Prednisone (Oral)

Prednisone reduces swelling associated with a host of inflammatory diseases, including arthritis, multiple sclerosis, and more.

Overview

Prednisone tablets are corticosteroids indicated for alleviating inflammation resulting from a host of conditions, including but not limited to:

  • Adrenal Disorders
  • Asthma
  • Blood Disorders
  • Bone Marrow Conditions
  • Dermatologic Conditions
  • Endocrine Disorders
  • Gastrointestinal Issues
  • Kidney Issues
  • Lupus
  • Multiple Sclerosis
  • Ophthalmalgia Issues
  • Rheumatoid Arthritis
  • Severe Allergic Reactions
  • Ulcerative Colitis

Prednisone is a prescription-only drug that is supplied in several formats, including tablets, syrups, solutions, and extended release pills. It is sold and marketed under several generic and brand names, including:

  • Deltasone
  • Sterapred
  • Sterapred DS
  • PredniSONE Intensol
  • Rayos
  • Prednicot

How it Works

When the body's immune system fights off infections or an underlying ailment, substances are released into the bloodstream, causing inflammation.

As a corticosteroid or steroid, Prednisone works by lowering the immune system's activity levels when fighting off inflammatory diseases. It is a potent immunosuppressant.

Prednisone is supplied in the following strengths:

  • Concentrate: 5 mg
  • Oral Solution: 5 mg
  • Immediate Release tablet: 1 mg, 2.5 mg, 5 mg, 10 mg, 20 mg, and 50 mg
  • Delayed Release Tablet: 1 mg, 2 mg, and 5 mg

Conditions Treated?

  • Inflammatory Conditions
  • Allergies
  • Asthma
  • Arthritis
  • Colitis
  • Multiple Sclerosis
  • Adrenal Issues
  • Lupus
  • Skin Disorders

Type Of Medicine?

  • Glucocorticoid
  • Immunosuppressant Agent

Side Effects

The most widely reported side effects of Prednisone include:

  • Appetite Changes
  • Back Pain
  • Blurriness
  • Bone Fractures or Joint Issues
  • Changes in Body Shape
  • Changes in Fat Deposits in the Face, Neck, or Trunk
  • Changes in Menstrual Cycle
  • Changes in Skin Color
  • Changes in Stool Color
  • Changes in Vision
  • Chills
  • Confusion
  • Coughing
  • Cramping or Pain in the Stomach
  • Dehydration
  • Depression
  • Diarrhea
  • Distended Stomach
  • Dry Skin, Scalp, or Mouth
  • Feeling Dizzy, Lightheaded, Or Faint
  • Fevers
  • Fruity Breath
  • Getting Easily Agitated
  • Hair Growth in Females
  • Headaches
  • Heartburn
  • Loss of Height
  • Hostility or Aggressive Behaviors
  • Increased Perspiration
  • Indigestion
  • Insomnia
  • Irregular Heartbeat
  • Labored Breathing
  • Lethargy and Weakness
  • Loss of Mobility
  • Low Urinary Output
  • Mood Swings
  • Nausea
  • Speech Impediments
  • Noisy Breathing
  • Pain in the Eyes
  • Pain in the Muscles
  • Pounding Ears
  • Rashes
  • Red and Purple Streaks on Skin
  • Throwing up Coffee Grounds
  • Severely Dry Scalp
  • Slow Healing
  • Speech Impediments
  • Sudden Weight Gain
  • Swelling or Puffiness
  • Tightness in the Chest
  • Tingling or Numb Sensations
  • Trouble Swallowing
  • Wasting of the Muscles
  • Yellowing Skin or Eyes

Note: Tell your doctor if your symptoms persist or if you or your child aren't developing normally. If you suspect a serious adverse reaction, call 911 right away.

When to Call a Doctor

Seek medical help if you experience any of the following side effects:

  • Changes in Vision “ Including blurriness or seeing circles in well-lit areas
  • Sudden Weight Gain “ Accompanied by shortness of breath
  • Extreme Mood Swings “ Or personality changes
  • Changes in Stool Color “ Especially if the stools are bloody
  • Vomiting “ Particularly if you notice a coffee ground texture

Signs of Pancreatitis

Prednisone may cause pancreatitis in certain patients and some of the warning signs include:

  • Chronic Back Pain
  • Abnormal Heartbeat
  • Nausea
  • Vomiting

Signs of Low Potassium

Low potassium is another common concern for doctors who prescribe Prednisone. The main symptoms associated with this condition include:

  • Pain in the Stomach
  • Abnormal Heartbeat
  • Nausea
  • Vomiting

Signs of Severely High Blood Pressure

Patients are advised to monitor their blood pressure levels consistently when using this medicine. In cases where the readings are dangerously high, it is vital to seek medical help. Some of the warning signs of this condition include:

  • A Very Bad Headache
  • Blurriness
  • Feeling Anxious or Confused
  • Ear Buzzing
  • Pain in the Chest
  • Convulsion
  • Shortness of Breath

Note: Additional warnings are outlined below.

Dosage

Prednisone dosage amounts vary based on the patient's age and other factors such as:

  • Weight
  • Intervals Between Doses
  • Brand Name
  • Medicinal Strength
  • The Underlying Condition

To reduce side effects, the lowest dose possible should always be prescribed. Prednisone is supplied in many brands and strengths. The below guide provides an overview of the average doses for various conditions:

General Doses for Inflammatory Treatments

  • Children: 0.05-2 mg | Split 1-4x Daily
  • Adults: 5-60 mg | Split 1-4x Daily (Initial Dose)

Adult Dose Amounts for Nephrotic Syndrome

  • Preliminary Doses for Adults: 2 mg Split 3-4x Daily
  • Next Follow-Up Doses for Adults: 1.5 mg | Every other Day (for 28 Days)
  • Maintenance Doses for Adults: 0.5-1 mg | Every Other Day (3-6 Months)

Children Dose Amounts for Nephrotic Syndrome

  • Preliminary Doses for Adults: 2 mg Split 3-4x Daily
  • Next Follow-Up Doses for Adults: 1.5 mg | Every other Day (for 28 Days)
  • Maintenance Doses for Adults: 0.5-1 mg | Every Other Day (3-6 Months)

Note: The maximum daily dose during the preliminary treatment of adults with nephrotic syndrome is 80 mg per day. This dose amount should not exceed 4 weeks and is generally modified when urine tests show no protein traces for three days in a row.

The maintenance doses for nephrotic syndrome is prescribed for patients with reoccurring symptoms or regular relapses.

Pediatric Dose Amounts for the Treatment of Asthma

Infants Less than 12 Months Old:

  • For Acute Asthma: 10 mg | 2x Daily (Every 12 Hours)
  • Maintenance: 10 mg | Every Other Day

Children 1-4 Years Old

  • For Acute Asthma: 20 mg | 2x Daily (Every 12 Hours)
  • Maintenance: 20 mg | Every Other Day

Children 5-12 Years Old:

  • For Acute Asthma: 30 mg | 2x Daily (Every 12 Hours)
  • Maintenance: 30 mg | Every Other Day

Children Older Than 12 Years Old:

  • For Acute Asthma: 40 mg | 2x Daily (Every 12 Hours)
  • Maintenance: 40 mg | Every Other Day

Best Practices for Use

  • Take with Meals “ For best results and to reduce the risk of an upset stomach, take this medicine with a full meal or a glass of milk.
  • Instructions for Extended Release Tablets “ To make sure the extended-release tablets work as they should take these whole without crushing or chewing.
  • Instructions for Syrups and Suspension Liquids “ To take the correct portions of the prescription, use the measuring cup, syringe, or dropper that comes with the medicine.

Other Tips

To taper the dose amounts, healthcare professionals recommend the following scenario for 4x daily doses of Prednisone:

  • 1x Before Breakfast Meals
  • 1x After Lunch
  • 1x After Dinner
  • 1x Before Bedtime

Stopping the Medicine

Patients who take Prednisone for a long time should be slowly weaned when it is considered safe to do so. Medical researchers advise against abrupt discontinuation. Consult your healthcare provider for advice before stopping this treatment, even if you begin to feel better.

Missed Doses

If you skip a dose, take it as soon as you remember. It is important, however, to meter doses so these aren't doubled. In the event of an overdose, call 911 and the American Association of Poison Control Center at 1-800-222-1222.

Interactions

Several noteworthy interactions have been observed with Prednisone. These include:

Drug Interactions

Certain medicines should not be used concurrently with Prednisone due to the risk of developing negative side effects. You should not take the live Rotavirus vaccine, for example, during treatment with Prednisone. An altered dose or alternative treatment may also be required if you take one or more of the following medicines:

  • Fepradinol
  • Etofenamate
  • Vecuronium
  • Salicylic Acid
  • Levofloxacin
  • Felbinac
  • Indomethacin
  • Primidone
  • Balofloxacin
  • Tolfenamic Acid
  • Tosufloxacin
  • Parecoxib
  • Aprobarbital
  • Nimesulide
  • Rofecoxib
  • Diclofenac
  • Metocurine
  • Ketoprofen
  • Ceritinib
  • Proquazone
  • Droxicam
  • Ciprofloxacin
  • Clarithromycin
  • Sparfloxacin
  • Prulifloxacin
  • Gemifloxacin
  • Gatifloxacin
  • Tacrolimus
  • Moxifloxacin
  • Niflumic Acid
  • Floctafenine
  • Loxoprofen
  • Flumequine
  • Rufloxacin
  • Ibuprofen
  • Dexketoprofen
  • Etodolac
  • Pixantrone
  • Oxaprozin
  • Fluconazole
  • Flufenamic Acid
  • Nadifloxacin
  • Feprazone
  • Choline Salicylate
  • Olaparib
  • Licorice
  • Clonixin
  • Hexafluorenium
  • Morniflumate
  • Alfalfa
  • Lomefloxacin
  • Diflunisal
  • Nabumetone
  • Amtolmetin Guacil
  • Fosphenytoin
  • Flurbiprofen
  • Oxyphenbutazone
  • Naproxen
  • Sulindac
  • Lopinavir
  • Nimesulide Beta Cyclodextrin
  • Valdecoxib
  • Celecoxib
  • Sodium Salicylate
  • Aspirin
  • Piperaquine
  • Aceclofenac
  • Montelukast
  • Ketoconazole
  • Piketoprofen
  • Tolmetin
  • Warfarin
  • Enoxacin
  • Dexibuprofen
  • Salsalate
  • Pefloxacin
  • Asparaginase
  • Daclatasvir
  • Bemiparin
  • Fenoprofen
  • Bosutinib
  • Ospemifene
  • Clozapine
  • Tenoxicam
  • Besifloxacin
  • Butabarbital
  • Ritonavir
  • Rifampin
  • Secobarbital
  • Butalbital
  • Phenobarbital
  • Acemetacin
  • Pancuronium
  • Rifapentine
  • Aldesleukin
  • Mefenamic Acid
  • Idelalisib
  • Etoricoxib
  • Lumiracoxib
  • Bupropion
  • Meclofenamate
  • Amobarbital
  • Fleroxacin
  • Telaprevir
  • Alcuronium
  • Bromfenac
  • Norfloxacin
  • Mephobarbital
  • Gallamine
  • Ketorolac
  • Phenylbutazone
  • Dipyrone
  • Phenytoin
  • Nifedipine
  • Fentanyl
  • Meloxicam
  • Pazufloxacin
  • Proglumetacin
  • Nepafenac
  • Pranoprofen
  • Bufexamac
  • Piroxicam
  • Atracurium
  • Ofloxacin
  • Propyphenazone
  • Saiboku-To
  • Tiaprofenic Acid
  • Lornoxicam
  • Nadroparin

Drug Classes to Avoid

The main classes of drugs to avoid when taking Prednisone are:

  • Anticholinesterases
  • Anticoagulants
  • Antidiabetics
  • Antitubercular Drugs
  • Cholestyramine
  • Cyclosporine
  • Digitalis Glycosides
  • Estrogens
  • Hepatic Enzyme Inducers
  • Hepatic Enzyme Inhibitors
  • Ketoconazole
  • Nonsteroidal Anti-Inflammatory Agents (NSAIDS)
  • Skin Tests
  • Vaccines

Note: Create a full list of all the medicines you currently take so that your doctor can measure the safety of prescribing Prednisone. This includes over-the-counter drugs, such as vitamins and herbal supplements.

Pre-Existing Conditions

Similarly, health interactions have been identified for Prednisone.

Prednisone may cause certain conditions to become worse. Additionally, some of the below conditions may influence how well the drug works. Tell your doctor if you currently have a history of the following pre-existing conditions before starting treatment with Prednisone:

  • An Injury to the Brain
  • Herpes of the Eye
  • Mental Health Issues
  • Personality or Mood Changes
  • Heart Health Issues
  • Glaucoma
  • Thyroid Disorders
  • Adrenaline Gland Disorders
  • Diabetes
  • Cataracts
  • Peptic Ulcers
  • Bone Health Issues
  • Hypotension or Hypertension
  • Hepatitis
  • Weakness in the Muscles
  • Cirrhosis
  • Tuberculosis
  • Bacterial or Viral Infections
  • Kidney Issues
  • Gastrointestinal Issues

Warnings

Ask your doctor if you have any concerns before or while undergoing treatment with Prednisone. Some of the main warnings that come with this medicine include:

Bloodwork and Lab Tests

After starting treatment with Prednisone, your doctor may schedule follow-up visits to determine if the medicine is working properly or if any adverse side effects occur. These visits may require blood or urine tests to be performed.

Additionally, if you have a new medical or dental procedure scheduled, inform your medical provider of Prednisone use, as this medicine could affect the outcome of test results.

Pediatric Use

Prednisone is considered safe for use in pediatric populations. However, as with all corticosteroids, extra precaution must be taken for this group due to the risk of:

  • Delayed Growth
  • Bone Health Issues

These negative side effects of Prednisone are predominantly caused by high-doses or long-term use. As a result, medical researchers suggest only the endorsed dose amounts. Following use, patients should be carefully monitored to determine if new issues develop.

Senior Use

Prednisone is also considered safe for use in seniors. Nevertheless, a close eye should be kept on seniors and follow-up tests scheduled to determine if the medicine causes newfound health issues. This is because seniors are more predisposed to chronic health conditions, such as kidney or heart issues. In this event, a modified dose may be required.

Pregnancy

Prednisone is not considered to be safe for use in expecting mothers. This is because the medicine can cause serious harm to a developing fetus, including low birth weight and birth defects. Be sure to tell your doctor if you are pregnant or plan to be. Additionally, if you take this medicine, your doctor may also recommend using a birth control option until it is safe to get pregnant.

If you do get pregnant while using this medicine, inform your doctor right away.

Emotional Stressors

Patients who are prescribed ongoing Prednisone may require altered doses in times of significant emotional stress. If you have depression, anxiety, or are facing chronic stress, for example, tell your medical provider “ to prevent the risk of adverse side effects.

Adrenal Gland Issues

High doses of Prednisone or long-term use could cause adrenaline issues to develop. Patients are urged to consult a healthcare provider if the following symptoms are observed:

  • Blurriness
  • Dehydration
  • Extreme Lethargy
  • Fainting Spells
  • Feeling Dizzy or Lightheaded
  • Frequent Urge to Urinate
  • Irregular Heartbeat

Low Immunity

Prednisone, as with most corticosteroid treatments, lowers the body's immunity responses. As a result, patients are at an increased risk of getting sick more than usual. To reduce the risks of new infections:

  • Stay Away from Sick Individuals
  • Practice Frequent Hand Washing
  • Avoid Taking Live Vaccines
  • Tell Your Doctor if You Feel Sick
  • Avoid Traveling Overseas

Vaccines

As mentioned earlier, patients are urged to postpone immunizations unless you have a doctor's consent. Some of the top live vaccines to avoid while using Prednisone include:

  • Influenza
  • Measles
  • Mumps
  • Typhoid
  • Yellow Fever
  • Chickenpox
  • Zoster
  • Rotavirus

Prednisone reduces the body's fight responses and therefore increases patients' susceptibility to contracting these viruses. Another word of caution provided by medical providers is keeping a safe distance from household members who have been recently immunized.

Anaphylaxis

Prednisolone contains ingredients that may trigger an allergic reaction. Anaphylaxis, for example, is a serious and potentially fatal condition that requires prompt medical intervention. Watch out for the signs of anaphylaxis if you take Prednisone and call 911 immediately. Some of the warning signs of Anaphylaxis are:

  • Swollen Hands or Face
  • Itchiness
  • Hives and Rashes
  • Difficulty Breathing or Swallowing
  • Tightness in the Chest

Ophthalmologic Concerns

Prednisone may cause some underlying eye conditions to get worse. There is also a slight risk of developing eye problems when taking this medicine. As a result, referrals are typically provided to an ophthalmologist. Keep all referral visits and tell your doctor immediately if you experience:

  • Any Sudden Visual Changes
  • Blurred Vision
  • Eye Strain While Reading
  • Pain in the Eyes
  • Halo-Like Symbols in Direct Light

Mood Changes

Prednisone has been observed to cause significant mood changes. An altered dose or different medicine may be required if you experience:

  • Fluctuations in Mood
  • Depression
  • A Distorted View of Reality
  • Insomnia
  • Changes in Personality
  • Constant Stress

Wear a Medical I.D. Bracelet

In the event of a medical emergency, an I.D. bracelet provides EMTs with valuable information when you are unable to do so. As a result, healthcare experts suggest wearing a medical I.D. bracelet at all times when undergoing treatment with Prednisone or other medicines.

Storage

Prednisone may be stored at a room temperature of 20° to 25° C (68° to 77° F). Do not place in direct light or heat, as doing so could compromise the quality of the medicine.

Additionally, the medicine should be discarded when it has been more than 3 months or 90 days since the bottle was first opened. To safely discard of medicines, consider returning unused portions to a local pharmacy through the take-back program.

For the safety of small children and pets, store in a high or hard to reach area.

Summary

When patients experience swelling due to inflammatory diseases such as arthritis, ulcerative colitis, or multiple sclerosis, for example, doctors sometimes prescribe Prednisone.

This corticosteroid is available by prescription only and it has an extensive list of applications in terms of the inflammatory conditions it's used to treat. The main indications for use include allergic states, dermatologic diseases, gastrointestinal disorders, endocrine and autoimmune disorders, neoplastic diseases, rheumatoid disorders, and more. As can be seen, the scope of Prednisone's uses is vast.

Prednisone works by interacting with substances released by the immune system which cause inflammation. Due to its immune suppressing features, Prednisone may impair the body's ability to fight off new infections. As a result, live vaccines should not be taken unless permission is granted by your medical provider. You should also stay away from others who are sick.

Prednisone is a strong anti-inflammatory agent and is usually well-tolerated by children and adults. However, this medicine is not indicated for use in pregnant and nursing mothers. Serious adverse reactions have been shown to occur. Moreover, children who take this medicine may experience stunted growth and should therefore be closely monitored.

Because significant adverse effects may occur when taking Prednisone, your doctor may advise you to wear a medical I.D. bracelet at all times. In the event of an emergency, EMTs have immediate access to current medications being used and are subsequently able to make decisions faster in a life and death scenario.

Doctors moreover prescribe Prednisone by mouth in the lowest dose amounts possible to reduce the patient's chances of developing adverse side effects. An initial high dose is typically prescribed to stabilize the patient's condition, followed by a reduced maintenance dose. This approach, however, is based on the patient's response to the medicine. To lower the chances of developing an upset stomach when using Prednisone, take it with food or a dairy beverage.

In summary, Prednisone is proven to effectively alleviate inflammation in the skin, joints, and vital organs due to a wide range of inflammatory diseases.