7 Day Prednisone Taper

Many of us have pretty bad memories of prednisone. OTOH a 7-day taper is nothing like the months and years of steroids that cause the most significant problems. Most pouchitis is cleared up by a course of appropriate antibiotics, which is generally considered a more specific and benign treatment. It's not really all that specific, of course, and antibiotics aren't completely benign.

Seems like a reasonable approach, particularly if antibiotics are not working. I occasionally use a two week prednisone taper for severe arthritis flares. It usually does the trick for me. I am only at 40mg for 4 days.

Jan

Yes, I've considered throwing this into my drug rotation maybe a couple times a year. I was on a 7 day taper with a shoulder issue last year. It did wonders for my pouch and gave me such a burst of energy. I actually sort of forgot about that option, so I may pursue again. I definitely do not want to be on them full-time...that is for sure.

I am not sure why Prednisone would be used, even on a short taper, when Entocort, another corticosteroid, which is considered a designer steroid with far less harsh side effects than Prednisone, is also available to accomplish the same objectives.

That being said, staying on Entocort on too high a dosage for too long can also have repercussions, as I recently discovered the hard way. But it seems Entocort is, nevertheless, more of a go-to drug to treat pouchitis than Prednisone is, in the corticosteroid family of drugs - a family that many of us have met and become familiar with.

On the other hand, the 7 day Prednisone taper sounds like an interesting idea. My question is whether it might not be ineffective taken for such a short duration. These drugs work in part by suppressing the immune system and that takes a while to accomplish. It took probably 2 months before I noticed palpable results from Entocort at a 9 mg dosage, and I overstayed my welcome at that dosage by the 7 month mark.

I am doing the exact same thing right now!

It was suggested as something to try for my RA and fistulas. Both were extremely painful and getting in the way of daily life. When my GI mentioned prednisone, it took me off guard because I had forgotten about that magic/evil drug.

It worked so well that I begged to extend it for another week. So we compromised at 10 days. I'm down to 10 mgs and my last day is tomorrow.

I was on Entocort for years for my pouchitis. I agree that it is without the highs of prednisone-the good and bad. It helped alot, but I have been off of it for well over a year now.

Good luck with your taper! Mine didn't seem too rough. The aches and pains are returning, but so far nothing devastating. Here's clicking my ruby red slippers together!

~Tammy

If these tapers prove to be effective, how often can you do it and get away with it (meaning not suffer the consequences of side effects)? One 7 day taper a month? Two? These are questions I would ask your Doctor. I would also wonder whether, with each successive taper, you get progressively diminishing returns. This is what happened when I took Prednisone to treat UC. Higher and higher dosages were needed to get the same results, and it got to the point where the maximum dosage was not getting the job done.

how long is too long on Entocort? Shen has had me on it for almost 2 years. Not really sure if its helping though.??

The big difference is that Entocort is considered topical and prednisone is systemic. Sometimes there is so much inflammation going on, you need the systemic approach, especially if you have extraintestinal manifestations. For me, it is only for the arthritis flares that I use the prednisone, but my pouch usually is acting up at the same time (probably because of all those inflammatory molecules racing around in my body).

I would think that you would not want to use prednisone more than a few times a year, not a week a month. Even for joint injections, it is 2-3 times a year for any one joint, and it stays within the joint.

Entocort is a different story, and is considered a maintenance drug for steroid dependent folks, because it is topical. If you don't want the entire GI tract exposed, they do make it in enema form, which would be a more targeted approach.

Jan

Poucho,

I experienced some apparent skin manifestations of a weakened immune system (warts in legpit/pubic area, yeast infections in armpits and legpit, hemangiomas on my hands), all at once, after taking 9 mg Entocort for 7 months. These symptoms were attributed to the Entocort by both my GI and my dermatologist. I have since reduced the Entocort dosage and the skin issues have cleared up, except for the hemangiomas, and I don't know when they will go away.

It should be noted that in February 2010, I had a similar outbreak of warts and yeast infection and I was not taking Entocort at that time.

From what I read about side effects of Entocort, they are not as bad as Prednisone, but they include the range of these kinds of things if you are immune suppressed. And it could also be the Entocort coupled with antibiotics possibly coupled with other factors created the "perfect storm" immune-suppressed environment for a sudden and vicious attack on my body by fungi and viruses. My dermatologist told me the hemangiomas are also a sign of a problem with my immune system, and although small, they, unlike the fungal rash and the warts, have not yet gone away.

Unfortunately, sometimes it does not matter what you do or not do, if you have autoimmune disease, things can go haywire. It can be purely random, and many of us need immune suppression, because the immune system is sort of hyperactive. That is why herbal supplements that "boost" the immune system are not recommended for those with autoimmune disease.

But, yeah, manipulating the immune system can be a double-edged sword, slicing both ways.

Jan

I am actually taking the 7 day prednisone taper for a sinus condition. It is something like the bottom (cannot remember exactly).

40mg - 3 days
30mg - 2 days
20mg - 1 days
10mg - 1 days

My pouch is actually doing very well! I notice much less frequency and much more former (but still passable) stools.

I think this course is way too short to have any side effects. Maybe it is worth considering taking prednisone for a while to heal things and that could help reduce dependancy on antibiotics. Worth a test? Id see what your doc has to say.