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Tapering off - when and how?

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Ulcerative Colitis
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Posted 8/8/2016 12:01 AM (GMT 0)
Since starting on suppositories, my symptoms have remained totally manageable. My GP advised me that, once things start to settle down, I should try and drop back to using either just oral meds or just rectal meds. Clearly, given the effectiveness of rectals, that's the path I'd pursue if it came to that.

I've been reducing my oral dosage, but have started to notice a small amount of discomfort toward my lower bowel over the last couple of days, so I'm wonder if I've tapered off too soon. It's been about 3 weeks now since I started the rectal meds. I'm happy to go back to the full oral dosage and the rectals, but thought I'd get people's thoughts on how they would go about tapering off, when is a good time to try, and how that exercise might look.

Thanks
Posted 8/8/2016 12:42 AM (GMT 0)
It's great if you could maintain on the rectal meds alone, but if your UC is beyond the rectum, you likely need the oral medication to help keep it managed. Perhaps trying to taper the rectals to every other day would be a start. The fact that you saw a difference that quickly from a slight decrease in the oral dosage would make me very nervous to continue going that route, but that's just me & I am a worrier.
Posted 8/8/2016 4:45 AM (GMT 0)
don't go below a maintenance dose of oral
Posted 8/8/2016 11:15 AM (GMT 0)
Are you in a stable, sustained clinical remission with no uc symptoms? That's the best time to consider tapering a uc medication down. If not, hold steady with your current medications.

Well, your signature says you have Proctosigmoiditis (rectum and sigmoid colon involvement), so a suppository isn't going to be a sufficient maintenance medication because it's limited to treating only your rectum. An enema would be a better choice as it covers both.
Posted 8/8/2016 4:52 PM (GMT 0)
Stay on at 2400mg daily of oral.
Taper the rectals to twice a week. use them to deal with flares and if they are more than in the past increase the supps to 2x daily or use the enemas. You have lots of rectal med options.

DO NOT STOP THE ORAL! You want to keep the entire colon covered. Supps will not deal with the top part of the rectum or into the sigmoid...thats where the enemas come into play. Its not an either or.

q
Posted 8/8/2016 8:43 PM (GMT 0)
I'm so glad we have this place as a resource. Once again, there's loads of explanations that are far more informative than anything I've had from a doctor to date. Thanks everyone.

I'm back on the 2.4g oral dosage, and will stay on that with the rectals initially, then look to taper THOSE off (not the orals). But nothing until I'm confident that things have settled down.
Posted 8/8/2016 8:57 PM (GMT 0)
Good luck, and remember not everyone can successfully taper their dosage down. If you begin regressing then return to your safe dose. We're all individuals with individual maintenance dose needs.
Posted 8/9/2016 3:20 PM (GMT 0)
Dont taper off the rectals either...taper down to a maintenance, especially with supps.

If you do start to flare, you should be using the 4g enemas.

Since you are here...there's time for suggestions regarding rectal med options.

q
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