Mesalamine Not Helping, Switched to Prednisone

Hi Everyone,

I'm in a mild to moderate flare for the first time in years, and wrote in last week about taking Mesalamine. Unfortunately, it hasn't been helping so my gastro put me on Prednisone. However, I'm a little skeptical about how aggressive the tapering schedule is. He said it should be okay since the flare isn't terrible, and I don't need to be on it for very long. He also said if you're on Preds for less than 21 days it won't shut down your body's ability to make cortisol on its own. Obviously I love the idea of only being on the drug for a short time, as the side effects are AWFUL for me, but I also want this dumb flare to be over once and for all.

I wanted to check with you all to see if you have ever successfully completed a tapering schedule like this without it re-triggering a flare:

- Take 40mg per day for 3 days
- Taper to 30mg per day for 3 days
- Taper to 20mg per day for 7 days
- Taper to 10mg per day for 7 days
- Then go off it altogether.

Does this seem right?

Thanks,

Laura

It's a fast taper but assuming your gastroenterologist is experienced and has tried this protocol with success before I would trust him more than unqualified people on the internet... there are no hard and fast rules with tapering schemes.

I wouldn't do well with that taper either, but everyone is different. If you don't see improvement please reach out to your doctor and let them know before the flare up worsens. I also don't think stopping your 5ASA's is really the best plan. I have flared on them and added pred to the mix to help stabilize the flare up, but needed to keep the 5ASA's in the mix. I also found that I couldn't process the North Star brand mesalamine but do fine with Rowasa (sulfite free due to a sulfite allergy). I switched to Colazal in 2019 and have done very well on that. Pred is really just a stop gap, not a maintenance med.

In the long term, biologics do much less damage than repeat courses of prednisone and would always be my first choice if I was ever offered pred again (I have severe osteoporosis from being on - mostly low dose - prednisone for 2 years)

I hope the colazal works for you without any bad side effects.

Happy to report that the Colazal is working well, and I'm down to 20mg prednisone at this point. So far I haven't had any recurring symptoms so fingers crossed that this flare is history and the Colazal will be the right maintenance drug long term. Thanks for everyone's support!

Glad to read that you are having positive results. Old Hat who is a member in this forum has been in remission on Colazal for quite a long time.

Keep us posted on how you are doing.