Overview Of Prednisone

Prednisone suppresses the immune system and prevents the body from releasing substances that trigger inflammation. Most patients take this medication by mouth, and it can be used for short and long-term therapy. Side effects are more likely to occur when prednisone is used for a long time. Taking doses higher than 7.5 milligrams per day could further increase a patient's chances of developing side effects.

Most patients will get a prescription for prednisone tablets from their doctor. Prednisone eye drops are not available, though patients may receive a similar drug if they need it in this form. This medication is an effective arthritis treatment. Many patients also take it as a part of their cancer treatment. In addition, patients may need prednisone as a medication to prevent organ rejection after an organ transplant. Certain individuals may use this corticosteroid as a treatment for allergies. Of course, patients must understand how this medication works first.

Medication Class

Prednisone is part of a medication class known as corticosteroids. It is one of the medications in this class that is only offered with a prescription from a doctor. Corticosteroids are designed to reduce inflammation in an individual’s body. Many of them also lower the activity of the patient’s immune system. Corticosteroids, like prednisone, are closely linked to cortisol. Cortisol, of course, is the stress hormone. It is a natural hormone that the adrenal glands produce. All individuals need cortisol for their body to function properly. These medications change how an individual’s immune system functions.

How It Works

Prednisone shares similarities with the glucocorticoids that occur naturally within the body. This medication imitates the action of cortisol. As mentioned, this is one of the natural hormones produced by the body's adrenal glands. It slows and inhibits the processes responsible for producing inflammation in the body. This is how it reduces inflammation. It also reduces the pain, redness, and swelling that can occur with inflammation.

The liver metabolizes prednisone. It is converted to prednisolone during this process. The medication has a half-life of two to three hours. It is excreted in the urine after it has been fully metabolized into inactive metabolites and filtered by the kidneys.

Uses

Prednisone helps patients manage swelling and pain caused by arthritis. It is also used for treating lupus, severe psoriasis, ulcerative colitis, asthma, and Crohn's disease. Patients with bronchitis may benefit from taking this medicine. It could be considered as a treatment option for autoimmune hemolytic anemia or idiopathic thrombocytopenic purpura as well. Prednisone is often recommended as part of palliative support for leukemia or lymphoma patients.

In addition, this medication is often used to prevent organ rejection in individuals who have had organ transplants. The medicine may be prescribed as a form of replacement therapy for patients who have adrenal gland problems that prevent the body from making sufficient amounts of cortisol on its own.

Common Side Effects

Commonly reported side effects of prednisone include mood changes, weight gain, increased appetite, insomnia, and headaches. Patients taking this medicine have also experienced dizziness, stomach pain, bloating, and increased sweating. Skin changes such as thinning skin, easy bruising, skin discoloration, dry skin, and acne may develop as well. Some individuals have observed changes in the distribution of their body fat while they are on this medication. For example, patients may notice they have more body fat in their arms, legs, face, neck, waist, or breasts than they did before beginning this medication. Patients should discuss any worrying side effects with their doctor.

Serious Side Effects

Prednisone also has potentially serious side effects. This drug may cause swelling, rapid weight gain, and shortness of breath. Patients have also reported blurry vision, seeing halos around lights, and eye pain. The medication could trigger dangerous elevations in blood pressure. Patients who have this could notice chest pain, tinnitus, shortness of breath, or an irregular heartbeat. Some individuals on this medication could observe blood in their stool. Their stool may look similar to tar. Some individuals have coughed up blood while they are on this drug.

Severe depression has been reported by patients who take this medicine. Individuals may display personality changes as well. Some patients report feelings of extreme happiness with prednisone use, and others report extreme sadness. Seizures have occurred in patients who take this medicine. The drug may also cause low potassium and pancreatitis. Patients on this medication who experience a rapid heart rate, irregular heartbeat, extreme thirst, muscle weakness, or severe pain in the upper abdomen should seek urgent medical care.

Prednisone And Allergies

Prednisone and allergies are closely connected. In fact, this medication, like many other corticosteroids, can help treat many symptoms of allergic reactions, including redness, itching, swelling. Many patients take prednisone for this purpose. However, it is possible to experience a reaction to this medication. Of course, allergic reactions to prednisone are quite rare. Symptoms of a serious reaction include significant dizziness, rash, trouble breathing, as well as itching and swelling. Itching and swelling are particularly concerning when they affect the patient’s face, throat, or tongue. Patients should call for immediate medical attention if they experience any of these symptoms while taking prednisone.

Precautions To Remember

Patients should go over their full medical history with their doctor to ensure prednisone is safe for their needs. In particular, the doctor will need to know about any history of cardiovascular disease, mental health conditions, eye problems, gastrointestinal issues, or bone concerns. Patients with these conditions may need to take another drug or be monitored more closely if prednisone is prescribed. Like other corticosteroids, prednisone may cause patients to retain both fluid and salt. This retention could trigger increases in blood pressure, calcium excretion, and potassium excretion. Patients may need to have their blood pressure monitored at follow-up appointments. Regular laboratory tests may be recommended to check calcium and potassium levels.

This medication could impact growth and development in pediatric patients if it is used for a prolonged period. Thus, doctors will need to monitor the child closely throughout their treatment. Patients who intend to receive a vaccine while on prednisone should speak with their doctor before doing so. Individuals who take high doses of this medication may need to delay receiving any live or live-attenuated vaccines for several months after prednisone is discontinued.

Potential Medication Interactions

Prednisone can interact with barbiturates such as amobarbital and pentobarbital. It also interacts with some diuretics, including furosemide, bumetanide, and torsemide. Diabetes patients should be aware that prednisone could interfere with insulin and some other injectable diabetes medicines. This drug also interacts with estrogen found in hormone replacement therapy and birth control pills.

Prednisone is known to interact with over-the-counter pain relievers and nonsteroidal anti-inflammatories. Two examples are ibuprofen and naproxen. It also interacts with diclofenac, indomethacin, and ketoprofen. Individuals who take acetylsalicylic acid (Aspirin) or other salicylates, such as choline magnesium trisalicylate, should check with their doctor about potential interactions with prednisone first.

Common Dosage Recommendations

The dose of prednisone that patients receive varies widely. Doctors determine the proper dose based on the patient's age, the condition they need the medication for, as well as the severity of their condition. Other factors are any underlying medical conditions as well as how a patient reacts to their first dose. The first dose of prednisone for most patients falls between five and sixty milligrams daily. In most cases, doctors will start at what they expect will be the lowest effective dose. If it is not effective, doctors will adjust the patient's dose until they show the desired results.

Many arthritis patients receive between five and ten milligrams of prednisone daily. If they receive ten milligrams, they often take it in two five-milligram doses. When patients are withdrawing from this medication, they will do so slowly. Most doctors recommend reducing the dose by one milligram every two to four weeks.

Common Medication Alternatives

As mentioned, prednisone is an oral corticosteroid. Patients take it to relieve inflammation and similar symptoms. Thus, when patients want or need an alternative, they often have to take another prescription corticosteroid. Of course, the exact alternative chosen can vary depending on the condition that needs treating. If they have asthma, common medication alternatives include dexamethasone, prednisolone, and methylprednisolone.

These three are also used as alternatives when treating arthritis. Other medication alternatives when treating arthritis include hydrocortisone and triamcinolone. Some patients with arthritis may avoid taking corticosteroids often and will rely on other options instead. These options include nonsteroidal anti-inflammatories, such as naproxen sodium.

Advice For Taking It

Since prednisone can cause an upset stomach, doctors generally recommend taking it with food or milk. However, patients may want to avoid simple carbohydrates, sugar, and highly processed foods. Examples, of course, include bread, cookies, honey, cake, and chips. Avoiding these foods is vital, as prednisone can increase an individual’s blood sugar. This may result in a higher risk of diabetes and increased body fat.

Patients should consume the tablet form with eight ounces of water. Patients who take a single dose of this medication each day are often advised to take their dose before nine in the morning. This is to mimic the body’s natural cortisol secretion. Doctors may need to adjust a patient's dose during times when the patient is under significant stress. In addition, patients should avoid consuming alcohol while they are on this medication to reduce the risk of gastrointestinal side effects.