About to start my 7th week on Pred

Personally, I totally and completely disagree with tapering back the Asacol at this point. Very stupid idea in my opinion. You can't take pred forever so the game plan is to take a maintenance med such as Asacol to hopefully keep you in remission once the pred is tapered completely off. You should remain at full dose Asacol for several weeks or months after the prednisone is completely eliminated and then begin tapering. If you taper to lower doses of pred or completely off and your symptoms begin returning again, then what will you do? If you are on full dose Asacol when the pred is tapered down or off then you know that the Asacol is not going to do good enough to keep you in remission by itself. The way you are doing it now it looks like your future could include increasing both the Asacol and the pred back up if your symptoms return which, unfortunately, is a real possibility.

I don't think it's a great idea to start tapering down on Asacol. I personally would prefer to focus on getting off pred, then worry about lowering the dose of other things. I did amazingly well on pred until I got down below 5mg, then all symptoms returned with a vengeance. I am sure what I experienced is not the norm but it can happen. You should probably be using rectal meds too. I am sure the path your GI is giving you works for some, maybe many, but it wouldn't work for me. I need to be on some kind of medication for maintenance. I don't know the extent of your UC - perhaps this is a good plan. You will have to talk to your GI.

Agree with the others, I definitely wouldn't be tapering down on the asacol just yet.

Are you still on the foam enema, or only on the supps now?

Someone will correct me but I believe one of the reasons you reduce down to 2.4mg is so that you can up to to 4.8mg if you start to have a slight 'blip'. I've stayed at the max dose of 4.8mg since diagnosis a few years ago. Once I'm out of my current flare and been in remission for a few months, I'll likely lower down to 2.4mg

I'd wait until at least a month or two after coming off pred before you go down to 2.4mg. Think you're fine to stay at 4.8mg for awhile and better to be safe, in my opinion. You've got nothing to lose by staying at the higher dose?

Oh, and why everyone is recommending you stay at higher dose is so you have the meds doing good things whilst you come off pred. 4.8mg = better than 2.4mg

I tapered Asacol at doctor's ordered to 6 tablets a day. Flared within a few weeks. I ask now, Who does that? Not a good idea to taper your maintenance drug. The pred is still working it's magic, taking over your system, and you need the Asacol as your backup med for when you taper below 10 mg.

I take the max dose of Lialda and there's no tapering.

Bez73, meslamine is a very safe medication, many of the members here stay on 4,800mgs for life. To be frank tapering down asacol is stupid especially since your disease spread and got worse when you did it last. If something is working for you treatment wise then do not, under any circumstances, change said treatment regiment.

You need to educate yourself about uc, be your own best advocate to your GI about what you need to stay healthy, and acknowledge your GI is a partner in your treatment decisions he/she is not a king/tyrant who calls all the shots for you. Many patients with chronic illness know as much about their disease as their doctor.

Uc can be quite aggressive within the first 5 years, if you start regressing and getting worse, then it's a huge waving red flag. If that happens, contact your GI immediately and adjust your treatment scripts accordingly.

Ok after much deliberation and reading through many posts on here I would have to agree with what you are saying.

it does appear that a very small percentage of people do have problems with melamine compared to that who have problems with Prednisolone. obviously Prednisolone being the more harmful drug of the two if used for long periods of time. What I don't want to happen as has been said is for symptoms to reappear and have to do more Prednisolone or become Prednisolone dependant.

I have decided to do as suggested and stay at 4.8 mg of Asacol for now until I finish my course of Prednisolone which is another 3 weeks. Tapering 5 mg a week until I get to 5 mg for one week then stop.

As long as all is ok still at this point I think I will then look at reducing my Asacol down to 3.6 then 2.4 as a maintenance dose.

The reason behind the decision to reduce the Asacol once of the Prednisolone is I can't really say that I have been on 2.4mg long term to see if this will work as a maintenance dose.

Now also I may be wrong but if I stay at 4.8mg and at some point in the future have another flare then I will have to use another drug to get it back under control again. My thought is that if I reduce to 2.4 mg and am ok and then again in the future if I feel symptoms are coming back then I can up the dosage back to 4.8 mg to get thing back under control again and then reduce once ok?

I also read that once I am doing a maintenance dose is it advisable to use lets say a Salofalk suppositories once a week also as maintenace?

Now I don't mean to sound stupid now but what are the first signs of my symptoms coming back I'm thinking loose stools are first and the gradually looser and more frequent trips to the loo and then obviously the place I don't want to be at and try to suppress before it ever happens is the urgency.

I appreciate I have asked a few questions in this post but I really do appreciate all the advice and support which is being given from all. Thank you so much.

I think you are right when you say that only you really no how you feel and that it's important that you work with you Gi in conjunction together rather than just taking what is said to you as set in stone. I do feel that I have finally got a good Gi who I believe is doing what he feels is the best for me as he has put me on the right path over the last few months with an Iron infusion and then done my first scope since being diagnosed 3 years ago.

I really do feel like I am on the mend and don't want to hamper my progress and the advice given also on this site has been invaluable and makes a lot of sense.

Again thank you for taking the time to read my posts and all the help and advice I have recieved.

Bez

I agree with doing the suppository or enema once a week for maintenance. That's a good idea. Good luck. Hope it all works. Going down to 2.4 g's of Asacol after pred removal may be enough to keep you in remission since you weren't really doing that before, especially if you bump it back up immediately at the first sign of trouble. You may also want to bump it back up any time you are sick with something or are under a lot of stress.