, food for thought

Unfortunately having symptoms return at 20mg is fairly common. From my own experience I went back up to 30mg and tapered by 5mg every 10-14 days instead of every 7 days. No one wants to stay on pred for a long period of time so your doc may be trying to get you off as soon as possible. Tapering successfully the first time with no return of symptoms is not common.

I also took Cortifoam in the AM and Mesalamine Enemas at night. You may find symptoms return again at 10mg. That is when people usually start to taper even slower by 2.5 or 1mg. Rectal meds help give an extra boost locally where it is needed. When you see your GI ask again about rectal meds---make it sound like it was his idea :)

Thanks for the help guys. I went to 25 and am going to speak to gi tomorrow. We will see what he says.