Side effects of Pentasa or Other Meds?

[Holly95]

I have been on Pentasa now since the day I was diagnosed, I have lost count of the weeks now but the date is in my signature. I am on 4g per day, and I am taking it in 2 doses, I have also been off Prednisone completely for around 2 weeks now?

I have a couple different side effect possibilities that I want to check out, and I am seeing my surgeon on November 11th, but I thought I would ask here anyway!

I used to have a brilliant memory, I never used reminders or diaries or notepads or anything like that, but I noticed when I got down to my 20mg week of Prednisone (3rd week of taper) that my memory was starting to be less reliable, not too badly, but I forgot completely about simple things and needed constant reminders for them. I didn't think anything of it.
Now that I am completely off Pred and only relying on Pentasa (and Ondansetron and Tramadol most days) my memory is horrible. I'm forgetting appointments, I'm double booking myself with friends and activities etc, I'm needing to set reminders to feed my animals, I've had to start relying on not only a diary, but a wall calendar, a notepad, AND alarms on my phone, any one on their own just doesn't work, and even then I still forget things.
I'm not sure whether this is because of the general feel-crap type thing I have going on after being off pred, or if it's my anaemia, fatigue, or the Pentasa.

Second, I always have some form of loss of feeling, or pins and needles in my arms and legs. I used to get them now and again in my legs due to my sciatic nerve, or in my arms after sleeping funny, but now I get them all the time, just sitting on the couch, even sleeping normally, I can't have anything sit on my legs for longer than a few minutes. If I have my legs in the wrong position I get pins and needles painfully from knee down, if I stop moving my arms I have that cramping type pins and needles sensation in my hands and fingers.

Then there's the muscle cramps, oh boy they hurt like crazy if I can't get rid of them quick enough. I never used to get a lot of muscle cramps, but now in my feet/toes, and my hands and fingers I get severe cramps if I so much as position them wrong ever so slightly for a few seconds, then it's agony trying to get rid of the cramps!

And every time I scratch an itch, say on my arm, it hurts like I've just been punched in that spot, even if I scratch ever-so-lightly, as soon as I stop scratching I go through about 30 seconds of feeling as if I've been punched in that spot and it hurts quite badly. I never bruise or anything, but it really hurts!

I'm sure there are more and I'm forgetting them but I can't remember due to my crappy memory right now, and I'm absolutely shattered! Grrr :confused2:

 

[Jennifer]

I'm looking up each of those medications to see if they can cause the symptoms you've been having. First one I checked on was the Pentasa/Mesalamine. Nothing popped out at first in the side effect list until I came to symptoms of overdose. I'm not saying that that's what you're dealing with so I don't want you to freak out but I would ask your doctor about it. Confusion and Numbness of the feet, hands, and around the mouth are listed as possible symptoms of an overdose. I didn't see anything linked to memory specifically. Muscle pain or stiffness is listed as a possible side effect and says that it may go away while your body adjusts to it. http://www.mayoclinic.com/health/drug-information/DR600901/DSECTION=side-effects Mesalamine usually has the least risk of side effects compared to other medications.

Since you weaned off of Prednisone recently it could still be the culprit. Trouble thinking, speaking, or walking, Numbness or tingling in the arms or legs, Muscle pain or tenderness are all possible side effects. http://www.mayoclinic.com/health/drug-information/DR603543/DSECTION=side-effects Back when I took Prednisone I recall my skin hurting after soft touches as well and I believe it was from the water retention that Prednisone causes but I could be wrong.

You may want to have your vitamin levels tested especially B12 and folic acid as being deficient in either can cause memory loss. http://www.nytimes.com/health/guides/disease/anemia/symptoms.html

Ondansetron can cause Numbness or tingling in the hands, feet, or lips, General feeling of discomfort or illness (was thinking of your pain after scratching an itch) and Muscle pain or cramps as possible side effects. http://www.mayoclinic.com/health/drug-information/DR603313/DSECTION=side-effects

Tramadol can cause Abnormal or decreased touch sensation (I mention this one because of your pain after scratching an itch), Loss of memory, Numbness and tingling of the face, fingers, or toes, Numbness, tingling, pain, or weakness in the hands or feet, Pain in the arms, legs, or lower back, especially pain in the calves or heels upon exertion, Pain or discomfort in the arms, jaw, back, or neck and so on. http://www.mayoclinic.com/health/drug-information/DR601787/DSECTION=side-effects

Honestly I think it may be from the Tramadol but I don't know how long you've been on it. You could also be dealing with meds interacting with each other or increasing symptoms since they all seem to have your symptoms as possible side effects. I'd for sure have your B12 and folic acid tested and talk to your doctor about an alternative to Tramadol (or a lower dose) to see if that's the culprit.

Hope you find the cause and start feeling better. Keep us posted.

 

[Holly95]

Thanks Jennifer, I'll ask my doctor about it on monday.. I got a call this morning from his receptionist saying that he won't be there tomorrow so has rebooked me for monday at 4pm. I'm not terribly impressed but at least it's less than a week to wait still.

 

[Cat-a-Tonic]

In addition to what Jennifer already said, I'd like to add that low potassium can cause muscle cramps, particularly in the toes & feet. Have you had any bloodwork done lately? If not, I'd ask for some bloodwork and specifically for them to look at your potassium level. Even if your potassium is borderline, if you sweat that can be enough to drop your potassium level low enough to cause cramps. I speak from experience - my potassium is usually borderline, and when I go to the gym and sweat, I often experience foot cramps during or right after my workouts, so me sweating is just enough to push my levels low enough to trigger cramps. Dehydration can also cause muscle cramps in the arms & feet, and your doctor can check your blood pressure while you're sitting, standing, and lying down to see if you're dehydrated, if you're not sure. Just a couple thoughts from me in addition to what's already been said - good luck Monday and I hope you can get this figured out!

 

[Holly95]

Thank you Cat, I have had some bloodwork done, about 2-3 weeks ago now and the Dr ordered a complete blood panel and made sure everything was checked, except pregnancy because they have all now finally realised that I am NOT pregnant and never have been lol.

Bananas have Potassium in them don't they? Bananas are on my very short list of safe foods at the moment so I'm having a lot of them, I would have thought my potassium would be ok, can excess potassium cause it too? Like how overdosing in salt can?
I should find out all my levels of everything come monday, including folic acid and B12 etc.

I didn't think of Dehydration however, I could be, I haven't been drinking so much water lately because even that sends me into bloat-fest -_-
I have been getting a lot of headaches and sore eyes the past couple days also, so I could well be dehydrated.

I went into a seminar for my sickness benefit today, aimed at getting youth off the benefit and back to work, I only had to walk up 2 flights of steps to get there, and by the time I got to the top I was visibly shaking and breathing really hard, also very light headed, they made me sit down in a room on my own because they thought I was going to pass out. then told me I didn't have to go to the seminar because my skin was gray and I didn't look well at all therefore it was obvious that I'm not ready for work... No kidding!! I hadn't just spent my morning being sick or anything, no not at all.
And the medical from both my GP and my surgeon both state that I won't be ready for work until well into the new year when we (hopefully) get this under control. They didn't believe me until they saw me for themselves.
I spoke to a nurse who is going to try and find me a dietitian and a GI. Can I do that without consent from my surgeon? Is that not superseding?

 

[Cat-a-Tonic]

Yes, bananas have potassium and so so sweet potatoes/yams. It seems to me that it's very difficult to get too much potassium - personally I have a banana or two blended into a smoothie every morning, and I try to eat sweet potatoes (skinless) with dinner, plus I take a potassium supplement, and I'm still borderline/low in potassium.

With the headaches, you may very well be dehydrated. You could try a sports drink if you think you're lacking in electrolytes, but otherwise water/tea/juice/etc should be just fine. A nurse once told me when I was dehydrated, "If you can drink without getting sick then just keep drinking!" She also said that room temperature water is easier on the stomach than cool water, and if you're feeling nauseous to just drink what you can when you can, take tiny sips with a straw, whatever you can do to keep hydrated. If you can't drink without getting sick, then you may need to go get some IV fluids.

As for getting a dietician and a GI, if you don't already have a GI then I think it's a good idea to get one. I'm not sure how the medical system works over there in NZ, but when you have any type of IBD, it's just generally a good thing to have a GI. So I wouldn't think it'd be a problem, but I'm not totally sure.