A synthetic glucocorticoid with anti-inflammatory and immunomodulating properties. After cell surface receptor attachment and cell entry, prednisone enters the nucleus where it binds to and activates specific nuclear receptors, resulting in an altered gene expression and inhibition of proinflammatory cytokine production. This agent also decreases the number of circulating lymphocytes, induces cell differentiation, and stimulates apoptosis in sensitive tumor cell populations.
Why is this medication prescribed?
Prednisone is used alone or with other medications to treat the symptoms of low corticosteroid levels (lack of certain substances that are usually produced by the body and are needed for normal body functioning). Prednisone is also used to treat other conditions in patients with normal corticosteroid levels. These conditions include certain types of arthritis; severe allergic reactions; multiple sclerosis (a disease in which the nerves do not function properly); lupus (a disease in which the body attacks many of its own organs); and certain conditions that affect the lungs, skin, eyes, kidneys blood, thyroid, stomach, and intestines. Prednisone is also sometimes used to treat the symptoms of certain types of cancer. Prednisone is in a class of medications called corticosteroids. It works to treat patients with low levels of corticosteroids by replacing steroids that are normally produced naturally by the body. It works to treat other conditions by reducing swelling and redness and by changing the way the immune system works.
How should this medicine be used?
Prednisone comes as a tablet, a solution (liquid), and a concentrated solution to take by mouth. Prednisone is usually taken with food one to four times a day or once every other day. Your doctor will probably tell you to take your dose(s) of prednisone at certain time(s) of day every day. Your personal dosing schedule will depend on your condition and on how you respond to treatment. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take prednisone exactly as directed. Do not take more or less of it or take it more often or for a longer period of time than prescribed by your doctor.
If you are taking the concentrated solution, use the specially marked dropper that comes with the medication to measure your dose. You may mix the concentrated solution with juice, other flavored liquids, or soft foods such as applesauce.
Your doctor may change your dose of prednisone often during your treatment to be sure that you are always taking the lowest dose that works for you. Your doctor may also need to change your dose if you experience unusual stress on your body such as surgery, illness, infection, or a severe asthma attack. Tell your doctor if your symptoms improve or get worse or if you get sick or have any changes in your health during your treatment.
If you are taking prednisone to treat a long-lasting disease, the medication may help control your condition but will not cure it. Continue to take prednisone even if you feel well. Do not stop taking prednisone without talking to your doctor. If you suddenly stop taking prednisone, your body may not have enough natural steroids to function normally. This may cause symptoms such as extreme tiredness, weakness, slowed movements, upset stomach, weight loss, changes in skin color, sores in the mouth, and craving for salt. Call your doctor if you experience these or other unusual symptoms while you are taking decreasing doses of prednisone or after you stop taking the medication.
Other uses for this medicine:
Prednisone is also sometimes used with antibiotics to treat a certain type of pneumonia in patients with acquired immunodeficiency syndrome (AIDS). Talk to your doctor about the risks of using this drug for your condition.
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
What special precautions should I follow?
- tell your doctor and pharmacist if you are allergic to prednisone, any other medications, or any of the inactive ingredients in prednisone tablets or solutions. Ask your doctor or pharmacist for a list of the inactive ingredients.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, and nutritional supplements you are taking or plan to take. Be sure to mention any of the following: amiodarone (Cordarone, Pacerone); anticoagulants (‘blood thinners’) such as warfarin (Coumadin); certain antifungals such as fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral) and voriconazole (Vfend);aprepitant (Emend); aspirin; carbamazepine (Carbatrol, Epitol, Tegretol); cimetidine (Tagamet); clarithromycin (Biaxin, in Prevpak); cyclosporine (Neoral, Sandimmune); delavirdine (Rescriptor); diltiazem (Cardizem, Dilacor, Tiazac, others); dexamethasone (Decadron, Dexpak); diuretics (‘water pills’); efavirenz (Sustiva); fluoxetine (Prozac, Sarafem); fluvoxamine (Luvox); griseofulvin (Fulvicin, Grifulvin, Gris-PEG); HIV protease inhibitors including atazanavir (Reyataz), indinavir (Crixivan), lopinavir (in Kaletra), nelfinavir (Viracept), ritonavir (Norvir, in Kaletra), and saquinavir (Fortovase, Invirase); hormonal contraceptives (birth control pills, patches, rings, implants, and injections); lovastatin (Altocor, Mevacor); medications for diabetes; nefazodone; nevirapine (Viramune); phenobarbital; phenytoin (Dilantin, Phenytek); rifabutin (Mycobutin), rifampin (Rifadin, Rimactane, in Rifamate); sertraline (Zoloft); troleandomycin (TAO); verapamil (Calan, Covera, Isoptin, Verelan); and zafirlukast (Accolate).Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor what herbal products you are taking or plan to take, especially St. John’s wort.
- tell your doctor if you have an eye infection now or have ever had eye infections that come and go and if you have or have ever had threadworms (a type of worm that can live inside the body); diabetes; high blood pressure; emotional problems; mental illness; myasthenia gravis (a condition in which the muscles become weak); osteoporosis (condition in which the bones become weak and fragile and can break easily); seizures; tuberculosis (TB); ulcers; or liver, kidney, intestinal, heart, or thyroid disease.
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking prednisone, call your doctor.
- if you are having surgery, including dental surgery, or need emergency medical treatment, tell the doctor, dentist, or medical staff that you are taking or have recently stopped taking prednisone. You should carry a card or wear a bracelet with this information in case you are unable to speak in a medical emergency.
- do not have any vaccinations (shots to prevent diseases) without talking to your doctor.
- you should know that prednisone may decrease your ability to fight infection and may prevent you from developing symptoms if you get an infection. Stay away from people who are sick and wash your hands often while you are taking this medication. Be sure to avoid people who have chicken pox or measles. Call your doctor immediately if you think you may have been around someone who had chicken pox or measles.
What special dietary instructions should I follow?
Your doctor may instruct you to follow a low-salt, high potassium, or high calcium diet. Your doctor may also prescribe or recommend a calcium or potassium supplement. Follow these directions carefully.
Talk to your doctor about eating grapefruit and drinking grapefruit juice while you are taking this medication.
What should I do if I forget a dose?
When you start to take prednisone, ask your doctor what to do if you forget to take a dose. Write down these instructions so that you can refer to them later. Call your doctor or pharmacist if you miss a dose and do not know what to do. Do not take a double dose to make up for a missed dose.
What side effects can this medication cause?
- difficulty falling asleep or staying asleep
- inappropriate happiness
- extreme changes in mood
- changes in personality
- bulging eyes
- thin, fragile skin
- red or purple blotches or lines under the skin
- slowed healing of cuts and bruises
- increased hair growth
- changes in the way fat is spread around the body
- extreme tiredness
- weak muscles
- irregular or absent menstrual periods
- decreased sexual desire
- increased sweating
Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:
- vision problems
- eye pain, redness, or tearing
- sore throat, fever, chills, cough, or other signs of infection
- loss of contact with reality
- muscle twitching or tightening
- shaking of the hands that you cannot control
- numbness, burning, or tingling in the face, arms, legs, feet, or hands
- upset stomach
- irregular heartbeat
- sudden weight gain
- shortness of breath, especially during the night
- dry, hacking cough
- swelling or pain in the stomach
- swelling of the eyes, face, lips, tongue, throat, arms, hands, feet, ankles, or lower legs
- difficulty breathing or swallowing
Prednisone may slow growth and development in children. Your child’s doctor will watch his or her growth carefully. Talk to your child’s doctor about the risks of giving prednisone to your child.
Prednisone may increase the risk that you will develop osteoporosis. Talk to your doctor about the risks of taking prednisone and about things that you can do to decrease the chance that you will develop osteoporosis.
Some patients who took prednisone or similar medications developed a type of cancer called Kaposi’s sarcoma. Talk to your doctor about the risks of taking prednisone.
Prednisone may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication.
*Source: National Cancer Institute
*Source: Medline Plus