Prednisone

💊 What is Prednisone used for?

• •Hormone problems, such as adrenal insufficiency, congenital adrenal hyperplasia, high calcium linked to cancer, and nonsuppurative thyroiditis
• •Short-term treatment of rheumatic conditions such as rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, bursitis, and gouty arthritis
• •Collagen diseases such as systemic lupus erythematosus and dermatomyositis
• •Skin conditions such as pemphigus, severe psoriasis, and severe seborrheic dermatitis
• •Severe allergic conditions, including bronchial asthma, allergic rhinitis, and atopic dermatitis
• •Serious eye inflammation, such as uveitis, iritis, and optic neuritis
• •Lung conditions, such as symptomatic sarcoidosis
• •Certain blood disorders, such as idiopathic thrombocytopenic purpura in adults and acquired hemolytic anemia
• •Palliative (symptom-relieving) treatment of some leukemias and other cancers

How it works

The label describes prednisone as a glucocorticoid, an adrenocortical steroid. It says corticosteroids suppress the immune system, which is why they are used for inflammation and immune-related conditions. The label does not explain the mechanism in more detail.

How it is usually taken

• •The label says it can be taken by mouth. Stomach irritation may be reduced if it is taken before, during, or right after meals, or with food or milk. The label recommends taking it in the morning, before 9 am, because the body's adrenal activity is highest in the early morning. When it is taken more than once a day, the doses are spread evenly through the day. The label says that dietary salt restriction may be advisable for some patients. Antacids between meals may be used when large doses are given, to help prevent peptic ulcers. The label says dosage needs vary and must be set individually, and that the prescriber will adjust the dose over time. Follow the instructions from your prescriber or pharmacist.

Comes as

• •1 mg tablets
• •2.5 mg tablets
• •5 mg tablets
• •10 mg tablets
• •20 mg tablets

⚠️ Prednisone side effects

🛑 Who should not take Prednisone, and who should be careful

The label says not to take it if

• 🚨You have a systemic fungal infection (the label lists this as a reason not to use prednisone).
• 🚨You have a known allergy (hypersensitivity) to any of the ingredients in the tablet.

Tell your doctor before taking it if

• •Tell your prescriber about all your medical conditions, including infections, tuberculosis or a positive TB test, hepatitis B, thyroid problems, diabetes, high blood pressure, and any recent heart attack.
• •Tell your prescriber if you have had chickenpox or measles, or if you are not sure. The label says particular care should be taken to avoid exposure to these diseases.
• •Do not stop taking this medicine without first talking to your doctor. The label says that abrupt withdrawal should be avoided, and that prolonged use can cause adrenal insufficiency and dependence.
• •Tell any medical staff who care for you that you take corticosteroids.
• •The label says that after prolonged therapy, stopping may cause corticosteroid withdrawal symptoms, including muscle pain, joint pain, and malaise (a general unwell feeling).
• •The label says that during periods of unusual stress, such as trauma, surgery, or illness, the dose may need to be increased. Talk with your prescriber about this.
• •The label says vaccines and other treatments may need review with your prescriber while taking corticosteroids.

🔀 Prednisone with other medicines, food and alcohol

The label says to discuss these with your doctor or pharmacist

• •Potassium-depleting medicines, such as amphotericin B injection and diuretics (water pills): the label says patients should be watched closely for low potassium.
• •Macrolide antibiotics: the label says they can significantly decrease how fast the body clears corticosteroids.
• •Anticholinesterase medicines, such as neostigmine and pyridostigmine: the label says they may cause severe weakness in people with myasthenia gravis.
• •Oral anticoagulants such as warfarin: the label says corticosteroids usually reduce warfarin's effect, so clotting tests may be checked often.
• •Antidiabetic medicines: corticosteroids may raise blood sugar, so diabetes medicine doses may need adjusting.
• •Isoniazid (an antitubercular drug): the label says its levels may be decreased.
• •Bupropion: the label says both can lower the seizure threshold, so they should be used together only with extreme caution.
• •Cholestyramine: the label says it may increase how fast the body clears corticosteroids.
• •Cyclosporine: the label says using both may increase the activity of each, and convulsions have been reported.
• •Digitalis glycosides (heart medicines): the label says low potassium may raise the risk of irregular heart rhythms.
• •Estrogens, including oral contraceptives: the label says they may increase the effect of certain corticosteroids.
• •Fluoroquinolone antibiotics: the label says the risk of tendon rupture may be increased when used together.
• •The label lists more interactions than are shown in the text provided. Ask your pharmacist for the full list.

Alcohol and food

The label does not discuss alcohol. It does say that stomach irritation may be reduced when prednisone is taken with food or milk, or before or after meals.

🤰 Prednisone in pregnancy and breastfeeding

Pregnancy

The label gives this medicine Pregnancy Category C. It says corticosteroids have caused birth defects (such as cleft palate) in animal studies, and there are no adequate, well-controlled studies in pregnant women. The label says corticosteroids should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Babies born to mothers who received substantial doses during pregnancy should be watched closely for signs of low adrenal activity.

Breastfeeding

The label says systemically given corticosteroids pass into human milk and could affect a nursing infant's growth or hormone production. It says a decision should be made whether to stop nursing or to stop the drug, taking into account how important the drug is to the mother.

🗓️ Storage, missed doses and taking too much

Storage

Store at 20 to 25 degrees C (68 to 77 degrees F), in a tight, light-resistant container, as defined in the USP.

If a dose is missed

The label does not say.

If too much is taken

The label does not say.

🗒️ Questions to ask about Prednisone

• What is the purpose of my prednisone, and how long am I expected to take it?
• Should I take this in the morning, and should I take it with food or milk?
• How will you lower my dose if I need to stop, and what symptoms should I watch for?
• What signs of infection should make me call you right away?
• Do any of my other medicines, including antibiotics, water pills, or blood thinners, interact with prednisone?
• Who should I tell that I am taking a corticosteroid, and what should I do if I am exposed to chickenpox or measles?

❓ Prednisone: frequently asked questions