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Tapering Colocort after long term steroid use.

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Ulcerative Colitis
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Posted 5/28/2011 4:53 PM (GMT 0)
I've been on steroids for about a year. I was on oral pred for about 5-6 months, and then was doing two colocort enemas for about 5 months. For the last month, I have tapered down to one colocort overnight, and switched the morning colocort to SFRowasa.

The SFRowasa has worked wonders and put me into remission symptom wise but I still need to get off the colocort. I am seeing my Doc in about a week. I'm pretty sure he will say to go to alternate nights with the colocort for a while, then off completely.

Has anyone else been in this situation, that is, tapering off colocort after long term steroid use? Is there any other approach besides going to alternate nights (i.e. every second night). I'm worried that my adrenal system is not producing any cortisol of it's own, and needs some time to become active again.
Posted 5/28/2011 5:04 PM (GMT 0)
I think you should start tapering every second night and continue then use the Rowasa on the night you're not doing it. Skip the Rowasa that morning.

It's great you're feeling better!

You'll see how you do after doing this for a few weeks...and adjust as necessary.

If you're worried about the steroid dosage, ask for a prescription for proctofoam...it's a lower dosage...so that you can use it for a bit of a boost if you need it.

It's great you're feeling better...long haul for you!

quincy
Posted 5/28/2011 5:24 PM (GMT 0)
Thanks Quincy.

I guess I will learn the first night I miss a colocort how it will affect me.

I thought I read somewhere that for most people a dose of about 7.5 mg of pred is enough to suppress the adrenal system. I've also heard that the average person absorbs the equivalent of 5-8 mgs of Pred from a colocort. That means I've been right on the bubble for the last month.

When I went from 2 colocorts to 1, i noticed my appetite went back to normal, and the acne I was having, mostly on my legs, slowly cleared up. Here's hoping my adrenal system already has reactivated.
Posted 5/28/2011 5:34 PM (GMT 0)
All you can do is try. But, while you may know after one night, continue the process. You have already changed one major dosage from morning/night to night. The Rowasa used in place of the steroid should keep much of the inflammation at bay.

You could also ask the doc for a script of Canasa to use in the mornings for a week or so, then start to taper the colocort the next week.

You have a few options...if one isn't enough, then there is always another to add or change. We can help with the suggestions.

OR...you can just use a half Rowasa in the mornings, etc.

q
Posted 5/28/2011 5:54 PM (GMT 0)
After about a week of using the SFRowasa, I added a Canasa after passing the Rowasa. The SFRowasa and Canasa seem to work beautifully together as the inflammation has been really relentless, and keeping rectal meds in for as many hours as possible during the day seems to be key for me. The SFRowasa has allowed me to retain the Canasa for up to 8 or more hours... sometimes right up until bed time.

The other thing is I need to get the Canasa in as high as possible. I think most of my inflammation is in the upper part of the rectum and possibly lower sigmoid.

At this point, I would trade some oral mesalamine tabs for a canasa if I had to so that I could keep using Canasa without using an excessive amount of mesalamine.
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