prednisone

Prednisone is a corticosteroid. It prevents the release of substances in the body that cause inflammation. It also suppresses the immune system.

Prednisone is used as an anti-inflammatory or an immunosuppressant medication. Prednisone treats many different conditions such as allergic disorders, skin conditions, ulcerative colitis, arthritis, lupus, psoriasis, or breathing disorders.

Important information

Prednisone treats many different conditions such as allergic disorders, skin conditions, ulcerative colitis, arthritis, lupus, psoriasis, or breathing disorders.

You should not take prednisone if you have a fungal infection anywhere in your body.

Steroid medication can weaken your immune system, making it easier for you to get an infection. Avoid being near people who are sick or have infections. Do not receive a "live" vaccine while using prednisone.

Call your doctor at once if you have shortness of breath, severe pain in your upper stomach, bloody or tarry stools, severe depression, changes in personality or behavior, vision problems, or eye pain.

You should not stop using prednisone suddenly. Follow your doctor"s instructions about tapering your dose.

Before taking this medicine

You should not use this medication if you are allergic to prednisone, or if you have a fungal infection anywhere in your body.

Steroid medication can weaken your immune system, making it easier for you to get an infection or worsening an infection you already have or have recently had. Tell your doctor about any illness or infection you have had within the past several weeks.

To make sure prednisone is safe for you, tell your doctor if you have:

• any illness that causes diarrhea;

• liver disease (such as cirrhosis);

• kidney disease;

• heart disease, high blood pressure, low levels of potassium in your blood;

• a thyroid disorder;

• diabetes;

• a history of malaria;

• tuberculosis;

• osteoporosis;

• glaucoma, cataracts, or herpes infection of the eyes;

• stomach ulcers, ulcerative colitis, or a history of stomach bleeding;

• a muscle disorder such as myasthenia gravis; or

• depression or mental illness.

Long-term use of steroids may lead to bone loss (osteoporosis), especially if you smoke, if you do not exercise, if you do not get enough vitamin D or calcium in your diet, or if you have a family history of osteoporosis. Talk with your doctor about your risk of osteoporosis.

Prednisone can cause low birth weight or birth defects if you take the medicine during your first trimester. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. Use effective birth control.

Prednisone can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Steroids can affect growth in children. Talk with your doctor if you think your child is not growing at a normal rate while using this medicine.

How should I take prednisone?

Take prednisone exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Take prednisone with food.

Your dosage needs may change if you have any unusual stress such as a serious illness, fever or infection, or if you have surgery or a medical emergency. Do not change your medication dose or schedule without your doctor"s advice.

Measure liquid prednisone with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.

Do not crush, chew, or break a delayed-release tablet. Swallow it whole.

While using prednisone, you may need frequent blood tests at your doctor"s office. Your blood pressure may also need to be checked.

This medication can cause unusual results with certain medical tests. Tell any doctor who treats you that you are using prednisone.

You should not stop using prednisone suddenly. Follow your doctor"s instructions about tapering your dose.

Wear a medical alert tag or carry an ID card stating that you take prednisone. Any medical care provider who treats you should know that you are using a steroid.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

An overdose of prednisone is not expected to produce life threatening symptoms. However, long term use of high steroid doses can lead to symptoms such as thinning skin, easy bruising, changes in the shape or location of body fat (especially in your face, neck, back, and waist), increased acne or facial hair, menstrual problems, impotence, or loss of interest in sex.

What should I avoid?

Avoid being near people who are sick or have infections. Call your doctor for preventive treatment if you are exposed to chicken pox or measles. These conditions can be serious or even fatal in people who are using a steroid.

Do not receive a "live" vaccine while using this medicine. Prednisone may increase your risk of harmful effects from a live vaccine. Live vaccines include measles, mumps, rubella (MMR), rotavirus, typhoid, yellow fever, varicella (chickenpox), zoster (shingles), and nasal flu (influenza) vaccine.

Avoid drinking alcohol while you are taking prednisone.

Prednisone side effects

Get emergency medical help if you have any of these signs of an allergic reaction to prednisone: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

• blurred vision, eye pain, or seeing halos around lights;

• swelling, rapid weight gain, feeling short of breath;

• severe depression, feelings of extreme happiness or sadness, changes in personality or behavior, seizure (convulsions);

• bloody or tarry stools, coughing up blood;

• pancreatitis (severe pain in your upper stomach spreading to your back, nausea and vomiting, fast heart rate);

• low potassium (confusion, uneven heart rate, extreme thirst, increased urination, leg discomfort, muscle weakness or limp feeling); or

• dangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, confusion, chest pain, shortness of breath, uneven heartbeats, seizure).

Other common prednisone side effects may include:

• sleep problems (insomnia), mood changes;

• increased appetite, gradual weight gain;

• acne, increased sweating, dry skin, thinning skin, bruising or discoloration;

• slow wound healing;

• headache, dizziness, spinning sensation;

• nausea, stomach pain, bloating; or

• changes in the shape or location of body fat (especially in your arms, legs, face, neck, breasts, and waist).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Prednisone dosing information

Usual Adult Dose for Nephrotic Syndrome:

Initial (first three episodes): 2 mg/kg/day (maximum 80 mg/day) in divided doses 3 to 4 times/day until urine is protein free for 3 consecutive days (maximum: 28 days); followed by 1 to 1.5 mg/kg/dose given every other day for 4 weeks.
Maintenance dose for frequent relapses: 0.5 to 1 mg/kg/ dose given every other day for 3 to 6 months.

Usual Adult Dose of Prednisone for Anti-inflammatory:

5 to 60 mg per day in divided doses 1 to 4 times/day.

Usual Pediatric Dose for Nephrotic Syndrome:

Initial (first three episodes): 2 mg/kg/day (maximum 80 mg/day) in divided doses 3 to 4 times/day until urine is protein free for 3 consecutive days (maximum: 28 days); followed by 1 to 1.5 mg/kg/dose given every other day for 4 weeks.
Maintenance dose for frequent relapses: 0.5 to 1 mg/kg/ dose given every other day for 3 to 6 months.

Usual Pediatric Dose for Asthma:

< I year:
acute: 10 mg orally every 12 hours.
maintenance: 10 mg orally very other day.

1 to 4 years:
acute: 20 mg orally every 12 hours.
maintenance: 20 mg orally every other day.

5 to 12 years:
acute: 30 mg orally every 12 hours.
maintenance: 30 mg orally every other day.

>12 years:
acute: 40 mg orally every 12 hours.
maintenance: 40 mg orally every other day.

Usual Pediatric Dose of Prednisone for Anti-inflammatory:

0.05 to 2 mg/kg/day divided 1 to 4 times/day

Usual Pediatric Dose for Immunosuppression:

0.05 to 2 mg/kg/day divided 1 to 4 times/day

What other drugs will affect prednisone?

Many drugs can interact with prednisone. Not all possible interactions are listed here. Tell your doctor about all your medications and any you start or stop using during treatment with prednisone, especially:

• amphotericin B;

• cyclosporine;

• digoxin, digitalis;

• St. John"s wort;

• an antibiotic such as clarithromycin or telithromycin;

• antifungal medication such as itraconazole, ketoconazole, posaconazole, voriconazole;

• birth control pills and other hormones;

• a blood thinner such as warfarin, Coumadin;

• a diuretic or "water pill";

• the hepatitis C medications boceprevir or telaprevir;

• HIV or AIDS medicine such as atazanavir, delavirdine, efavirenz, fosamprenavir, indinavir, nelfinavir, nevirapine, ritonavir, saquinavir;

• insulin or diabetes medications you take by mouth;

• a non-steroidal anti-inflammatory drug (NSAID) such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others;

• seizure medications such as carbamazepine, fosphenytoin, oxcarbazepine, phenobarbital, phenytoin, primidone; or

• the tuberculosis medications isoniazid, rifabutin, rifapentine, or rifampin.

This list is not complete and many other drugs can interact with prednisone. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.