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Medications > Prednisone > Prednisone – Detailed Information

Prednisone

What is Prednisone?

Prednisone is a synthetic hormone commonly referred to as a “steroid”.  Prednisone is very similar to cortisone, a corticosteroid hormone produced by your adrenal glands.  Prednisone is used for the treatment of Rheumatoid Arthritis, Psoriatic Arthritis, Polymyalgia Rheumatica, Systemic Lupus Erythematosus, vasculitis, many other types of arthritis, and for diseases other than arthritis.

How does Prednisone work?

Prednisone works by suppressing the body’s immune system.  Although this suppression can make it slightly harder for you to fight off infections, it also stabilizes the immune system if it is overactive.  Prednisone also works to reduce inflammation (heat, redness, swelling, & pain).

What is the usual dose of Prednisone?

  • Prednisone is usually taken by mouth (tablets).  Medications similar to Prednisone (other corticosteroids) can be given by injection.
  • Prednisone is available in 1, 5, and 50 mg tablets.  The dose is variable and can range from 1 mg per day to 100 mg per day.
  • Your dose may be increased during stressful events (such as surgery or other medical illness) to mimic the body’s normal response.

How often do I take Prednisone?

  • Prednisone is usually taken once a day.  Taking your prednisone in the morning with breakfast mimics your body’s natural production of corticosteroid hormones.
  • Occasionally, your doctor may ask you to take Prednisone every other day and sometimes even twice to three times a day.

Who should Not take Prednisone?

  • Patients who have had a previous serious allergic reaction to Prednisone.

When will I start to feel the effects of Prednisone?

Most patients start to feel the effects of prednisone within a few days.  Some patients will start feeling better hours after taking the first pill.

What Medications are safe with Prednisone?

All medications can be given safely with Prednisone.  As an example, some of the medications which may be safely added to Prednisone include: Acetaminophen (Tylenol), Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), Other DMARDs (i.e. Methotrexate, Sulfasalazine, Hydroxychloroquine, and Gold), and Biologics (i.e. Etanercept, Infliximab, Anakinra).

What are the side-effects of Prednisone?

Not all patients who take prednisone have side-effects.  The side-effects are largely related to the dose and the length of time you take the prednisone.  Therefore, higher doses taken for long periods of time would be more likely to cause side-effects than short courses of lower dose prednisone.

Short-term side effects

As the dose of prednisone is decreased and stopped these side-effects disappear.

  • Prednisone can affect your mood.  Some patients feel full of energy (euphoric) which may result in difficulty with sleeping while others patients may feel depressed or irritable or rarely have hallucinations.
  • Prednisone increases your appetite which may result in weight gain.
  • Prednisone can cause swelling of the face or the upper part of the back.
  • Prednisone can sometimes upset the stomach with nausea or indigestion.
  • Prednisone may cause blurry vision.
  • Prednisone can decrease your resistance to infection.  Any infections or fevers should be taken seriously and reviewed by your doctor.
  • In women, Prednisone may cause alterations in the menstrual cycle.
  • Prednisone may cause a rise in  blood sugars sometimes resulting in diabetes.
  • Prednisone may cause a rise in blood pressure or fluid retention (ankle swelling).

Long-term side-effects

These side-effects might occur when Prednisone has been used for long periods of time.  In many patients, the side-effects can be reduced by appropriate prevention.

  • Prednisone can affect your skin.  You may notice an increase in acne, hair growth, easy bruising, or wounds which take longer to heal.
  • After prolonged use of Prednisone, cataracts or glaucoma may develop.
  • In some patients, Prednisone can cause loss of calcium from the bones resulting in fragile bones (osteoporosis).
  • A rare side-effect of Prednisone is damage to bones (osteonecrosis).  This can occur in any bone but the most common site is the hip, resulting in groin pain.
  • Prednisone rarely causes the muscles around the hips and shoulders to become weak with difficulty climbing stairs or getting up from a chair.

How can I help to minimize the side-effects of Prednisone?

  • Take your Prednisone as prescribed and attend regular follow-up visits.
  • If you will be taking Prednisone for a prolonged period (> 3 months) obtain a MEDIC-ALERT BRACELET (www.medicalert.ca or phone 1-800-668-1507).
  • Taking your Prednisone with food can help to reduce problems with nausea.
  • Follow a diet to maintain your weight.
  • Your doctor may prescribe a medication to reduce the risk of osteoporosis. Please make sure you are taking appropriate amounts of calcium and vitamin D. Discuss this with your doctor.

Do I need to have regular blood tests while taking Prednisone?

NO, you do not need to have regular blood tests while taking Prednisone.  However, your doctor will likely order blood tests to help follow the activity of your disease.

How do I stop the Prednisone?

  • DO NOT STOP YOUR PREDNISONE ABRUPTLY.  Prednisone needs to be GRADUALLY REDUCED.
  • Stopping Prednisone too quickly can sometimes result in SERIOUS side-effects.
  • DISCUSS WITH YOUR DOCTOR before making any changes in your dose.
  • If you are planning a trip, always take an extra supply.

What should I do if I miss a dose of Prednisone?

If you forget to take your prednisone at the usual time but remember later on the same day, take the missed dose immediately.  If you forgot to take yesterday’s dose, skip yesterday’s dose and take your usual dose for today.

If you are on an alternate day schedule and forgot yesterday’s dose, take yesterday’s dose today.  Tomorrow resume the alternate day schedule.

Is Prednisone safe in Pregnancy?

It is generally advisable to avoid all medications during pregnancy and while you are trying to become pregnant.  However, Prednisone is believed to be one of the safer medications and has been used safely and successfully to treat arthritis during pregnancy.