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Pred side effects/questions about other meds

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Posted 12/19/2009 4:00 AM (GMT 0)
I seem to be having these side effects from my prednisone course:

Exhaustion, weight gain, moodiness, frequent urination (especially at night), thirst, and over the past few days I've had mild dizzyness/lightheadedness. I also think it may be causing muscle cramping in my legs.

I have 14 days left of my taper.

I was also curious about the other non steroid non 5-ASA drugs (Imuran, 6mp, Remi, Humira). What is their mode of action? How are they delivered? Side effects? Stuff like that. Because if I keep flaring, I don't think I can really tolerate the pred on top of the rest of my life.
Posted 12/19/2009 4:06 AM (GMT 0)
I'd say those are all normal. Personally I got weight gain, hyperactivity/very very easily amused (picture someone high), lots of energy, moon face... I dunno about the peeing, because I pee every time I poo, just body habit, and I was pooping more than is normal.

Well, Imuran suppresses your immune system, it's used for people who've had organ transplants but at much higher doses. It is broken down into the liver to 6mp, your doctor probably knows which one would work better for you... Personally? Absolutely no side-effects. But some people do get nausea (take it at night), and maybe fatigue? Some people also get skin problems being out in the sun, so just make sure you wear your sunscreen. As for the other meds, I don't know, but I'd go the Imuran route before I tried those.
Posted 12/19/2009 4:39 AM (GMT 0)
Imuran and 6-MP are both immunosuppressants. They put a damper on your immune system. Possible side effects include nausea, sensitivity to sun, fatigue, and liver problems. There's also an association with lymphoma when taken at high doses (roughly 3-4 times what is prescribed for UC) or when taken in conjunction with the biologicals. Liver problems are not common, and lymphoma is very rare.

Remicade and Humira are bilogicals. They work by suppressing a specific component of the immune system, TNF. People can have allergic reactions to either, and may build antibodies to the drugs so they no longer work. There are a number of other possible reactions described, but they happen in a very small number of people. In people who have latent multiple sclerosis, Remicade can activate it. The biologicals can also produce lupus-like symptoms.

Immunosuppressants are oral medications. Remicade is given by IV every 8 weeks, and Humira is injected, I think weekly.

You can get more information from the CCFA web site:


http://www.ccfa.org/info/treatment/medications

Prednisone is not appropriate for long-term therapy because it has some truly grim side effects from long-term use.
Posted 12/19/2009 2:43 PM (GMT 0)
     Malk...have your blood glucose tested.  While on prednisone, which gave me osteoporosis and high blood pressure, my glucose levels skyrocketed and your symptoms are that of diabetes.  While my fasting blood glucose levels were always normal, my 2 and 3 hr pp were over 200.  Watch your carbs and sugar intake.  When off the prednisone, my levels returned to normal.

     I was on 6MP for seven years.  It only gave me a two year remission after I first went on it but then I flared yearly and in the past eighteen months had three bad flares.  I am now on Remicade with my third infusion coming up on the 31st of Dec.  I was doing great but today I have diarrhea.  I have no idea what from but my prednisone was tapered down to 5 mgm yesterday from a week on 10 mgm.  My body LOVES the prednisone, unfortunately.

Posted 12/19/2009 3:34 PM (GMT 0)
Christine: Is that a fasting blood test? How would I go about getting a prescription? I try to watch my diet, though sometimes it's kinda hard, and I've been eating a decent amount of bread lately cause it doesn't bother my stomach much. Typical meals for me lately tend to be egg on toast for breakfast, soup and sandwich/burger and maybe a yogurt for lunch, and whatever I have access to at dinner, plus usually I'll have a snack at night of whatever's in the house. My body is usually good about tapering but this time it's a really fast one and also I'm busy so I can't get the amount of sleep I need to counteract the not-sleeping-well side effects.

Judy-Thanks. I've luckily never used it for more than 2 months at a time, but even then my GI is very stringent about making sure I take my calcium supplements. Any indicators of which people are likely to have allergic reactions to biologics? Also do you do the Humira injection yourself?

ElephantPipe-I've been up peeing every few hours in the middle of the night. Quite obnoxious. It happened last time too. Thanks for the advice.
Posted 12/19/2009 3:54 PM (GMT 0)
Malkavian, Christine is correct in that your symptoms can be caused either by elevated blood glucose or by Prednisone. You'd start with a fasting blood sugar or perhaps a sample 2 hours after eating; call your doctor and ask about getting an order for the lab. Some doctors follow up with a glucose tolerance test, but most do a simple hemoglobin A1C if the first test is high; that tells them what has been going on with your BGL for the past three months.

Humira is self-injected. It may or may not be covered by insurance, because it is not yet FDA approved for UC. I contacted the manufacturer about a month ago, and they could not or would not make any comment as to when it might be available. If you're interested in it, check with your insurance to see if they will cover.
Posted 12/19/2009 4:07 PM (GMT 0)
If you want to reduce the weight gain/water retention then avoiding sodium should make a difference. Also, if you're getting muscle cramps (which happens often due to low potassium when on pred) eating a banana should reduce the cramping.
Posted 12/19/2009 4:16 PM (GMT 0)
Rio-Thanks for the banana tip...though there is potassium in my cal supplements, which is strange....

Judy-is it worth doing the test even if my course is only for another 2 weeks? I actually never thought about my side effects that way, but now it makes sense considering intense thirst/frequent urination is a huge indicator for diabetes.
Posted 12/19/2009 4:27 PM (GMT 0)
It isn't a bad idea to get tested anyway. Usually it goes away gradually, but it would be good to know what effect it's having. Even if your BGL is high for two or three months while you're on Pred, if it gets too high it can still do damage to your heart, kidneys, etc. Also, occasionally it will not come back down for some people, then they do need to be followed and treated.

No reason to be terrified, but it's a good idea to get checked just in case. Your GI may not take it seriously; if that happens ask your PCP for an order.
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