- Psoriasis Slideshow: Symptoms, Causes and Treatment
- Psoriasis Quiz: Test Your Medical IQ
- Moderate to Severe Forms of Psoriasis Slideshow
- What is prednisone, and how does it work?
- What diseases and conditions does prednisone treat (uses)?
- What is the dosage for prednisone, and how should it be taken?
- How should prednisone be tapered, and what are the withdrawal symptoms and signs?
- Is this drug available in generic form?
- Do I need a prescription for this drug?
- Prednisone side effects and adverse events
- Which drugs or supplements interact with prednisone?
- Is it safe to take prednisone over a long period of time?
- Is this drug safe to take if I'm pregnant or breastfeeding?
- What brand names are available for prednisone?
- What else should I know about this medicine?
What is prednisone, and how does it work?
These synthetic corticosteroids mimic the action of cortisol (hydrocortisone), the naturally-occurring corticosteroid produced in the body by the adrenal glands. Corticosteroids have many effects on the body, but they most often are used for their potent anti-inflammatory effects, particularly in those diseases and conditions in which the immune system plays an important role, for example, arthritis, colitis, asthma, bronchitis, skin problems, and allergies. Prednisone is inactive in the body and, in order to be effective, first must be converted to prednisolone by enzymes in the liver. Therefore, prednisone may not work as effectively in people with liver disease whose ability to convert prednisone to prednisolone is impaired. The FDA approved prednisone in 1955.
What diseases and conditions does prednisone treat (uses)?
Prednisone is used in the management of inflammatory conditions or diseases in which the immune system plays an important role. Since this drug is used for the treatment and management of so many diseases and conditions, only the most common or FDA approved uses are listed.
- Several types of arthritis
- Ulcerative colitis
- Crohn's disease
- Systemic lupus
- Allergic reactions
- Severe psoriasis
It also is used the treatment of:
Corticosteroids, including prednisone, are commonly used to suppress the immune system and prevent the body from rejecting transplanted organs.
Prednisone is used as replacement therapy in patients whose adrenal glands are unable to produce sufficient amounts of cortisol.
What is the dosage for prednisone, and how should it be taken?
The initial dosage of prednisone varies depending on the condition being treated and the age of the patient.
- It's recommended that you take this medication with food.
- The starting dose may be from 5 mg to 60 mg per day, and often is adjusted based on the response of the disease or condition being treated.
- Corticosteroids typically do not produce immediate effects and must be used for several days before maximal effects are seen. It may take much longer before conditions respond to treatment.
- When prednisone is discontinued after a period of prolonged therapy, the dose of prednisone must be tapered (lowered gradually) to allow the adrenal glands time to recover.
How should prednisone be tapered, and what are the withdrawal symptoms and signs?
Patients should be slowly weaned off prednisone. Abrupt withdrawal of prednisone after prolonged use causes side effects because the adrenal glands are unable to produce enough cortisol to compensate for the withdrawal, and symptoms of corticosteroid insufficiency (adrenal crisis) may occur. These symptoms include:
Therefore, weaning off prednisone should occur gradually so that the adrenal glands have time to recover and resume production of cortisol. Until the glands fully recover, it may be necessary to treat patients who have recently discontinued corticosteroids with a short course of corticosteroids during times of stress (infection, surgery, etc.), times when corticosteroids are particularly important to the body.
Do I need a prescription for this drug?
Yes, you need a prescription from your doctor or other medical professional to obtain this medication.
Quick GuidePsoriasis Types, Images, Treatments
Prednisone side effects and adverse events
Side effects of prednisone and other corticosteroids range from mild annoyances to serious, irreversible organ damage, and they occur more frequently with higher doses and more prolonged treatment.
Common side effects include:
- Retention of sodium (salt) and fluid
- Weight gain
- High blood pressure
- Loss of potassium
- Muscle weakness
- Thinning skin
- Problems sleeping
Serious side effects include:
- Puffiness of the face (moon face)
- Growth of facial hair
- Thinning and easy bruising of the skin
- Impaired wound healing
- Ulcers in the stomach and duodenum
- Worsening of diabetes
- Irregular menses
- Rounding of the upper back ("buffalo hump")
- Retardation of growth in children
- Anaphylaxis (severe allergic reactions like hives, itching, skin rash, swollen lips/tongue/face)
- Vision changes
- Congestive heart failure
- Heart attack
- Pulmonary edema
- Allergic dermatitis
- Low blood pressure
- Amenorrhea (lack of menstruation)
- Newly onset diabetes
This drug also causes psychiatric disturbances, which include:
Other possible serious side effects of this drug include:
Prednisone and diabetes: Prednisone is associated with new onset or manifestations of latent diabetes, and worsening of diabetes. Diabetics may require higher doses of diabetes medications while taking prednisone,
Allergic reaction: Some people may develop a severe allergic reaction (anaphylaxis) to prednisone that includes swelling of the airways (angioedema) that may result in shortness of breath or airway blockage.
Immune suppression: Prednisone suppresses the immune system and, therefore, increases the frequency or severity of infections and decreases the effectiveness of vaccines and antibiotics.
Osteoporosis: Prednisone may cause osteoporosis that results in fractures of bones. Patients taking long-term prednisone often receive supplements of calcium and vitamin D to counteract the effects on bones. Calcium and vitamin D probably are not enough, however, and treatment with bisphosphonates such as alendronate (Fosamax) and risedronate (Actonel) may be necessary. Calcitonin (Miacalcin) also is effective. The development of osteoporosis and the need for treatment can be monitored using bone density scans.
Adrenal insufficiency and weaning off prednisone: Prolonged use of prednisone and other corticosteroids causes the adrenal glands to atrophy (shrink) and stop producing the body's natural corticosteroid, cortisol.
Necrosis of hips and joints: A serious complication of long-term use of corticosteroids is aseptic necrosis of the hip joints. Aseptic necrosis is a condition in which there is death and degeneration of the hip bone. It is a painful condition that ultimately can lead to the need for surgical replacement of the hip. Aseptic necrosis also has been reported in the knee joints. The estimated incidence of aseptic necrosis among long-term users of corticosteroids is 3%-4%. Patients taking corticosteroids who develop pain in the hips or knees should report the pain to their doctors promptly.
Which drugs or supplements interact with prednisone?
- Prednisone may interact with estrogens and phenytoin (Dilantin). Estrogens may reduce the action of enzymes in the liver that break down (eliminate) the active form of prednisone, prednisolone. As a result, the levels of prednisolone in the body may increase and lead to more frequent side effects.
- Phenytoin increases the activity of enzymes in the liver that break down (eliminate) prednisone and thereby may reduce the effectiveness of prednisone. Thus, if phenytoin is being taken, an increased dose of prednisone may be required.
- The risk of hypokalemia (high potassium levels in the blood) increases when corticosteroids are combined with drugs that reduce potassium levels (for example, amphotericin B, diuretics), leading to serious side effects such as heart enlargement, heart arrhythmias and congestive heart failure.
- Corticosteroids may increase or decrease the response warfarin (Coumadin, Jantoven). Therefore, warfarin therapy should be monitored closely.
- The response to diabetes drugs may be reduced because prednisone increases blood glucose.
- Prednisone may increase the risk of tendon rupture in patients treated with fluoroquinolone type antibiotics. Examples of fluoroquinolones include ciprofloxacin (Cipro) and levofloxacin (Levaquin).
- The elderly are especially at risk and tendon rupture may occur during or after treatment with fluoroquinolones.
- Combining aspirin, ibuprofen (Motrin) or other nonsteroidal anti-inflammatory agents (NSAIDS) with corticosteroids increases the risk of stomach related side effects like ulcers.
- Barbiturates, carbamazepine, rifampin and other drugs that increase the activity of liver enzymes that breakdown prednisone may reduce blood levels of prednisone. Conversely, ketoconazole, itraconazole (Sporanox), ritonavir (Norvir), indinavir (Crixivan), macrolide antibiotics such as erythromycin, and other drugs that reduce the activity of liver enzymes that breakdown prednisone may increase blood levels of prednisone.
Is it safe to take prednisone over a long period of time?
Is this drug safe to take if I'm pregnant or breastfeeding?
- Corticosteroids cross the placenta into the fetus. Compared to other corticosteroids, however, prednisone is less likely to cross the placenta. Chronic use of corticosteroids during the first trimester of pregnancy may cause cleft palate.
- Corticosteroids are secreted in breast milk and can cause side effects in the nursing infant. Prednisone is less likely than other corticosteroids to be secreted in breast milk, but it may still pose a risk to the infant.
What else should I know about this medicine?
Prednisone is available as:
- Tablets of 1, 2.5, 10, 20, and 50 mg.
- Extended Release Tablets of 1, 2, and 5 mg.
- Oral solution or syrup of 5mg/5ml
Keep this drug stored at room temperature 20 C -25 C (68 F -77 F), and keep away from moisture.
Prednisone is a drug that belongs to the corticosteroid drug class, and is an
anti-inflammatory and immune system suppressant. It's used to treat a variety of diseases and conditions, for example: inflammatory bowel disease (Crohn's
disease and ulcerative colitis), lupus, asthma, cancers, and several types of
Common side effects are weight gain, headache, fluid retention, and muscle weakness. Other effects and adverse events include glaucoma, cataracts, obesity, facial hair growth, moon face, and growth retardation in children. This medicine also causes psychiatric problems, for example: depression, insomnia, mood swings, personality changes, and psychotic behavior. Serious side effects include reactions to diabetes drugs, infections, and necrosis of the hips and joints.
Corticosteroids like prednisone, have many drug interactions; examples include: estrogens, phenytoin (Dilantin), diuretics, warfarin (Coumadin, Jantoven), and diabetes drugs. Prednisone is available as tablets of 1, 2.5, 10, 20, and 50 mg; extended release tablets of 1, 2, and 5mg; and oral solution of 5mg/5ml. It's use during the first trimester of pregnancy may cause cleft palate. This medicine is secreted in breast milk and can cause side effects in infants who are nursing. You should not stop taking prednisone abruptly because it can cause withdrawal symptoms and adrenal failure. Talk with your doctor, pharmacist, or other medical professional if you have questions about beta-blockers. Talk with your doctor, pharmacist, or other medical professional if you have questions about prednisone.
If you notice other effects not listed above, contact your doctor or pharmacist. In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
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Treatment & Diagnosis
- Swollen Lymph Nodes (Lymphadenopathy)
- Pleurisy (Pleuritis)
- Shortness of Breath (Dyspnea)
- Doctor: Checklist to Take To Your Doctor's Appointment
- Buttock Pain
- Contact Dermatitis
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- Meniere's Disease
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- Multiple Myeloma
- Joint Warmth
- Paraneoplastic Syndrome
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Medications & Supplements
- hydrocortisone oral, A-Hydrocort, Solu-CORTEE, Cortef
- prednisolone (Flo-Pred, Pediapred, Orapred, Orapred ODT)
- methylprednisolone, Medrol, Depo-Medrol, Solu-Medrol
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- Corticosteroids (Systemic, Oral and Injectable)
- dimethyl fumarate (Tecfidera)
- teriflunomide (Aubagio)
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Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
Top prednisone Related Articles
AcneAcne is a localized skin inflammation as a result of overactivity of oil glands at the base of hair follicles. This inflammation, depending on its location, can take the form of a superficial pustule (contains pus), a pimple, a deeper cyst, congested pores, whiteheads, or blackheads. Treatments vary depending on the severity of the acne.
Acne PictureExactly what causes acne? Acne develops when cells and natural oils begin to block up tiny hair follicles in the skin. See a picture of Acne and learn more about the health topic.
Take the Acne QuizAcne is the most common skin disorder in the world. If you suffer from acne, you are not alone and many treatment options are available. Learn more about pimples, blackheads, and comedones with the Acne Quiz.
Adult Acne SlideshowAcne (pimples) is a skin condition that blocks pores. Get answers on causes, solutions and treatments for this skin condition that can still be a problem in adults.
Aseptic NecrosisAseptic necrosis (avascular necrosis or osteonecrosis) develops when blood supply diminishes to an area of bone and causes bone death. Though aseptic necrosis may be painless, pain is often associated when using the degenerating bone. If caught early, aseptic necrosis may be treated by grafting new bone into the degenerating area. In later stages, joint replacement surgery may be required.
Asthma OverviewAsthma is a condition in which hyperreactive airways constrict and result in symptoms like wheezing, coughing, and shortness of breath. Causes of asthma include genetics, environmental factors, personal history of allergies, and other factors. Asthma is diagnosed by a physician based on a patient's family history and results from lung function tests and other exams. Inhaled corticosteroids (ICS) and long-acting bronchodilators (LABAs) are used in the treatment of asthma. Generally, the prognosis for a patient with asthma is good. Exposure to allergens found on farms may protect against asthma symptoms.
Take the Asthma QuizAsthma is a chronic disease of the airways of the lungs, which can be managed with proper treatment. Triggered by two main causes, asthma symptoms can be brought on by environmental factors and surprising allergens.
Atopic DermatitisEczema is a general term for many types dermatitis (skin inflammation). Atopic dermatitis is the most common of the many types of eczema. Other types of eczema include: contact eczema, allergic contact eczema, seborrheic eczema, nummular eczema, stasis dermatitis, and. dyshidrotic eczema.
Boils SlideshowWhat causes boils? Learn home remedies for boils on the skin, how to get rid of boils, as well as the causes, symptoms, and types of boils, including furuncles and carbuncles.
Cortisone InjectionCortisone injections are used to treat small areas of inflammation or widespread inflammation throughout the body. There is minimal pain from these injections, and relief from the pain of inflammation occurs rapidly.
Crohn's DiseaseCrohn's disease is a chronic inflammatory disease, primarily involving the small and large intestine, but which can affect other parts of the digestive system as well. Abdominal pain, diarrhea, vomiting, fever, and weight loss are common symptoms.
Cushing's SyndromeCushing's syndrome, sometimes referred to as hypercortisolism, is a hormonal disorder caused by prolonged exposure to high levels of the hormone cortisol. Symptoms may include obesity, thinning arms and legs, a rounded face, and increased fat around the neck. Some causes of Cushing's syndrome is from taking glucocorticoid hormones such as prednisone for inflammatory diseases. Treatment for Cushing's syndrome depends on the cause.
Take the Eczema QuizDoes dry, itchy, flaky, scaly, red, inflamed skin sound familiar to you? Take the Atopic Eczema (Atopic Dermatitis) Quiz to learn more about the causes, symptoms, and treatments of this common skin condition.
Juvenile ArthritisJuvenile idiopathic arthritis (juvenile rheumatoid arthritis or JRA) annually affects one child in every thousand. There are six types of JIA. Treatment of juvenile arthritis depends upon the type the child has and should focus on treating the symptoms that manifest.
MS SlideshowLearn about multiple sclerosis (MS) causes, symptoms, and treatment for this autoimmune disease that attacks the nerves of the central nervous system and damages myelin affecting the brain and spinal cord.
Steroids to Treat ArthritisSteroids decrease inflammation and may be used to treat many inflammatory conditions and diseases, such as systemic vasculitis, rheumatoid arthritis, lupus, and Sjögren's syndrome. Steroids are injected, rather than administered orally, to deliver a high dose of medication to a specific area. Side effects of steroid injections include infection, tendon rupture, skin discoloration, allergic reaction, and weakening of bone, ligaments, and tendons.
Total Hip ReplacementDuring total hip replacement, diseased hip cartilage and bone is replaced with artificial materials. Risks of the surgery include blood clots in the lower extremities, difficulty with urination, infection, bone fracture, scarring, limited range of motion, and prosthesis failure.
Ulcerative ColitisUlcerative Colitis is a form of inflammatory bowel disease and is slightly different than Crohn's disease. Your diet can impact the severity of your symptoms. Learn the causes, symptoms, and treatment options associated with ulcerative colitis.