Short prednisone treatment?

[Txarmywife]

I went to the ER for pain and throwing up blood...and of course a lot of D. They gave me prednisonolone 45 mg for 5 days. No taper...just a 5 day course. I've never taken such a short dose for a flare and never not tapered. They also gave me IV Rocephin and sent me home with a script for Cefdinr antibiotic? I'm in the process of being referred to a GI again after moving. Just wondering if anyone has taken pred for such a short time (without taper) and had improvement in symptoms? Prednisone has always worked for me in the past for my flares but I'm just so concerned while I wait for this GI appointment.

Also should mention I'm 18 weeks pregnant.

 

[mickey]

at the very least, ask your obgyn about the pred, until you get your gi doc.

 

[Txarmywife]

I did today...said it was fine and to follow the directions. But I don't have very much faith in the OBs there. I had to beg just to get a GI referral.

 

[Jennifer]

Let's see if I can tag Judith in here and get some of her advice as far as pregnancy goes with Prednisone.

As far as the short course goes, as I mentioned before, hospitals normally prescribe a 10 day dose (at least where I'm from) and usually they give a high dose like 50mg with no taper because they expect your specialist to handle it from there (but I know you aren't seeing one yet). If you're taking it for over 10 days then yes a taper is usually expected if not required. As far as it getting your flare under control, well, I've never taken it for 10 days even and found it to do anything other than help me feel better for a few days but after its gone, everything went right back to the way it was. If you do in fact need Prednisone, you'll likely need to be on it longer even if you did split up the doses you were given.

 

[Txarmywife]

I think you're right in the the ER docs expected my OB to monitor me and prescribe more meds for me but the OB I saw today just wondered why I was seeing him if I'm already on meds. Didn't add anything or give me more meds for pain like the ER doc recommended. I sure hope I see the GI soon. I'm worried this Prednisone will be wasted if not

 

[Judith]

Hi Txarmywife,

Your doctor is probably trying to quiet your immune system using a prednisone (prednisolone) burst ranther than doing a long course protocol with the taper because you are pregnant. Prednisone is a Pregnancy Category C drug. This means:

from the wiki ".... Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks."

It is not advisable to use prednisone in pregnancy unless it is really necessary. But, studies have shown a Crohn's flare is more harmful to the fetus than a short course of steroids. Also, prednisolone is less able to cross the placental barrier than some other steroids.

Also problematic with a flare during pregnancy is the increased likelihood of dehydration. Since you are having vomiting plus diarrhea you are losing a lot of liquids. Make sure you are getting enough vitamins especially folic acid. You may want them to check your vitamin levels (when you are finally seen).

I checked on your antibiotic. Cefdinir is a Pregnancy Category B, which basically states that there was no increased risk to the fetus in animal studies but there is not enough data in humans to consider the drug "safe" for pregnant women. [wiki]Pregnancy Categories for Drugs[/wiki]
Cefdinir Antibiotic


How long do you have to wait to see the GI? It is highly recommended to be monitored by your GI in concert with your OB / GYN because of increased risk to the fetus during Crohn's flare.

I really hope you are seen soon......


IBD in Pregnancy:
http://www.wjgnet.com/1007-9327/pdf/v17/i22/2696.pdf
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2693677/pdf/WJG-14-1326.pdf

 

[Txarmywife]

Thanks for the reply. I made an apt with GI for Monday yay! I really hate this Prednisonolone or whatever. The dissolvable ones? It tastes so bad makes me want to barf. Also noticed I began having leg cramps. Wondering if its the pred or maybe I'm dehydrated.

 

[Jennifer]

Could be both. It is listed as a side effect though. And EEW! Dissolvable Prednisone? No way am I sucking on that! Blech! I'm sorry.

Glad you got an appointment with a GI! Any special trick work or did the referral just go through quickly?

 

[Txarmywife]

I can't even describe the taste. But it's disgusting. I dread taking them (it's two pills that have to disolve in the month...one of which is rather large (30 mg) so it take forever to disolve *cringe*

I called and originally they couldn't get me in until August so I called the insurance company and told them it was an emergency situation and I'm pregnant so I guess they worked their magic and the GI called me with an appointment for Monday Much better than August!!

 

[Jennifer]

VERY NICE! Please do keep us updated and let us know how you're doing and how the appointment goes.

 

[David]

Are you familiar with enteral nutrition? It may be a treatment option to discuss with your GI on Monday, especially since you're pregnant. It has remission induction rates on par with prednisone without the side effects and danger to your baby.

 

[Judith]

I called and originally they couldn't get me in until August so I called the insurance company and told them it was an emergency situation and I'm pregnant so I guess they worked their magic and the GI called me with an appointment for Monday Much better than August!!

Great! What a wonderful insurance company to call on your behalf.

 

[Jessasha]

:dance::dance::dance::dance:Yay! I'm so happy for you.. Good work girlfriend! Glad you finally got that appointment..