Prednisone

About Prednisone

Prednisone is a drug that comes under the class of steroids and is a corticosteroid. There are two kinds of corticosteroids, they are Mineralocorticoids and Glucocorticoids. The drug in question, Prednisone is a glucocorticoid. Glucocorticoids are eminent for their extremely powerful anti-inflammatory properties.  The side effects of prolonged use can do more harm than good. One good reason for its prescription being for a shorter duration is because prednisone is a high potency drug.

Akin to the action of cortisol, this steroid actually works by weakening the immune system and reducing inflammation. Even though it is close to cortisol, it is considered four-fold effective in controlling inflammation.

Discovery of Prednisone

Arthur Nobile, an American Microbiologist, is the father of this powerful anti-inflammatory drug, Prednisone, more than 6 decades ago.  It was discovered by Nobile in 1950 and received the approval from FDA in 1955.

This milestone paved the way for treatment of many medical conditions, especially arthritis. Today, this drug is used to treat allergies, skin conditions, asthma, lupus, ulcerative colitis, and multiple sclerosis. This drug assists in reducing the inflammation and has indeed been a life saver for many medical conditions.

The main role of this drug is to suppress the immune system and is administered either an inhaler, injection or a pill. The function of the drug Prednisone and its impact is just like the other corticosteroids, dexamethasone (Decadron), methylprednisolone (Medrol) triamcinolone (Kenacort) prednisolone (Prelone).

Ingredients of Prednisone

The available strength of prednisone in the oral tablet is 5 mg, 10 mg, and 20 mg. The other ingredients are 5 mg: colloidal silicon dioxide, microcrystalline cellulose, anhydrous lactose, magnesium stearate, talc, and sodium starch glycolate.

How does it work?

Prednisone is available as a liquid, delayed-release tablet, and an immediate release tablet. All these can be consumed orally. Prednisone is available in its generic form as a delayed-release tablet under the brand name, Rayos.

• Prednisone acts on the immune system and reduces its activity.
• It reduces the pace at which the body responds to injury and disease.
• Prednisone acts by reducing certain symptoms associated with the immune system like swelling and inflammation. T
• These drugs behave just like cortisol, the naturally produced corticosteroid in the adrenal glands.

Dosage

The dosage of the drug is an important factor in treating any condition and prednisone is no exception.

• The dosage is entirely dependent on the medical condition it is meant for and the patient’s age.
• The initial dose could be from 5 mg to 60 mg per day and is usually set after evaluation of patient response.
• Further, Corticosteroids are not immediately effective after consumption and may take days before its impact can be experienced.
• The dosage of prednisone has to be specific to suit each case and condition. Care must be taken regarding dosage as it is quite tricky. A higher or low dose will not have the desired effect. Another, key factor in the dosage of this drug is to taper the dose gradually after prolonged use so as to allow the adrenal glands to restore its
• It is very important for patients to read the label as well as adhere to instructions from the medical practitioner in the use of this drug.

How to use Prednisone

The advice of a medical practitioner must be sought before starting this drug even after one course. Instructions need to be followed very strictly. The medication should always be consumed with food. Prednisone can be taken orally but not on an empty stomach as it can trigger a stomach upset

• Patients must not resort to more than the dose recommended
• Measurements need to be exact while taking the liquid form of this medication
• The dosing schedule and quantity should exactly be as per the prescription as it is tailor-made to suit the medical condition
• The length of the treatment advised should be followed
• The drug must not be stopped all of a sudden especially with prolonged use
• Sudden cessation of prednisone can cause fatigue, dizziness, nausea, headache, and pain in the muscles
• In order to avoid these withdrawal symptoms, the dosage of this drug is gradually tapered so that the systems in the body adjust.

Facts on Prednisone

• Prednisone may increase appetite causing its users to remain perennially hungry with this medication
• The taste buds may perform a disappearing act. Patients have complained that about a funny taste in the mouth. A craving for mint or other mouth fresheners has also been recorded among users of this drug.
• Restlessness and trouble falling asleep is a common complaint of prednisone users
• Irritability and mood swings are high among prednisone users. Some complaint about losing their cool over the slightest of provocation, only to regret later.
• There could be spikes of high energy making patients want to perform energetic activities.
• Users of this drug also report feeling lethargic.

Uses and Benefits of Prednisone

Prednisone acts well to alleviate symptoms in the following medical conditions. They are:

• Arthritis
• Asthma
• Crohn’s disease
• Systemic Lupus
• Skin allergies and Rashes
• Fluid Accumulation in the Brain
• Psoriasis
• Post kidney transplant to offset rejection of organ

Management of kidney diseases such as:

• Minimal change disease (MCD)
• Focal glomerulosclerosis (FSGS)

IgA nephropathy: Prednisone is used to treat kidney diseases such as the above which could lead to nephrotic syndrome. It helps reduce the incidence of protein leak into the urine, medically called proteinuria.

• Myasthenia Gravis
• Multiple sclerosis
• Leukemia
• Hodgkin’s lymphoma
• Lymphomas
• Vasculitis
• Autoimmune hemolytic anemia
• Rheumatoid Arthritis
• TB involving the lungs
• Follicular Lymphoma
• Addison’s Disease
• Bell’s Palsy that causes partial paralysis of the face
• Increased calcium in the blood from sarcoidosis
• Presence of Polyps in the Nose
• Prednisone is also employed as replacement therapy in those whose adrenal glands are unable to produce adequate amounts of cortisol.

Side-effects

Prednisone is a potent drug. The side effects of prednisone are in varying degrees dependant on the dosage, and duration of use. The side effects are more common when it is a higher dose and prolonged use. Minor side effects could be nausea and stomach problems, while the major ones can be permanent like organ damage.

Prednisone side-effects manifest even as exacerbation n of existing health conditions. For instance, in the presence of diabetes, or latent diabetes, prednisone can trigger the onset of the condition or even worsen the condition. It is therefore advised that diabetics seek the advice of their medical experts regarding the dosage of diabetes medications.

Allergic reaction: A severe allergic reaction that can even be life-threatening for instance anaphylaxis is very much a possibility with prednisone.  Angioedema or inflammation of the airways can occur which can block the airway and lead to breathing problems.

Immune suppression: The immune system gets suppressed by this drug which also means the vulnerability of infections goes up. It can also cause the efficiency of antibiotics and drugs to drop.

Long term use of prednisone could also weaken bones that can result in fractures. Experts’ advice the intake of calcium and Vitamin D supplements to counter bone loss. Osteoporosis is a very likely possibility.

Atrophy of adrenal glands: When prednisone is consumed long term, it can lead to a weakening of adrenal glands. The glands are unable to perform the natural production of cortisol, which is a natural corticosteroid.

Necrosis of hips and joints: Prolonged use of prednisone could lead to serious damage to the hip bone, in most severe cases, it can lead to degeneration of the hip bone, leading to hip replacement surgery. Nearly 3 to 4% of patients on corticosteroids such as prednisone for the long term may need surgical intervention for the hip. It can cause problems in the knee too.

Minor Side Effects Include:

• Acne
• Feeling of restlessness
• Nausea
• Sleep Troubles
• Headache
• Weight gain
• Loss of potassium
• Fluid retention
• Skin issues
• Muscle weakness

If the side effects disappear in a few days, there is no cause for concern, but the severe ones may persist in which case the advice of a medical practitioner will go a long way.

Major side effects

• High blood pressure
• Glaucoma
• Amnesia
• Uncontrolled diabetes
• Low blood pressure
• Syncope
• Vision problems
• Amenorrhea (lack of menstruation)
• Irregular menstrual cycle
• Puffiness on the face
• Pancreatitis
• Cataracts
• The tendency for skin bruises
• Congestive heart failure
• Heart attack
• Tachycardia
• Vasculitis
• Anemia
• Hiccups
• Allergic dermatitis
• Growth of facial hair
• Anaphylaxis
• Thinning and easy bruising of the skin
• Pulmonary edema
• Stomach ulcers
• Necrosis of joints and hips
• Impaired wound healing
• Hypothyroidism
• Hyperglycaemia
• Obesity
• Convulsions
• Thrombophlebitis

Long term use of this drug can also cause psychiatric disturbances

• Insomnia
• Mood swings
• Personality changes
• Psychotic behavior
• Depression
• Euphoria

Reduce the risk of side effects

Prednisone is known to interact with other medications. These interactions could either upset the way the drug works in the body or reduce its efficiency. It may even cause some harm to certain interactions.

• It is imperative that the guidance of a medical expert is taken to manage all the medications with care and caution.
• In order to make the most of corticosteroid medication and minimize the risk, a good way is to stick to lower doses.  Consuming doses intermittently can help in this objective
• A trial with lower doses best as the more recent corticosteroids are available in varying strengths and duration. It is good to consult with the medical expert regarding short term low dose consumption of prednisone.
• In this respect, corticosteroids which are not in oral form, for instance, inhalers to treat asthma protect the rest of the body form the onslaught of side effects because it reached the lungs directly. The side effects are much lesser compared to oral corticosteroids.
• Dietary and lifestyle choices towards better health are imperative for the success of this treatment. In the case of prolonged corticosteroid use, It is important to consult with the medical expert and thrash out ways to minimize the adverse side effects of prolonged use of corticosteroids.
• The corticosteroids must be weaned gradually especially after prolonged use. This is to give the adrenal glands adequate time to recover since the drug will have weakened its function.
• Another strategy to help with quick action response in times of an emergency will be to sport a medical alert badge/bracelet on the person. This identification could be a flag about long term corticosteroid use so it can alert medical experts during an emergency.
• Those that are using corticosteroids for the long term should get regular medical check-ups done. This is important to evaluate the side effects to provide a timely remedy.

Consider the risks and benefits of corticosteroid use. The use of this medication alleviates the symptoms of many medical conditions while reducing pain, inflammation, and discomfort. It is good to work in tandem with the medical specialist so strategies can be devised to reduce the risk of major side effects.

Drugs Interactions

Some of the drug interactions with the use of prednisone are indicated below:

Live vaccines: The action of prednisone in the body weakens the immune system. Therefore, if a live vaccine injection is taken the risk of infection looms large. The immune system is not equipped to deal with a live vaccine

Bupropion: This drug combo ( bupropion with prednisone) may trigger seizures.

Mifepristone:  Mifepristone consumed when prednisone is already being taken may reduce the working efficiency of the drug. It is advisable to avoid this combination

Haloperidol: This drug taken along with prednisone may cause heart rhythm abnormalities.

Diabetes drugs: Drugs that are consumed to treat diabetes may interact with prednisone and may elevate blood glucose levels. This could pose a huge obstacle in the management of diabetes.

References
https://www.healthline.com/health/prednisone-oral-tablet
https://www.medicinenet.com/prednisone/article.htm
https://medlineplus.gov/druginfo/meds/a601102.html
https://www.cancer.gov/about-cancer/treatment/drugs/prednisone
https://medlineplus.gov/druginfo/meds/a601102.html

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