Prednisone Experiences Requested

Firstly, thank you for all the sharing your stories on this website.  It's been a huge resource since I was diagnosed.    Some quick background, I was diagnosed 2 years ago with the usual symptoms, bloody stool and diarrhea.   After s ome quick prednisone and continual mesalamine and I’ve been in remission for two years.   In fact, I stopped taking my mesalamine for a year, but my doc convinced me that was dumb, and I’ve been taking it regularly for a year.   I received a smallpox vaccine a month ago, and it triggered a flare.   Fever, diarrhea, bloody stool.   20/20 hindsight, my doc says I should not have received the vaccine since mesalamine is an immunosuppressant.     I am seeing a GI doc of a the local country nationality and he seems k nowledgeable but I'm questioning his application of prednisone.  His  demeanor when talking about the dosage and length was very non-chalant.    I responded well to prednisone, after 4 days of 40mg all my symptoms subsided.   I tapered myself to 30 after a week, I’ve been on 30mg for 17 days, BM once a day or every other day, no pain.  The doc prescribed a drop to 20mg starting now, and 20mg for two weeks, and to just stop.  I'm concerned about the length of time and sudden drop.   I have had zero symptoms for two weeks and I’m already taking my mesalamine. My plan is to taper from 20   to 10 after a week, then stop after 10.   The shorter the time I’m on the prednisone the better.  I don't expect anyone to tell me what I should do since we're not doctors, but your personal experience would help.  Bare in mind my UC is classified mild/moderate, no active ulcers, just inflamation, and my response to prednisone was extremely good.  

The pharmacist I spoke with said that if I was on prednisone for 14 days or less there was no need to taper. I am not able to provide any first experience. When I as on it, it was for longer than 2 weeks so I had to taper.

Thank you for the replies. Enemas seem a bit extreme, even if they are the best advice. I have been doing 25 for a couple days, I'll drop to 20 for a week, and cut to 10mg after a week. Thankfully my worst symptom right now is pimples from the steroids.

I have read a LOT of stories on healingwell.com from UC sufferers and I have no idea how chronic sufferers endure. I was wrecked from a 103 fever, I couldn't stand or function for very long without needing to sleep.

Enemas are not 'extreme' I agree they're probably a good option for you. They're in fact a much safer option than oral pred. If you wanna get better you're gonna have to do the yucky stuff.

I would also be concerned as that seems like a very fast pred taper.

You can taper off pred fast if you haven't been on it long. In fact, it might be better that way. Most have bad enough disease where they have to take it longer and taper longer. I also don't believe that mesalamines are immunosuppressants. It sounds to me like your doc is a mixed bag of good advice and not knowing what they are talking about. He is definitely correct though in that you should always take the mesalamines, even when in remission. Many have paid a dear price for not doing that. Don't make the mistake of believing everything a doctor tells you, just because they are a doctor.

1. Enemas are one of the least extreme medications used to treat UC.

2. You should talk to your doctor or pharmacist about how best taper prednisone. You should always take as prescribed and not taper the day after you feel better. The underlying problem is still there. The prednisone is usually used to keep the inflammation at bay until other medicine kicks in.

That said I never drop off 20 mg cold. I would go back into a flare because that is my body. I usually stay on 50-40 mg for 4-6 weeks, then 40-30 for 4-3, then 10 mg. tapering every two weeks until I get to 10 mg. At that point I stay on 10 mg for 3 weeks, 5 mg for 3 weeks. If at any time the flare comes back I up my dose by 5-10 mg for 3 weeks.

My doctor is very respectful of my feedback regarding how my body is responding. He also never uses prednisone as a long term plan. The goal is always to get off it once a different long term medication has kicked. And I'm sorry, but enemas are a part of life and staying in remission and most effectively treating a flare.