Transition from IV to oral steroids

[vonfunk]

Hello All,

I spent last week in the hospital due the current flare I'm in. They had me on IV steroids, the entire time and the released me on Saturday on 50mg of pred with a tapering dose.
I was fine on Saturday, I was operating at about 80%. Then the next day things started going down hill. And I'm almost where I was a couple of weeks ago.

Do other people have issues switching from IV to oral steroids? And if you do how long does the transition last.

 

[Crohn's 35]

Not me, I have been on an IV and continue it at home but I have only been on 50mg 18 years ago, and the most is 40mg. It works for me. Hope you feel better soon!

 

[saidinstouch]

I never had an issue switching from IV to oral. It should be fairly straightforward. Are you taking the right dose (I know it's a silly question, but if you were on say 10mg pills in the past and got 5mg pills this time, you might forget to up the pill number from 5 to 10)? Other than that, I would email/call your doctor and find out what they recommend since there is no real reason for the IV to work any better than the oral unless your absorption is incredibly low.

 

[vonfunk]

It's the right dose. I've only ever been given 5mg pills. In theory it's a tapering dose going down 5mg every week.
It seems to be going back and forth each day, and I doubt diet is influencing it all that much because I'm not really eating much of anything recently.

My first Remicade infusion was yesterday so I'm hoping that one of the two drugs kick starts the other into working.

 

[ChefShazzy]

Same here, I never had a problem going from IV to oral steroids, but I was sent home on 60mg of pred each time.

Do you recall what your IV dose was? Were you on solu-medrol?

 

[vonfunk]

I was on solu-medrol, but I don't recall the dose.

 

[Rob]

All depends how much they were giving you really

when I was in hospital with my flare I was on hydrocortisone iv 4x100
with what I was told - because it's an iv type steroid it actually ends up being double the effective dose of oral pred so 100mg iv = 200mg pred (approx)

when I went to oral they kept me in for about 2-3 days to see if I went downhill etc because of the large drop in medication
(from approx 800mg worth to 50mg)

I'd speak to your dr if things keep gettin worse, wouldn't let it go for to long or you could end up back in hospital again

best of luck

 

[kari]

I'm speaking for my husband here. He was in the hospital for 3 weeks and they had him on IV steroids then they switched him to oral while he was still there to see what would happen. He continued to get better on the oral steroid in terms of his UC bowel symptoms but literally in between the time they stopped the IV and started the oral his sacroillitis came back as bad as when he went into the hospital. The pain had completely gone away and he was feeling and acting great when he was on the IV. Now, he is going to start Humira to help with the arthritis but his colon symptoms are all but gone.

 

[vonfunk]

Thanks for everyone's input. I was given the choice of leaving on Saturday or staying, this was my first out right hospitalization for my UC since my initial flare up a couple of years ago. I probably should have stayed longer, however I'n the past 10 weeks, I've had 2 blood transfusions and 3 hospital stays, so I was a bit anxious to be in my own bed for awhile.

Things seem to be going better, as I managed to go the entire day at work without using the washroom, and when i got home there was a definite absence of blood, so knock on wood. However I still have no appetite.

 

[TheWelshBoyo]

Whoah, whoah. I'm pretty sure it's because you've been misinformed here, Rob, but hydrocortisone, which is IV steroids, is actually weaker that prednisolone, which is why they give you more.
Hydrocortisone is 4 x weaker than prednisolone, so a 400mg dose of hydro would equal 50mg of pred.

 

[Rob]

I questioned my drs about that
they said no
it would also explain why I blew up like a balloon with water retention
something I don't do with 50mg of pred
the reason for the big dose is to try an quickly restore your health while in a safe controlled enviroment ie hospital

so from what I've been told by several different nurses and drs that it's doubly strong/effective