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How long can you stay on 5mg prednisone?

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Ulcerative Colitis
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Posted 6/8/2018 4:50 PM (GMT 0)
So I went on a small dose of prednisone because I was flaring on vacation. And it helped a lot and I stopped flaring. But as soon as I stopped taking it I flared immediately. Remicade still hasn’t worked for me and I’m sick of being in a flare. So until I get my next dosage (5th) I want to be on 5mg of prednisone just so I can live somewhat of a decent life. But is this safe? I would be on it for like 3 weeks to a month.
Posted 6/8/2018 5:38 PM (GMT 0)
prednisone is one drug you generally don't want to be on long term due to the long list of horrible side effects. I was on it for quite some time. Some are even steroid dependent. I always had to use prednisone as a "bridge" between Remicade infusions. My infusions would start to wear off before my next one and prednisone helped keep symptoms in check, that and along with 6MP. I've developed osteopenia in my hips due to long term steroid use, it really is a horrible drug for side effects but works so well for many at the same time. For me, anything below 20mg would cause my flare to start back up.
Posted 6/8/2018 6:07 PM (GMT 0)
Can you remind us which medications you are currently on, and their dosages (I do not see a signature with that information)?

If all you need is 5mgs of pred, a real low dose, then I bet you could add a safer mild medication to your regiment and then kick the pred for good (rowasa enemas, etc.).
Posted 6/8/2018 6:29 PM (GMT 0)

iPoop said...
Can you remind us which medications you are currently on, and their dosages (I do not see a signature with that information)?

If all you need is 5mgs of pred, a real low dose, then I bet you could add a safer mild medication to your regiment and then kick the pred for good (rowasa enemas, etc.).

I’m taking mesalamine enemas&remicade that’s it. Penatasa and asacol didn’t work. The only thing that seems to work so far is prednisone (even at a low dosage). Even budesonide didn’t work.
Posted 6/8/2018 6:30 PM (GMT 0)
Enemas are twice daily & are 2g each
Posted 6/8/2018 6:57 PM (GMT 0)
I hear you on the pred, it is one of the most effective medications available for UC, however, it cannot be used longterm.

How long, cumulatively have you been on prednisone within the last 12-months? Curious whether you fit the definition of long-term usage yet.

Your options are to reintroduce pentasa/asacol (wait 3-4 weeks and stop the pred) or add immunomodulators azathioprine/imuran/6mp (wait 3 months and stop pred). I'd recommend reintroducing the mildest meds first, the pentasa/asacol.
Posted 6/8/2018 7:35 PM (GMT 0)

iPoop said...
I hear you on the pred, it is one of the most effective medications available for UC, however, it cannot be used longterm.

How long, cumulatively have you been on prednisone within the last 12-months? Curious whether you fit the definition of long-term usage yet.

Your options are to reintroduce pentasa/asacol (wait 3-4 weeks and stop the pred) or add immunomodulators azathioprine/imuran/6mp (wait 3 months and stop pred). I'd recommend reintroducing the mildest meds first, the pentasa/asacol.

When I was extremely sick, as in I was litterally pooping blood to the point where I almost went into hemoglobic shock, they had me on pred for about 1 month and a half with a Taper every week by 5mg. They had me on asacol and meslamine enemas. Which worked so well until I was off. Then I was just on asacol which really started to not work without the pred. It was just hurt my stomach and cause a lot more complications along with the Pentasa which I tried after the asacol. I’ve tried incorporating them back but they always make things worse. My second bout of pred was just for a few weeks while I was on vacay. I went from 15mg and taperd by 5 till off. Just got off 2 days ago. I also took budesonide for about 1 and a half months which didn’t do anything (not sure if that matters)
Posted 6/8/2018 8:07 PM (GMT 0)
Another 3 weeks of pred at 5mgs won't kill you, if you want to buy more time for remicade to work. Just make sure to keep your gasteroenteroligist in the loop of what you're doing and why. You shouldn't be going completely rogue and doing this all yourself. Continuing Pred isn't something you should be deciding by yourself.

In your shoes, I would start an immunomodulator asap (imuran/azathioprine/6mp), it takes a long time to work, so starting it early is preferable. Rowasa + remicade + azathioprine might give you a remission.
Posted 6/8/2018 11:08 PM (GMT 0)

iPoop said...
Another 3 weeks of pred at 5mgs won't kill you, if you want to buy more time for remicade to work. Just make sure to keep your gasteroenteroligist in the loop of what you're doing and why. You shouldn't be going completely rogue and doing this all yourself. Continuing Pred isn't something you should be deciding by yourself.

In your shoes, I would start an immunomodulator asap (imuran/azathioprine/6mp), it takes a long time to work, so starting it early is preferable. Rowasa + remicade + azathioprine might give you a remission.

I agree. Can. My gi’s are quite stubborn though every time I suggest something they brush it off and just tell me to wait for the remicade to work. But it’s been a solid 4 months and nothing’s really happened. Can You tell me more about immunomodulators?
Posted 6/9/2018 5:26 PM (GMT 0)
With UC you either use anti-inflammatory meds (the mesalamines like asacol/apriso) or you suppress the immune system in several ways. When we flare our WBCs go through the roof. WBCs directly cause inflammation. Immunomodulators work by reducing the amount of WBCs our body can have in the circulatory system at one time, by slowing the rate WBCs can be produced. The less WBCs the less inflammation, and the better our UC symptoms are. Immunomodulators require blood monitoring every 3 months for the duration you are on those meds. As your WBCs cannot get too low. Immunomodulators are generics, pills you take. I'm on 6MP, since 2012. No side effects.
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