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Anyone else on pred, entocort and pentasa

My Dr. lowered my pred dose to 20 mg, still on Pentasa 8 capsules daily, and started entocort 9mg. He is trying this before trying remicade and/or imuran. Has anyone had more success on entocort w/ pentasa than they have on pred and pentasa? I was diagnosed in June and when he lowered the pred. my symptoms of pain and diahrrea came back and then he started entocort (only been on it 3 days so far). Do they usually try AZA /6mp first or remicade?
Any responses would help. Thanks
 

Jennifer

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I've never taken Pentasa before but I have been on Prednisone, Entocort, Asacol and 6MP before. They tried to switch me to Entocort but instead they had to bump up the dose on all the meds before I finally had surgery. Lots of people think they (Pred and Entocort) can't be taken together but they can.

From the information I've gathered more recently is that Remicade and Humira are more commonly used now to treat Crohn's because they are newer and have had some great success where things like steroids, Asacol, and 6MP and the like are older medications yet a lot of GI docs are still trying these meds first before going towards the "big guns" whereas the "big guns" aren't really that big compared to the combination of the ones listed above yet one can still get the same if not better results than the mass combination.

Each person and each flare is different though so the older meds may work just fine for some people.

I've been taking 6MP since my resection and every time I start having symptoms my GI bumps up the dose of the 6MP (I'm at 100mg now). I'd rather avoid dangerous levels of this type of drug so thankfully my Rheumatoid specialist is prescribing Humira for me so hopefully some day I'll be able to stop the 6MP.
 
So you are saying you have been on prednisone at a dose higher than 20 mg since sometime in June when you were diagnosed.

You have also been on Pentasa since you were diagnosed.

Now, in early August, your doctor has lowered the pred to 20 mg and added 9 mg Entocort.

I see from your other posts that you have other autoimmune disorders. Are you already on any immune suppressing meds for those?

Entocort is supposed to be more powerful than oral prednisone but it is topical. It's like you are applying liquid prednisone to the inside of your intestines, directly to the inflamed tissues. Up to 20% may be absorbed by your body so I would hope that you are able to wean down off the oral prednisone soon in part because of the systemic effects of Entocort.

Your other posts didn't really give much detail about the extent and location of your disease but I will tell you that the vast majority of people with CD are on immune suppressing meds (6-MP or Methotrexate) and/or the biologics like Humira and Remicade. Most people who are on biologics are also on 6-MP or MTX because that has been shown to be the most effective way to control the disease.

There have been a lot of posts lately discussing the risks and benefits of using these meds. I suggest you check out this relatively short thread as a place to start and then ask specific questions as they come up.

http://www.crohnsforum.com/showthread.php?t=39290&highlight=scared
 
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Sorry, I didn't clarify my situation a little better. I was started on 40 mg pred, then 30 and now am on 20 mg of pred along with pentasa since starting the pred, and now also entocort. I also have hypothyroidism and interstitial cystitis but they are not treated with immune suppressing meds so I am new to this kind of medication. I will see the dr. in another week so I will see how entocort is going but I will be glad to get off pred. It is wreaking havoc with everything. I have the shakes constantly, profuse sweating, a short temper, depression, moon face, weight gain. I stopped counting how many people within the last week have told me my face is swollen (like I haven't noticed:ysmile. I teach school and am just worried about taking remicade and not being able to work around children who tend to have lots of colds, etc. At this point I am not sure what path I will have to take to get my symptoms under control and missing work, etc. Sorry for rambling. Thanks for the input.:ysmile:
 
I forgot to mention that there was a narrowing at the terminal ileum and the ileocoecal valve due to inflammation. That is where my problem seems to be concentrated.
 
I started on predisone and pentasa. They then have me three sets of three infusion of remicade. Had major side effects. Then did complete bowel rest with iv steroids. Got things calmed down. Did this for about2 years along with 4 gm of pentasa daily. When things got bad predisone and steroid injection.
Finally lived on 9 mg of entocort for three years and hospital stays before I have in and went on humaria. Was terrified after remicade reaction. Best move I made.
 
the pred is really a wonder drug but with horrible side effects i gained sooo much weight on it i went from 70 kilo to 121 kilo over the yearss of taking it and still trying to shake the weight...
 
Can you take entocort for a longer period than prednisone? I didn't ask my dr. when he called back with my blood results the last time. Thanks for the info. I can't wait to get off the pred. I am definitely not myself on this med.
 
Vonnie yes you can be on it for a longer period than predisone, however there are still side effects which is why up have ostepenia. Look up the drug on the internet and talk with your doctor. I would try it for a while and if puts you in remission go for it. you can always try weaning off of it very slowly.
9 mg for a month then 6 for a month then 3 mg for month
 
Thanks Mark74. I already have osteopenia which is a concern with the entocort I guess. This is my 5th day on entocort and some of my symptoms seem to be improving. I'll keep my fingers crossed.
 
Entocort is still a steroid which should only be used in short term for quickly getting you into remission. Although they say it can be used for long term it doesn't mean its safe as far as causing Cushing syndrome. I would highly recommend starting on a 6MP, they will do an liver enzyme test to see if you are able to 'process' the medication and it will take 3 months to start working during which time you will have blood work every week or couple of weeks. If this proves beneficial for you its the best place to start. If this doesn't work you can move onto the biologics, but the 6MP's are the maintenance medications not Entocort that should be tried first in my opinion.
 
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