Notice: For Anyone Taking Entocort In Multiple Doses

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tex
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Notice: For Anyone Taking Entocort In Multiple Doses

Post by tex »

Hi All,

I've been meaning to post this for some time, now, and I keep forgetting to do so. Sorry about that - there's always too much going on for my one-track mind to be expected to remember anything. :lol:

The topic of when and how to take Entocort comes up every so often, and for most people, the details may not matter, but for some of us, it does matter. Research shows that Entocort is almost 50% more effective at bringing remission, within a given time interval, if it is taken the same way that all corticosteroids are intended to be administered - namely, the full daily dose should be taken at one time. It's usually better to do this first thing in the morning, simply because the drug is less likely to interfere with sleep, this way, but timing is not critical to effectiveness.

The reason why this dosing works better, is because corticosteroids supplement, (and replace), the cortisol that the body naturally supplies, and cortisol usually peaks in mornings, and declines for the rest of the day. Corticosteroids are more effective at suppressing inflammatory effects, if they are applied in a manner which provides the maximum dose, at one time during the day, (to provide maximum "shock" value), and then allowed to decline, for the rest of the day. This is more effective than providing the same dose at an average, metered rate, at multiple times during the day. If you want to see a reference on this, here's a link:
Results—After eight weeks of treatment, remission occurred in 60% of patients receiving budesonide once daily or prednisolone and in 42% of those receiving budesonide twice daily


http://gut.bmj.com/content/41/2/209

Tex
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It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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DebE13
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Post by DebE13 »

Thanks Tex- good to know.

My GI never bothered to tell me that info and I found out the hard way that prednisone should be taken in the morning. I started by taking it right before bed. :roll: Maybe they're so used to the idea that they forget to tell people- frustrating.
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Post by kitty16 »

Thank you Tex,

I was actually going to ask that very question today I WAS told to take all 3 pills at one time in the AM, but I saw some other's here post different and since I don't fully trust my GI to tell me correct info....

Thanks again

KK
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Post by brandy »

Hi Tex,

Good for you to confirm as it is somewhat confusing when we start Entocort. Brandy
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Post by Phil554 »

That's exactly what the nurse told me when I mentioned my previous history of sleep loss every time I had taken any steroid in the past. She said just take all 3 pills first thing in the morning since the doc had not specified when to take it.

I still have to wait for a new ophthalmologist to see me and OK me taking it at all with previous eye pressure elevation problems with steroid eye drops. My appointment is Tuesday so looking forward to his approval.

Thanks again to everyone for all the advice!

Phil
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Post by Golfingail »

I have finished the 8 weeks of pepto with no real improvement so I will be starting with generic Entorcort in the morning. Nurse says it will be effective immediately and I won't need pep to or Imodium. Is this true? I have a golf outing on Thurs and sure don't want any surprises on the course!
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Post by janet »

NO SORRY I WOULD NOT TRUST TO THAT IDEA.
NOT THAT FAR AWAY FROM A TOILET.

THATS JUST MY OPINION, BUT IF I WERE YOU, THEN NO, NOT LIKELY.

REGARDS
MARIE
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Post by nerdhume »

My Uceris 9 mg tablet has a label that says 'take in the morning'. I am supposed to take this until June 1st and then stop without any tapering.
Theresa

MC and UC 2014
in remission since June 1, 2014

We must all suffer one of two things: the pain of discipline or the pain of regret. ~Jim Rohn
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T
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Post by T »

TEX

I picked up my 3rd bottle of generic Entcort this week from A different pharmacy and the directions read 1 capsule 3 times daily
bad instructions for A newbie or anyone else.I was never told how to take Entcort at the beginning and just assumed 3x daily until I
read your post after taking it wrong for 3 days.In 2 months I start Pepto treatment was told 3 daily I assume 3 at the same time.

TERRY
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tex
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Post by tex »

Hi Terry,

Some people can't detect much difference in results regardless of how they take Entocort, but for most of us it seems to work best first thing in the morning. And for most of us, it's usually easier to remember to take it then, also.

If you're only going to take 3 Pepto tablets per day, the medication would probably work better if you took it at roughly equal intervals during the day. The all-at-one-time strategy is mainly for corticosteroids (because they mimic the action of the body's natural cortisol release, which normally peaks in the mornings). As far as I'm aware, Pepto-Bismol has no cortisol-related effects.

Pepto is claimed to work by coating the lining of the intestines with a protective film, so it should work best if we repeat the treatment several times each day (rather than once per day).

Tex
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It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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Post by Stephanie »

Question for anyone out there: I took entocort for 18 weeks (6 weeks of each 9mg, 6mg, and 3mg) ending in December. As I got down to,3 mg, my D started back up. My GI doc put me back,on Jaunary 7th. I have been taking my 9mg, all at once, each morning. It is doing nothing. If after more than 2 weeks, should I stop or keep.going? She gave me an open-ended prescription telling me to play with my doses to get at the lowest daily dose I could., but last time at 9mg I saw huge improvements after only three or four days. I am thinking of trying the pepto (8 tablets per day for 8 weeks) while I get off of the Cymbalta. Thoughts?
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Post by tex »

Entocort becomes less effective each time that it is stopped and then restarted. Because of that, it can take longer to show benefits each time it is restarted. But if this is only the second time that you started taking it, it shouldn't have lost much effectiveness at this point. Still, it might begin to help after another week or so.

When Entocort loses it's effectiveness as the dose is reduced, that's usually a sign that there are additional food sensitivities in the diet. In addition to gluten, most of us here are also sensitive to all dairy products and soy. Some are also sensitive to eggs. Cutting those foods out of your diet might allow the Entocort to begin working again.

Entocort uses up the vitamin D in our body. It uses vitamin D to suppress the inflammation. Our immune system also uses up vitamin D if our MC is active. If Entocort worked the first time, but it doesn't work now (after a couple of weeks), it's possible that your blood level of vitamin D may have become too low. You might be able to get the Entocort to work again by increasing your supplemental rate of vitamin D.

If you would rather use Pepto-Bismol, there is nothing wrong with trying it. It usually takes roughly 2 weeks to become effective for MC, but the time varies by the individual, of course. It works faster in some cases, slower in others. One of the possible side effects of bismuth subsalicylate is tinnitus (ringing of the ears). If this should happen to you, please stop taking it immediately, because if that symptom is ignored for too long, it can become permanent, in some cases. Tinnitus only occurs in a minority of cases, but it's a side effect that should not be ignored, if it occurs.

It's also safe to take Pepto-Bismol while taking Entocort, because there are no known interactions between the 2 medications.

Tex
:cowboy:

It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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Post by Stephanie »

Thanks Tex! You are a wealth of information.
I had basically lost hope until I found this site a few weeks ago.
Hugs to you all!
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Post by tex »

You're very welcome. I hope that you will be feeling much better soon.

Hugs,
Tex
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It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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Cholestyramine and Budesonide

Post by edreggi »

Hi -

I am brand new to this forum and group. I have been lurking for a few days every since I was recently diagnosed with MC. For me, I have been diagnosed over 4 years ago with Bile Dumping Syndrome after I had my gallbladder removed due to stone blockage. I was fine after my gallbladder surgery but almost with 6 months I began having severe D with excess bile in all watery BM. The doctors kept saying I would adjust and to eat less fat which I did. I never did eat much fat before the surgery nor touched alcohol. I was only in my early 30's when I began having issues with my gallbladder which it took years for them to even catch a stone in a MRI.

I have been using Cholestyramine for over 2 years to curb my Bile Dumping issues. It seemed to work but then about a year ago it began not working. The doctors decided to up my dosage of powder to twice a day and it was a challenge to keep up with the Cholestyramine cocktail while taking other medications. (Cholestyramine will neutralize some meds if taking in combination.)

I had a colonoscopy recently and the gastro doc said I was perfect with zero issues. I didn't believe him and got a second opinion from a top liver doc in my region. He said I had MC for sure from the biopsy lab results. This doc has now put me on Budesonide 9 mg which I started 48 hours ago. It has been impossible to function because the doc said to stop taking the Cholestyramine powder. Without taking the powder, I am in the bathroom all day with Bile Dumping again.

Can I take both Cholestyramine and Budesonide? I am thinking I can take the 9m Budesonide first and then 1 hour later the powder cocktail?

I am not even ready to begin any of the diet changes, as I am just trying to work on being freshly diagnosed with MC. However, can the Bile Dumping all be linked to MC or can I have both problems that are separate issues?

Thanks for any help or advice...
Ed
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