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Patient recovered after treatment with intravenous methylprednisolone, followed by a tapering dose of oral prednisone. htm"Management: Mild to Moderate diseaseAgents: 5-Aminosalicylic Acid Derivatives (5-ASA agents)No Sulfa AllergySulfasalazine (Azulfidine)Sulfa AllergyMesalamine (Asacol, Pentasa)Olsalazine (Dipentum) 500 mg PO bidBalsalazideDuration of medication use: 6-12 weeksTaper preparations to prevent reboundRouteRectal suppositories are preferred for proctitisUse oral and rectal agents together for pancolitisManagement: Moderate to Severe diseaseCorticosteroids: OralAgentsPrednisone 40-60 mg/day orallyMethylprednisolone (Medrol) 35-40 mg/day orallyHydrocortisone (Cortef) 200-300 mg/day orallyMethylprednisolone (Solu-Medrol) 40 mg IV dailyTaper Corticosteroids gradually to prevent reboundContinue starting dose until clinical response (typically 10-14 days)After response, reduce dose by 5mg per weekEfficacySystemic Corticosteroids do not maintain remission and have serious side effectsCorticosteroids: Rectal (for distal Ulcerative Colitis)Hydrocortisone Enema (Cortenema) 100 mg qd to bidHydrocortisone Acetate rectal foam (Cortifoam)DispositionHospitalization required when cases refractory to oral steroidsCyclosporine (Sandimmune) is used in acute cases refractory to IV CorticosteroidsManagement: Immunosuppressants for Refractory diseaseAgentsInfliximab (Remicade)Azathioprine (Imuran) 50-100 mg/day6-Mercaptopurine (Purinethol)Indications:Poor control with CorticosteroidsSerious Corticosteroid complicationsSteroid dependent to control symptomsDurationFor long term therapy onlyIneffective for acute dxOnset of action: 2-6 months"I am unsure whether they can be taken together. Should infection occur, it must be brought under control by the use of appropriate antibacterial measures, or administration of methylprednisolone should be discontinued. When employed as a temporary substitute for oral therapy, a single injection during each 24-hour period of a dose of the suspension equal to the total daily oral dose of MEDROL® Tablets (methylprednisolone tablets, USP) is usually sufficient. If a rapid hormonal effect of maximum intensity is required, the intravenous administration of highly soluble methylprednisolone sodium succinate is indicated.
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