- 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 interacts with many drugs, examples include:
- 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?No, prolonged therapy with prednisone causes the adrenal glands to atrophy and stop producing cortisol.
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.
Reference: FDA Prescribing Information
Quick GuidePsoriasis Types, Images, Treatments
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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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 SlideshowWhat is Crohn's disease? Get more information on this digestive disorder and how Crohn's can affect your diet. Learn more about tests to diagnose Crohn's disease, as well as treatments for Crohn's.
Cystic Acne PictureCystic acne is a type of abscess that is formed when oil ducts become clogged and infected. See a picture of Cystic Acne and learn more about the health topic.
Eczema SlideshowEczema (Atopic Dermatitis) is a common allergic skin condition. Get the latest information on causes of eczema and skin rash symptoms. Find treatments for eczema as well as treatments for dermatitis, contact dermatitis, seborrheic dermatitis, and more.
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.
HeadacheHeadaches can be divided into two categories: primary headaches and secondary headaches. Migraine headaches, tension headaches, and cluster headaches are considered primary headaches. Secondary headaches are caused by disease. Headache symptoms vary with the headache type. Over-the-counter pain relievers provide short-term relief for most headaches.
HivesHives, also called urticaria, is a raised, itchy area of skin that is usually a sign of an allergic reaction. The allergy may be to food or medications, but usually the cause of the allergy (the allergen) is unknown.
LeukemiaLeukemia is a type of cancer of the blood cells in which the growth and development of the blood cells are abnormal. Strictly speaking, leukemia should refer only to cancer of the white blood cells (the leukocytes) but in practice it can apply to malignancy of any cellular element in the blood or bone marrow, as in red cell leukemia (erythroleukemia).
PsoriasisPsoriasis is a long-term skin condition that may cause large plaques of red, raised skin, flakes of dry skin, and skin scales. There are several types of psoriasis, including psoriasis vulgaris, guttate psoriasis, inverse psoriasis, and pustular psoriasis. Symptoms vary depending on the type of psoriasis the patient has. Treatment of psoriasis may include creams, lotions, oral medications, injections and infusions of biologics, and light therapy. There is no cure for psoriasis.
RashThe word "rash" means an outbreak of red bumps on the body. The way people use this term, "a rash" can refer to many different skin conditions. The most common of these are scaly patches of skin and red, itchy bumps or patches all over the place.
Rheumatoid ArthritisRheumatoid arthritis (RA) is an autoimmune disease that causes chronic inflammation of the joints, the tissue around the joints, as well as other organs in the body. Because it can affect multiple other organs of the body, rheumatoid arthritis is referred to as a systemic illness and is sometimes called rheumatoid disease.
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.