40 mg prednisotone for UC. Immediate relief. Can I cut back after a day or two?

Posted , 4 users are following.

I've had a long history of ulcerative colitis with occasional flareups. After experiencing 15 or so bowel movements a day I was put on 40 mg prednisone. The first day it seems to have cut back my bms to a very few. I was told to reduce by 5mg per week. But since it's worked so well after less than a day I was considering cutting back to 30mg on day two and 25 on day three. I won't be able to talk to my doc till then and I'd rather reduce quicker if possible.

In the past when I was put on prednisone it either didn't seem to work at all or worked very slowly.

Does anyone have similar experience or suggestions?

Thanks.

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13 Replies

  • Posted

    Don't cut back so quickly. You need to maintain your remission. The fastest you would want to do is down 10 mg every 5 days.
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  • Posted

    Thanks Andee. My thinking was that 40mg is the standard starting dose, but what if I only need 30 or even 20 to start with? Perhaps differenent people/seerity react differently? If I find the reduced amount makes things worse I can always move back up to 40.
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  • Posted

    The problem is with the side effects that come with such quick reduction.
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  • Posted

    Yes, that's true if you've been on it for a long time. But my thinking is that after one day of use, one should be able to reduce quickly if it's not needed, as your body has not become used to the high level and reducing the level should not be a problem. I'm trying to quickly find the level I need and take that for a while and reduce slowly from there.
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  • Posted

    If your symptoms were bad your doc will have prescribed a dose that will see you through to remission, finishing sooner could bring all the symptoms back but worse. My Gastro team advised me to stick to the prescribed dose as I'd asked them the same question. My own GP (not specialist in gastro) thought like you and prescribed pred at 40mg for 1 week - sure enough the symptoms returned with a vengence. I've been off them just over a week and I'm feeling good!

    I hope you are soon in remission again.

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  • Posted

    Thanks Nita. So what did regimen did your GI specialist recommend?

    I was told 40 mg a day and reduce by 5 mg every week, which is a relatively quick reduction.

    Did your symptoms improve immediately too when you started taking pred?

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  • Posted

    Hi gabe

    40mg is a pretty standard dose recommended in UK guidelines and you should taper it slowly as per the advice you have been given. 5mg reductions per week are the norm - if you reduce any faster you increase the risk of relapse, which if severe may need a hospital admission. Great news to hear your symptoms are improving but don't chance it with the steroids. If you have had multiple courses of high dose steroids in the past, abruptly stopping a new course can be dangerous.

    Tarun (hospital pharmacist)

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  • Posted

    Thanks Tarun.

    This is my first course of Prednisone in years. I just thought if the effect after one day is so dramatic I may not have needed the 40 mg to start with. I will take the same 40mg today and check with my doc on Monday depending on how it goes on day two. I just want to take as little for as short a time as possible. I can imagine that not everyone requires the same dosage for the same lenght of time as everyone else, but the proven and safe course is what doctors recommend.

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  • Posted

    Hi Gabe,

    I was prescribed 40 mg reducing by 5mg per week as you were, however, this was my 3rd or 4th relapse in 6 months, I finished the course of Pred about two weeks ago and I'm still feeling fine (I was bad within 10 days of finishing the short one week course prior to this course prescribed by my gastro team. I was also started on Azathioprine in early January and I already take Mezalazine since I came out of hospital last June. I'm hoping to stay healthy this time - fingers crossed. I was diagnosed wih Coeliac disease in Aug 2012, and tested postitive for Crohn's and colitis at the same time - but the UC came as shock and it has been nasty!

    Hope you do well. X

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  • Posted

    Meant to say also that my symptoms improved within three days of starting the Pred, the last time I was prescribed 40mg reducing by 5mg per week was when I came out of hospital in June 2012 and I managed to stay in remission for 8 weeks before I started feeling ill again. X
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  • Posted

    Thanks Nikita,

    Well I didn't stop or reduce the Prednisone and my symptoms worsened after that first day. After three weeks it was worse still and I was prescribed Rifaximin for a week. It's helping somewhat, but still getting up every two hours at night with somewhat firmer stool. Currently on 25mg Prednisone reducing by 5mg each week and will be seeing my doc next week. Unless things get significantly better I'm going to ask him for new ideas (short of surgery). In forty years it's never been nearly this bad except for the first onset but even that improved quickly.

    I've read that marijuana seems to bring relief and long term improvement. Much testing/experimentation has been done on marijuana for various ailments including colitis and chron's in Israel. CNN had several hours' coverage recently on the benefits of cannabis for various problems and much support from the their chief medical correspondent, Dr. Sanje Gupta.

    Has anyone tried marijuana for uc? I'd love to hear about both positive and negative EXPERIENCEs or credible scientific reports.

    Thanks!

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  • Posted

    Sorry - meant Nita! But only re-checked your name after posting. My apologies!
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  • Posted

    LOL! Gabe99, I didn't notice until you pointed it out!

    I haven't heard of the medicinal marijuana, but I think, from reading another post, that there have been trials in Canada. You may be able to find out more by googling it? Good luck.

    I'm currently off pred', still taking mesalazine but have been told to stop taking azathioprine for two weeks as I had some unusual blood results - I'm due to start taking this again in Friday again but need to let my IBD nurses know if I experience any side effects (I'd been having a few). Gastro wise I feel the best I have since being diagnosed in June last year - I do suffer when on more meds though and I'd be interested in alternatives.

    At present, apart from massive joint pain, I feel I have my life back - I'm not racing to the loo and I'm able to ride my horse and go out for hours with no worrying where the nearest loo is. I hope it continues and I hope you soon start to feel better too.

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