Prednisone 80mg IV every 6 hrs. Is it normal?

21 year old male. Diagnosed with UC in august 2013. Having flare ups since 3 weeks but didnt take it seriously until last week. Doc started off with 40 mg prednisone per day + lialda 4 tabs per day. Didnt see improvement. Put me on liquid diet for 1 week and increased prednisone to 60 mg. still didnt help so i m hospitalized for 3 days and he is giving me 60 mg iv prednisone every 8 hours. Bleeding has reduced but not completely stopped so he wants to put me on Humira but still wants to see if prednisone can stop the bleeding so i dnt have to start humira. But i was worried about the dosing. I have never heard anyone taking this much prednisone per day. Any suggestion? The pain has gotton much better since i m in hospital so i m thinking prednisone is working but slowly. I dnt want to go on Humira just yet. Any suggestion will be appreciated. Thanks

Yea i was just lialda and canasa as needed while on remission. But since flare up, it hasnt been working

You should ask your doctor to clarify your question and your concerns about the dosing. Is your doctor a GI and if so is your doctor an IBD GI? I'd recommend an IBD GI, they are more experienced with UC.

Did they test you for any bacteria infections? like c.diff?

I'd also ask the doctor about Remicade vs Humira. The statistics on Remicade are much better for UC than Humira, if you need to go the biological route.

If it is IV steroids administered in a hospital setting then it is most likely either methylprednisolone or solumedrol. They are different than prednisone, but similar. The administration for these are different mg dosages than oral pred. When I was in the hospital I was on 120 mg of methylprednisolone to start then 80 mg of it. My bags were changed several times per day as well. I wouldn't be too concerned over this as it seems pretty standard. But if you still are then confirm it with the visiting GI.

double check drug and dose. make sure what is /8hr and what is /day.

also is it prednisolone or methylprednisolone? I don't think they do prednisone in IV form, but I think prednisone metabolizes to prednisolone 1 to 1.

Common regimens for intravenous steroids include prednisolone (30 mg IV every 12 hours), methylprednisolone (16 to 20 mg IV every eight hours)

I think docs routinely use upto double common dosages. But I don;t know much about this.

Anyway, are you reading the bag, or your chart, or ....

I have to agree with ks. If the remission rates were the same Humira would be preferred due to the convenience. But, the remission rates are not the same. Remicade has much higher remission rates. I don't know about Simponi remission rates but I believe that is self injected and many here have had more success with that than with Humira. You may want to look into that option.

for 8 days in the hospital they had me on solumedrol 100mg I'm pretty sure. Then they put me on 40mg oral prednisone...then 60mg prednisone, and then when I finally seen my GI he thought 60 was too high so I was only on it for a day and put me back down to 40. a month and some later out of the hospital and I'm at 20mg now, no signs of blood yet, fingers crossed.

SoluMedrol is Methylprednisolone sodium succinate

if you are getting 60mg/day, or 20mg every 8 hour, that is par.

60mg every 8hr would be on the high side

I am on Humira for the simple fact that my doctor wanted to try it before remicade in hopes that it would work. He said remicade works great but when it stops there is usually little else (currently on the market) that will work. He wants to try and save that card for me if possible. Humira really has helped. It took a couple months to really see the difference, but now I feel a lot better. The first week after my shot is great, just like no UC. The second week is another story, so we are probably going to weekly after next weeks visit. I'm happy I have the remicade card still waiting for me and that I am feeling the way I do with Humira.

Btw, my doc wanted to try Simponi first but my insurance denied it hense the Humira.

I was discharged on 60 mg oral pred. I was taking about 39 pills per day of meds (pred, colazal, 6MP, etc.) when I first got home from the hospital. I was still bleeding when I was discharged, but was definitely substantially improved. It is not a given that you will have to go to either remicade or humira. I have been lucky to have flared several times while on maximum dosages of my maintenance meds, then go on pred, and then go back to my maintenance meds once tapered off pred. I was discharged on 6-MP as a backup plan once I was off the pred. I guess the thinking was that I would need more than my maintenance meds to keep me in remission. However, I reacted badly to the 6-MP before it even had a chance to kick in and just went back to my maintenance meds and achieved remission.

I know many people become pred dependent so they need to go to stronger drugs in order to get off the pred. (Such as remicade). Just wanted to say that is not the case all the time since I was fortunate enough to not have to go that route.

Wait and see how you do once you taper. But it's good to have a backup plan in case you start to get worse once you taper. Definitely do the mesalamines while tapering pred and see how it goes.

Should I wait few more days to see if IV Steroids kick in before starting Humira? I am really scared to start it and i actually dnt want to start it if i can get remission through steroids in the long run.

good point that Remicade antibodies may be making Humira look less effective.

It may be a good idea to start Humira 1st if you think steroids are giving you enough time.

the whole point of steroids is to buy time for some other med to work.

In my case, I took a modest oral dose for an extended time, and Lialda was able to slowly move me 95% of the way to remission.

I was on 40 mg prednisone/day for 1 weeek then 60mg/day for around 4 days but since bleeding didnt stop i was hospitalized and started solumedrol IV. I m currently on 3rd day on IV with high dose of solumedrol 60mg q 6 hours. I saw an improvement from what i was experiencing at home while i was on oral prednisone. So i told my doc to keep me on solumedrol for 2 more days. So he increased solumedrol to 125mg q 6 hours.