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Prednisone alternative?




Some time ago I read about an alternative to prednisone that is much better as your body only absorbs 10% of it while the majority is targeted on your intestines.

Anyone happen to know what this might have been?
This is probably budesonide which targets your terminal illeum specifically so if you have illeitis then this is a good option, but otherwise you are stuck with prednisone.
entocort is budesonide, and yes I'm on it...don't know if it or the prednisone knocked my flare up down, but the combination sure prevented my losing 8 inches of large intestines + part of my terminal illeum :D.


I am currently stepping down on Prednisone which I've been taking since mid-December. We added Entocort-EC to my regimen in mid-February. Our objective is to be Prednisone free by the 21st of April and to then maintain on Entocort-EC for an as yet to be determined time after that. I'm doing well. MY objective is to get off all medication between flares. We shall see ...

How bad do things have to get before you go on prednisone? I was diagnosed in October and went on pentasa and imuran. For about the past 2 months i have been bleeding and the doc put me on entocort. It has cleared it up a little, but some bleeding is still there. When i go back to see him I am worried he is going to suggest prednisone. I really want to avoid it if I can, so I guess my question is if I just have some bleeding is it ok to live with it and skip the prednisone?
Depends (again I hate that word) on the frequency/volume of blood, as well as other symptoms, but as long as you trust your dr and give him sufficient info on your status, let him make a well-intentioned decision on it. I hate the stuff like nothing else, but if it's all that'd make me better to kick me out of a flare (like January when I went on IV Solumedrol because the oral pred was doing nothing), it may be your only option until the people in the labs come up with a better alternative. One plus I'll say about pred is it's cheap compared to many other more powerful drugs when you've got insurance(look Benson found a pro to the pred!).

I paid $10 per bottle and that lasted 30 days.
chris your doctor will most likely goto a biologic before going to prednisone if the other meds arent clearing it up as they are better long-term solutions...they just come at a heavy cost. Realistically your doctor should give you a number of options including prednisone and biologics(remicade/humira) and discuss the pros and cons to each and then let you decide with his suggestion of what he would recommend. Not all doctors will do this, but the better ones will unless you have a very clear need for a specific course of action. If that is the case they should still outline the alternatives but explain why exactly you need this set course of action.


I have been through two complete cycles of Entocort and its wonderful. It goes directly to the lower bowel so does not get absorbed into the blood like Predisone does. I had no side effects and it was like a miracle drug. Some people get a rash from it. It started working within 8 hours. Only problem is that I only stay in remission for about 2 months after 3 per day for two months then 2 for a month, then one for a month. I plan to continue it as long as GI will let me. I am currently taking one per day on my own as an experiment for 2 months until I see the GI again and that dosage is working fine. I would take it like this for life if he will let me.



Senior Member
Yeah, steroids work wonders. I know lots of folks don't appreciate some of the short term side effects... mood swings, moon face, increased appetitie. but those aside, it does make one feel like they could literally move mountains. Shame the well known long term adverse effects cause most dr's to take patients off as soon as possible. Even if/when there are no signs of them. Like, I was on steroids for nearly a year straight (48 wks) and yet my bone density scan AFTER that period showed everything A-OK
The problem with the steroids is that even if you prevent bone density loss on the short term, over a longer timeline (years not months) the effects will become apparent. One of my main concerns with the steroids is they destroy your skins ability to heal after cuts after years of use meaning a simple cut requires stitches that would otherwise have been left alone. Considering many of us are immuno-compromised, having open wounds like that for extended time isn't a good idea.

I do agree that these steroids work wonders for the pain and once you adapt to the side effects they really aren't that bad. The weight gain from hunger sucks but even that with healthier snacks and some exercise can be mitigated. Also there are people working to reduce the side effects at various universities. I know at UCSF there is a project going on that is getting some interesting results in lab tests to try and modify prednisone analogs.
One thing that's arisen in the last few weeks as the most recent (of many) sides that isn't too bad compared to the others is I'm getting "furry", like growing small amounts of black hairs where I never had any hair before, like on my upper cheeks, shoulders, etc...places I KNOW I didn't have hair before. I'm naturally low on facial hair as it is, I only have to shave a couple times a week and can't grow a full beard (father was like that too), so this is peculiar. I know pred can mess with your hair though, but it's ironic it's instigating hair in places I don't care to have it, and causing me to lose it in places it ought to be (like on my HEAD).