HealingWell
Search Close Search
☰

Prednisone length & dosage

Support Forums
>
Ulcerative Colitis
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 6/6/2015 9:32 PM (GMT 0)
Hello,

I started flaring about 3-4 months ago after about 3 years in remission an on maintenance Pentasa. I was finally able to se a doctor in late April and he prescribed Prednisone 30mg/Day while keeping my Pentasa maintenance dosage (2.5g /day). While I saw a quick improvement after a week being on Prednisone, I kind of got stuck after that, some bleeding and mucus returned, and I haven't been able to reach the point to start tapering down. 2 weeks ago I added 25mg HC supps twice a day.

My concern is that I've been on Prednisone for 6 weeks already and given my current progress I don't see I'll start tapering anytime soon... I haven't felt terrible side effects due to the relatively low dosage, but lately my urine has been cloudy sometimes (I've red somewhere that this may be calcium-related) and I'm starting to feel weaker and finding it harder to focus at work, etc. While I've been on Pred before I'm really worried about being on Prednisone for too long (the longest I had been before was almost 2 months but including the tapering period), I'm don't have much experience with it, and I really want to avoid starting to get some of the long-term side effects.

I terms of UC symptoms I'm doing "fine", with 3-4bms a day (the early morning ones are usually bloddy) and I've been able to lead a normal life during this flareup. Any thoughts or advice? Should I ask my doctor to bump the dosage to stop the bleeding and start tapering? I would appreciate your comments.

Thanks!
Posted 6/6/2015 9:49 PM (GMT 0)
going higher to stop bleeding is a reasonable option. but you may also be not responding, which would mean some other drug. maybe inflammation has spread beyond where supp can reach. should discuss all these options with doc.
Posted 6/6/2015 9:52 PM (GMT 0)
Thanks! Also forgot to add, should I take Calcium supplements as well? While living in Chile my doctor there prescribed me calcium supplements with Prednisone, but I decided not to take the Pred so I neger took the calcium either. I've read mixed opinions on that. I'd appreciate the advice!
Posted 6/6/2015 9:55 PM (GMT 0)
Longterm prednisone usage for permanent side effects is rather subjective, but often means a year or more, so you're no where near it yet. I did a continuous year on prednisone, no permanent damage that has been found.

What to do? Ask your doctor to up your pentasa oral to 4.8 grams a day (the max). Ask for up to 4 grams of enema a day (the max). If that's not enough then you need to strongly consider immunosuppressive medications (imuran, 6mp, aza). Prednisone is more dangerous than any of those medications.
Posted 6/6/2015 10:28 PM (GMT 0)
Just thought I'd add this in and hopefully someone can chime in. I've been in the same boat as you before, at a high dose of prednisone I seem to see little improvements, and then it plateaus after a week. When I start tapering (below 15mg) is when I actually start to see significant improvements. Not sure if it's just me or not. Not sure why that would happen either. But regardless, I would probably taper if I were you.
Posted 6/7/2015 1:00 AM (GMT 0)
I'm kind of shaking my head a little bit. The doc has you on a mtnc dose of Pentasa and then when you start flaring they keep you on a mtnc dose of Pentasa. What's wrong with that picture?
Posted 6/7/2015 3:05 AM (GMT 0)
Call your doc
If he isn't helpful than go for a second opinion when you are flaring you need to be in close contact with them
Good luck
Posted 6/7/2015 5:10 AM (GMT 0)
Honestly, im not convinced at how well calcium pills work. Ive taken pred a total of 9.5 months out of my 10 years of ibd and was taking calcium/vit d during each course. I was diagnosed with osteoporosis last year. I think the dose needs to be really high to counteract the prednisone.
Posted 6/7/2015 6:29 AM (GMT 0)
How much calcium were you taking at a time
Also what format? Chewable is usually easiest to absorb
Also your body can't use more than about 500 mg at a time so it's best to take the supplements throughout the day
You also need adequate vitamin d to absorb it
And steroids will take a lot out of your bones
Which is why they sometimes advice calcium with it
Posted 6/7/2015 8:07 AM (GMT 0)
Calciium is a must when on pred but it does not offer any guarantees. It's like eating a whole gallon of ice cream and expecting that doing twenty minutes of exercise will negate it.
✚ New Topic ✚ Reply