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predisone taper questions.

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Ulcerative Colitis
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Posted 2/10/2015 1:40 AM (GMT 0)
Have been working on taper since Dec... slow business. Has anyone had problems about 3 days after reduction. Reducing 2.5mg every 2 wks, then tenesmus shows up.... backup2.5mg, then down then back.
Started at 15 mg in Dec and now at 7.5mg.
Posted 2/10/2015 1:53 AM (GMT 0)
What mtnc meds are you on and their dosages? Whatever they are, they're not working. You can taper pred up and down until the cows come home and your results will never change unless your mtnc program is sufficient enough to work after tapering and yours is not.
Posted 2/10/2015 3:27 AM (GMT 0)
Oh yes, I have had that problem a lot. If it's just a few days of instability and it resolves, that's not a big deal, the problem is that you never know whether it's a few days or if it's a relapse!
Posted 2/10/2015 4:24 AM (GMT 0)
on entyvio..... for mtnc. But have been on prednisone .... I have stayed on the reduced doses about 2-3 weeks between the reduction. The tenesmus shows up around the 3 day and last about 4-5 days then things are ok until the next taper. The entyvio has been the best so far. When I was on the 15mg prednisone + entyvio had no problems at all.....coming off the ugly stuff started.
Posted 2/10/2015 4:30 AM (GMT 0)
How long have you been on Entyvio? Do any oral or rectal mesalamines help? You may need more than just Entyvio and a pred taper.
Posted 2/10/2015 4:42 AM (GMT 0)
mesalamines were no help.... actually made things worse. Ended up in hospital while using them.. MD felt I had allergic reaction to them. Blood veins in legs and feet started to break rapidly.. looked like I had been beat. and B/P dropped to 70/50... Don't remember too much about it... MD felt that I almost coded. Then started prednisone... Then REmi and prednisone.... then simponi and prednisone.
Started entyvio in Sept....with 15mg prednisone.. in Dec started the taper. Now on entyvio Q 8 weeks... with taper to 7.5mg of prednisone.
Posted 2/10/2015 4:44 AM (GMT 0)
Also tried Canasa... Really did not help.
Posted 2/10/2015 12:52 PM (GMT 0)
I don't think you started at a high enough dose of pred to heal your colon and give the Entyvio enough time to keep you in remission. But, the bottom line is if Entyvio is not good enough to keep you in remission all by itself then it doesn't matter how you taper the pred. By continually decreasing, increasing, decreasing the pred all you are doing is buying time and you will never get completely off the pred, ever. If I were the doc I would have started you out at 40 mgs of pred plus the Entyvio and I would have kept you there until you were totally in remission and then began tapering the pred down. If, at that point, your symptoms returned during the taper as they have now then you know 100% that you will never be able to rely on Entyvio to keep you in remission and you will never be able to taper completely off the pred without symptoms returning and you would either have to live with that or consider plan Z.
Posted 2/10/2015 1:53 PM (GMT 0)
How about adding an immunosuppressive med (imuran, 6mp, aza)? I see you had a bad reaction to meslamine. However, no mention of immunosuppressives.
Posted 2/11/2015 12:08 AM (GMT 0)
aza ....could not tolerate..... Gary you have good information.. will be going to GI this week... to update and get on track. thank again
Posted 2/11/2015 1:51 AM (GMT 0)
You can get Pred in 1 mg tablets and I always recommend that people use them when tapering below 10 mg.

You can also try alternating days each time you step down. For example if you were going from 7.5 to 5 mg, you do 5 one day then 7.5 the next day, then 5 again, 7.5 the next day and then go forward with just 5. It can wake up your adrenals more gradually.

Of course, this advice is assuming that your body is ready to taper off of prednisone.
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