Prednisone

Prednisone - Use | Dose | Side Effects

Prednisone is a medicine from a group of corticosteroids and is used in the treatment of many diseases with etiological origins in inflammatory processes. According to the Patient Information Leaflet (PIL) Prednisone is used in the treatment of the following diseases:

  • Allergic reactions
  • Bronchial asthma (usually in combination with bronchodilators)
  • Addison's disease
  • Sarcoidosis
  • Pulmonary fibrosis
  • Idiopathic retroperitoneal fibrosis
  • Pulmonary aspergillosis
  • Autoimmune hemolytic anemia
  • Hypercalcaemia caused by malignant lymphoma
  • Prophylaxis of postherpetic neuralgia
  • Jackknife seizures
  • Myasthenia gravis
  • Guillain-Barre syndrome (an autoimmune disease characterized by polyneuropathy)
  • Tolosa-Hunt syndrome (inflammatory disease characterized by severe periorbital headaches)
  • Multiple sclerosis
  • Endocrine orbitopathy
  • Malignant ophthalmic Graves' disease
  • Ulcerative colitis
  • Crohn's disease
  • Scleritis (inflammatory disease of the white outer wall of the eye that threatens vision)
  • Episcleritis (inflammatory disease of the episcleral tissue in the eye that does not threaten vision)
  • Hodgkin's lymphoma
  • Non-Hodgkin's lymphoma
  • Waldenstrom's macroglobulinemia
  • Multiple myeloma
  • Thrombocytopenia including thrombocytopenic purpura
  • Jarisch - Herxheimer reaction (a reaction that is characterized by the release of the toxins after the death of the bacteria and other microorganisms)
  • Behcet's disease (an autoimmune disease characterized by the occurrence of aphthous ulcers in the mouth and genital area)
  • Prophylaxis of respiratory distress syndrome
  • Rheumatic fever
  • Rheumatic polymyalgia
  • Polymyositis
  • Chronic polyarthritis
  • Juvenile chronic arthritis
  • Systemic lupus erythematosus
  • Pemphigus (an autoimmune skin disease that is characterized by the appearance of blisters on the skin, especially in elderly patients)
  • Tuberculous meningitis
  • Adrenal insufficiency
  • Lupus nephritis

Precautions

Contraindications to the use of the Prednisone are:

  • Serious infections
  • Herpetic eye infections
  • Hypersensitivity to the Prednisone

Prednisone should not be used in the following conditions:

  • HBsAg-positive chronic active hepatitis
  • Two months before and fourteen days after prophylactic vaccination
  • Herpes simplex infection
  • Herpes zoster infection
  • Other viral infections

Prednisone may be used only with extra precaution and only after the consultations with your doctor in the following situations:

  • Ulcers in the stomach and duodenum
  • Acute and chronic bacterial infections
  • Fungal infections affecting the skin and internal organs
  • Infections caused by parasites
  • Unstable hypertension
  • Osteoporosis
  • Neuropsychiatric disorders
  • Glaucoma
  • Diverticulitis
  • Cushing's disease

Use of this drug for an extended period of time can lead to hypothalamic-pituitary-adrenal (HPA) suppression, which can threaten life! The risk of this adverse effect is increased if this drug is rapidly discontinued. Therefore, it is very important to reduce the dose gradually before finally completely stopping Prednisone.

For example, if you've been taking 5 mg of Prednisone a day, it is first necessary to reduce the dose to 2.5 mg per day which should be used for about one week, and then the dose should be reduced again to 1.25 mg per day and used for one more week and then you can finally stop using this medicine. Your doctor will explain how to eject from prednisone therapy.

Bear in mind that Prednisone works as an immunosuppressive drug, which means that it will weaken your immune system significantly. Because of this, it will be difficult for your body to fight against infections caused by bacteria, viruses, parasites and other microorganisms. If you notice signs of infection while taking this drug, inform your doctor immediately.

Prednisone, pregnancy and breastfeeding

Prednisone can cause intrauterine growth retardation and cleft palate, and its use during pregnancy is recommended only in situations where the benefits to the mother outweigh the risks to the fetus. Cases of hypoadrenalism (reduced levels of adrenaline in the blood) in newborns have been reported, but symptoms quickly go away without any complications. Cases of cataracts in newborns whose mothers took this drug during pregnancy have been reported.

Since it is excreted into breast milk in the concentrations which correspond to 5-25% of the maternal dose, breastfeeding should be avoided.

Dosage

Dose ranges from 5-60 mg per day and depends primarily on the disease and its severity.

Use of this medicine in children can slow their growth and development, therefore use of Prednisone in patients under the age of 18 should be limited to the shortest possible time. In order to minimize the risk of growth and developmental delay in children Prednisone is often taken once every other day.

It is very important that you take Prednisone tablets regularly. Never stop the treatment with this medicine without consulting your doctor. The abrupt withdrawal of Prednisone may lead to the HPA suppression which can be fatal!

Interactions

Prednisone should not be used simultaneously with the following medicines:

  • Adalimumab (a monoclonal antibody which is used in treatment of rheumatoid arthritis and ankylosing spondylitis). Co-administration of these drugs can significantly weaken your immune system, which further increases the risk of severe infections
  • Leflunomide and teriflunomide (medicines used in the treatment of multiple sclerosis). These drugs weaken the immune system, just like Prednisone, and taking these drugs concomitantly increases the risk of serious infections.
  • Quinolone antibiotics (norfloxacin, ofloxacin, ciprofloxacin, levofloxacin and moxifloxacin). Concomitant use of Prednisone with these drugs increases the risk of tendon rupture.
  • Bupropion (a drug used for smoking cessation and as an antidepressant). Co-administration of these drugs increases the risk of seizures.
  • Etanercept and infliximab (medicines used in the treatment of autoimmune diseases). These drugs weaken the immune system, just like Prednisone, which increases the risk of serious infections.
  • Deferasirox (a drug used to treat chronic hemochromatosis). Concomitant use of these drugs increases the risk of digestive side effects.
  • Mifepristone (a drug used in the termination of pregnancy). This medicine can reduce the effect of the Prednisone.
  • Vigabatrin (a drug used to treat epilepsy). Co-administration of these two drugs increases the risk of vision loss.

Side effects

If you notice any of the following side effects, contact your doctor immediately:

  • Severe pain in the stomach (which is a sign of pancreatitis)
  • Seizures
  • Vision problems
  • The appearance of bruises, reddening of the skin in the form of spots and frequent bleeding of the gums or nosebleeds (which indicates the occurrence of thrombocytopenia)
  • Increased eye pressure
  • Increased intracranial pressure and headaches
  • Difficulty breathing
  • Insomnia
  • Hirsutism (excess hair growth)
  • Generalized weakness
  • Muscle pain
  • Tendon rupture
  • Bone fractures
  • Fluid retention
  • High blood pressure
  • Loss of muscle mass in the arms and legs
  • Increase in body weight
  • Increased sweating
  • Bloating
  • Indigestion