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In need of help: can prednisone work if it didn't before?

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Ulcerative Colitis
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Posted 10/26/2014 1:36 AM (GMT 0)
Hello,

I'm on Simponi and rectal meds. Simponi had me in 6 mos remission, but now I'm bleeding and in discomfort for a week.

I tried pred (40 mg taper) 3 years ago. It helped for about a week but that was all. Is it worth trying again if it didn't put me in remission the first time?

Other options? (tried imuran, remicade, rectals, gluten-free)

Thanks!
Posted 10/26/2014 1:42 AM (GMT 0)
What other meds were you on with prednisone the first time around?
Posted 10/26/2014 1:51 AM (GMT 0)
6mp I believe, which didn't help at all. I also tried Uceris when it first came out. Provided zero relief, so I'm thinking steroids just don't work for me.
Posted 10/26/2014 2:20 AM (GMT 0)
I wouldn't count it out. I don't think it is a sure thing that it won't work. Might not hurt to give it a try.
Posted 10/26/2014 2:34 AM (GMT 0)
I've used Prednisone taper before and it did okay, but then I flared up again and Prednisone was prescribed for me again, and it helped me stop bleeding, but my sulfasalazine was increased to 6 pills a day (500 mg tabs) over the course of the day and I have been in remission for 1 1/2 years. My GI doctor said I would be on sulfasalazine for the rest of my life. It is cheap and seems to be working. Drink plenty of water though!
Posted 10/26/2014 2:40 AM (GMT 0)
Thank you for the replies. I tried sulfasalazine a while back, but had to stop because I was getting headaches. Might be worth revisiting. . .
Posted 10/26/2014 3:20 AM (GMT 0)
Some people need to start higher than forty mg. also, did you taper off slowly last time? If you taper too quickly, it's very easy to relapse. It's easy to anyway. I don't think I would discount the possibility of it working just because it didn't work in the past. The bottom line is that if simponi isn't keeping you in remission, you will need to find a new maintenance med. maybe there is a chance you can stabilize with steroids and continue with your current treatment but it doesn't seem to work out that way in a lot of cases. What did your gi suggest moving forward?
Posted 10/26/2014 3:28 AM (GMT 0)
Agree with notsosicklygirl - some people need to start at a higher dose than 40. Last time I flared, I did 60 for 2 days, then 50 for 2 days, then 40 and tapered more slowly from there.

Also, after my really bad flare and hospitalization four years ago, I told my internist about how I'd been on 40 mg IV Pred for a week and barely felt better, she was shocked that my GI hadn't upped the dose. She said she'd had patients on 100 mg and that was ok for short periods.

I got a new GI after that.
Posted 10/26/2014 11:04 AM (GMT 0)
I'm not sure about the prednisone because it has always made me worse, but if you choose to retry sulfasalazine, start low and work up from there. I had horrible headaches and nausea/vomiting at first so worked up slowly instead and the side effects were still there but less severe. After a while my body learned to tolerate it and now I have no side effects on it. I'm sorry with all the drugs you're on you still haven't found relief. Had you tried any dietary changes? Sometimes that combined with meds work better than meds alone.
Posted 10/26/2014 1:57 PM (GMT 0)
Thank you!

How long did it take for the sulfasalazine to help your condition? I've tried asacol and colozal, neither of which helped.
Posted 10/26/2014 6:44 PM (GMT 0)
about a month but it didn't get me into remission, it worked better than Mexicans though (adagio). LDN was what finally put me into remission.
Posted 10/26/2014 6:45 PM (GMT 0)
That was supposed to say it worked better than mezavant (asacol). I need to turn off autocorrect lol!
Posted 10/26/2014 7:12 PM (GMT 0)
Prednisone only seems to work at higher doses for me and the symptoms come back when I taper. But at least while I'm on prednisone I can function. Can't sleep and a little scary psycho, but I can leave the bathroom.

At lower doses it did nothing.
Posted 10/27/2014 6:34 PM (GMT 0)
Entyvio? Gosh, I hate Pred.
Posted 10/27/2014 8:25 PM (GMT 0)
I need a higher dose of prednisone too. I think 60 mg for 4 weeks or so. Then I taper 5 mg a week or every other week depending. A lower starting dose or quicker taper doesn't help at all.

Unfortunately Prednisone doesn't work as well as it used to for me. I think it may be one of those drugs that is less effective with time. I usually start to flare again at 15-20 mg.
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