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Prednisone dosage/length

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Posted 9/5/2014 10:25 AM (GMT -5)
There is a lot of discussion about being on "high" amounts of prednisone for "long term". But what is that high amount and what is considered long term? Is there a rule of thumb?
Posted 9/5/2014 11:51 AM (GMT -5)
My doctor told me just a few months is considered long term. Any dosage can do damage but obviously the higher the more damage it will do.
Posted 9/5/2014 12:00 PM (GMT -5)
Your body makes approximately somewhere between 7 - 12 mgs of cortisol every day on it's own. Whenever you take that dose or higher of pred your adrenal glands shut down and no longer produce it. So, I would consider a high dose to be whatever shuts down your body completely from making it's own cortisol, and of course anything higher than that. The definition of long term is more debatable but mine would be taking 3 straight months or more of a dose that shuts down your adrenal glands completely and, of course, the longer the term the worse it gets and it probably gets worse exponentially. If you take pred longer than 3 months but the dosage is less than what your body would normally make on it's own then your body will be manufacturing some cortisol on it's own, which is a good thing. It may be possible to take pred long term at these lower levels (let's say 5mgs or less). There isn't really much information on taking low dose prednisone long term.
Posted 9/5/2014 12:18 PM (GMT -5)
imo, numbers don't mean squat - there are people who can be on fairly high doses forever and suffer limited damage - unfortunate others need only be on a low dose for a relatively short amount of time and experience significant damage - the effects, like uc, are very individual -

same answer as to why my 86 yr old mom has smoked all but about 16 yrs of that, and has no apparent damaging effects - then there are folks dead at half her age from the same amount of smoke -

regardless, the best answer is like most drugs, only more so do the possible major & permanent damage from pred - use it as little as possible to achieve the desired results - get in and get out -

most docs treat pred with the respect it deserves -
Posted 9/5/2014 12:27 PM (GMT -5)

jacket fan said...
There is a lot of discussion about being on "high" amounts of prednisone for "long term". But what is that high amount and what is considered long term? Is there a rule of thumb?

It is often cited that you do not want to be on prednisone for longterm. However "Longterm" is quite subjective and you will get a lot of answers of varying lengths. I've never seen a hard and fast rule, or rule of thumb on it. The best answer is stay on prednisone for the shortest amount of time you can, and on the lowest dosage you can. Any level of prednisone is dangerous to your system over the longterm, whether that is 5mgs of 40mgs doesn't matter in that regard you are still at risk. Of what? Osteoporosis, Glaucoma, Type II Diabetes and other irreversible side effects. I did a yearlong continuous course of prednisone in order to recover from my last flareup of uc (longer than most would like) and I didn't get any of those things (lucky perhaps). Right around the year mark and beyond you are pushing your luck though regarding the aforementioned risks. As Prednisone isn't meant to be a uc maintenance drug, and when used as one, even at 5mg dosages, you will get one or more of those permanent side effects.

I am willing to bet you don't have to worry yet...
Posted 9/5/2014 12:55 PM (GMT -5)
yeah, I fell like I'm okay for the time being. I'm about a month and a half of being on between 30-50mgs. Right now I'm on 50, and I'm really hoping to start tapering soon. I'm just not sure that I will be able to. At the same time, I'm still going between 10-15 times a day so I'm wondering if it is even doing anything for me?
Posted 9/5/2014 1:15 PM (GMT -5)
well, the question is, how many dumps/day would you have w/o the pred ?

to me, it doesn't seem to be doing much - at least according to my butt scale - pred usually knocks me back to 2, maybe 3 -

sounds like time to toss the pred -

wish I had something better to offer jf :-(
Posted 9/5/2014 1:32 PM (GMT -5)
That's the million dollar question Soy! It scares the crap out of me (even more of it) to think about what that number might be without the pred. At the same time, I wasn't going more than 15 x a day consistently before I started the pred and now I'm averaging between 10-15. So how much can it really be doing for me. I have a busy week at work next week and my plan was to start tapering after that, but I might see how the weekend goes and get a jump on my tapering.

Thanks for the replies and advice.
Posted 9/5/2014 1:46 PM (GMT -5)
Jacket, whats up Man... I basically have that same question right now. I'm back to 40mg of pred and still going 8-10 times... But it scares the hell out of me to because if I stop how many then? My plan is to be at 40 for a week and then hopefully start the taper, while I'm waiting on this stupid Simponi to work. I have an appointment Tuesday with my GI again so we will see...Good Luck Jacket!!
Posted 9/5/2014 3:10 PM (GMT -5)
Thanks dude, you too. I had my second Remi infusion yesterday, but nothing to speak of yet. I meet with my GI on Tuesday also. Maybe i'll just wait until then and see what he has to say about the tapering.
Posted 9/5/2014 7:57 PM (GMT -5)
News flash guys you don't taper pred until you're at least 90 percent healed. You'll just get worse if you taper too soon.
Posted 9/5/2014 8:11 PM (GMT -5)
but that's assuming everyone will heal using pred ........
Posted 9/5/2014 8:23 PM (GMT -5)
I guess hoping to get to 90% in a week is maybe a little to hopeful...maybe not?
Posted 9/6/2014 6:00 AM (GMT -5)
I have been on pred for 10 weeks starting at 40 mg tapered 5mg a week until I got to 20 mg stayed at that for two weeks then tapper again 5 mg a week.

I saw results almost straight away fully formed stools once a day until I got down to 5mg I now have loose stools still only once to twice a day at the minute. Been at 5 mg for one week and have now decided to do another week at 5 mg then tapper to 2.5 mg for a week to see how I go.

I have read an article about pred tapper after talking to people on here and it can take a week or two for it to kick in again and start producing its own cortisol.

pred suppress the adrenal gland and I've read that vit b1 and b6 along with cod liver oil, calcium and magnesium can help with this as you tapper.

I am no expert and this is my first time on pred and it has been quite a roller coaster ride of emotions as I' m sure you are aware.

hope fully I will be ok to finish in another couple of weeks. I am also taking what is in my signature.

good luck with your journey
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