Prednisone

Brand names

• Apo-Prednisone
• Aspred-C [CD]
• Deltasone
• JAA-Prednisone
• Liquid Pred
• Meticorten
• Metreton [CD]
• Novo-Prednisone
• Orasone
• Panasol-S
• Paracort
• Winpred

Usage

To treat numerous conditions that involve inflammation (a response by body tissues, producing redness, warmth, swelling, and pain). Such conditions include arthritis, allergic reactions, asthma, some skin diseases, multiple sclerosis flare-ups, and other autoimmune diseases. Also prescribed to treat deficiency of natural steroid hormones.

How it works

Prednisone mimics the body's natural corticosteroid hormones. It depresses the synthesis, release, and activity of inflammation-producing body chemicals. It also suppresses the activity of the immune system.

Side effects

Serious

Vision problems, frequent urination, increased thirst, rectal bleeding, blistering skin, confusion, hallucinations, paranoia, euphoria, depression, mood swings, redness and swelling at injection site.

Common

Increased appetite, indigestion, nervousness, insomnia, greater susceptibility to infections, increased blood pressure, slowed wound healing, weight gain, easy bruising, fluid retention.

Less common

Change in skin color, dizziness, headache, increased sweating, unusual growth of body or facial hair, increased blood sugar, peptic ulcers, adrenal insufficiency, muscle weakness, cataracts, glaucoma, osteoporosis.

Possible interactions

Other medicaments:

Prednisone may decrease the effects of:

• insulin (various), requiring dosing changes of insulin.
• isoniazid (INH, Niconyl, etc.).
• salicylates (aspirin, sodium salicylate, etc.).
• vaccines (such as flu vaccine), by blunting the immune response to them.

Prednisone taken concurrently with:



• amphotericin B (Abelcet, Fungizone) may result in additive potassium loss.
• birth control pills (oral contraceptives) will prolong the prednisone effect.
• clarithromycin (Biaxin) may lead to psychotic symptoms. Patient behavior must be closely watched if these medicines are combined.
• cyclosporine (Sandimmune) can cause increased cyclosporine levels and increased prednisone levels. Dose decreases may be needed for both medicaments.
• foscarnet (Foscavir) may result in additive potassium loss.
• ketoconazole (Nizoral) will lessen the therapeutic benefits of ketoconazole.
• loop diuretics (furosemide [Lasix], bumetanide [Bumex]) may blunt their effects.
• macrolide antibiotics (erythromycin, troleandomycin and perhaps others) can lead to prednisone toxicity.
• NSAIDs may result in additive stomach and intestinal irritation.
• oral anticoagulants may either increase or decrease their effectiveness; consult your physician regarding the need for prothrombin time testing and dose adjustment.
• oral antidiabetic medicaments or insulin may result in loss of glucose control.
• ritonavir (Norvir) and perhaps other protease inhibitors may lead to toxicity.
• theophylline (Theo-Dur, others) may result in variable responses to this medicine. Increased frequency of theophylline level testing is recommended.
• thiazide diuretics or loop diuretics may result in additive potassium loss.
• vaccines (flu, pneumococcal, varicella and others) may result in blunted response to the vaccine and decreased preventive benefits.

The following medicaments may decrease the effects of prednisone:



• antacids-may reduce its absorption.
• barbiturates (Amytal, Butisol, phenobarbital, etc.).
• carbamazepine (Tegretol).
• phenytoin (Dilantin, etc.) and fosphenytoin (Cerebyx).
• primidone (Mysoline).
• rifampin (Rifadin, Rimactane, etc.).

Foods:

Ask your doctor about restricting salt or eating potassium-rich foods. During long-term use, it is best to eat a high-protein diet.

Herbal medicines or minerals:

Hawthorn, ginger, garlic, ma huang, ginseng and nettle may change blood sugar.
Fir or pine needle oil should not be used by asthmatics. Ephedra alone does carry a German Commission E monograph indication for asthma treatment. If you are allergic to plants in the Asteraceae family (aster, chrysanthemum, daisy or ragweed), you may also be allergic to Echinacea, chamomile, feverfew and St. John's wort.
During long-term use, take a vitamin D supplement and increase calcium. During wound repair, take a zinc supplement. Potassium loss may need to be replaced. Talk to your doctor before adding any herbal to any other medicines that you already take.

Alcohol:

Use caution if you are prone to peptic ulcers.

Tobacco smoking:

Nicotine increases the blood levels of naturally produced cortisone.

Marijuana smoking:

May cause additional impairment of immunity.

Occurrence of unrelated illness:

This medicament may decrease resistance to infection. Tell your doctor if you develop an infection of any kind. It may also reduce your ability to respond to the stress of acute illness, injury or surgery. Keep your doctor informed of any changes in health.

Discontinuation:

After long-term use, do not stop prednisone abruptly. For 2 years after stopping this medicament, it is essential in the event of illness, injury or surgery that you tell medical personnel that you have used this medicament.