Why is it prescribed?
Prednisone is used to treat and relieve symptoms of different respiratory disorders (e.g. asthma, pneumonia). Prednisone is also used for many other disorders and diseases but this material will be limited to the respiratory tract.
Along with its needed effects, prednisone may cause some unwanted or undesirable effects. The frequency and severity of these effects is dependant on many factors including dose, duration of therapy and individual response. Your pharmacist will be able to tell you which ones will be more likely to occur with your particular treatment plan. Possible unwanted effects include:
- upset stomach
- increased appetite
- weight gain
- sleep disturbances
- fluid retention
- higher blood sugar levels
- increased risk of infection
- impaired wound healing
- peptic ulcers
- growth retardation in children (prolonged treatment at anti-inflammatory doses)
- Cushing's Syndrome (long-term use): Appearance of "moonface"(facial rounding); enlargement of some fat pad areas; obesity in the midsection; diabetes; osteoporosis; acne; excessive body hair growth; muscle weakness
- withdrawal effect, if therapy is discontinued abruptly (nausea, fatigue, lowered blood pressure, joint and muscle aches, fever, dizziness, fainting)
- muscle weakness
- mental disturbances
Prednisone is considered an important drug in cases where anti-inflammatory activity or suppression of the body's immune system is desirable. The mechanism by which prednisone exerts it's anti-inflammatory effect is not clear but it is thought that many factors are involved. Its ability to affect the body's immune system is also due to several factors that take place at the cellular level.
High dose or long term therapy must be withdrawn gradually (tapered).
Growth may be suppressed in children receiving long-term daily therapy.
While taking prednisone, signs of infection can be masked and new infections may appear.
Diabetics may need to increase their dose of insulin or oral diabetes medications.
Prednisone can cause mental or mood disturbances (e.g. depression).
Drug Interactions: It is important to tell your doctor and pharmacist of any over-the-counter or prescription medications you are taking. The dose of one or both medications may need to be altered or a new medication may need to be prescribed. The following drugs and drug classes have been known to interact with prednisone:
- barbiturates (e.g. phenobarbital)
- phenytoin (e.g. Dilantin®)
- rifampin (e.g. Rifadin®)
- nonsteroidal anti-inflammatory drugs (e.g. Aspirin®)
- warfarin (e.g. Coumadin®)
- antidiabetic agents (e.g. insulin)
- cyclosporine (e.g. Neoral®)
Your pharmacist will be able to answer any questions you may have regarding the seriousness or the mechanism of the interaction.
Use is not recommended in the following situations:
- allergy to prednisone or any component of the preparation
- fungal infections
- administration of live vaccines in people who are taking doses of prednisone high enough to suppress the body's immune system.
Caution is recommended in the following situations:
- high blood pressure
- diverticulitis (inflammation of the sacs or pouches that are formed at weak points in the wall of the colon causing abdominal pain with diarrhea or constipation)
- peptic ulcers
- herpes simplex in the eye
- kidney disease
- liver disease
- psychiatric conditions
- myasthenia gravis
- ulcerative colitis (inflammation of the colon causing symptoms like diarrhea with or without blood and mucus, and lower abdominal pain)
Use in pregnancy: Prednisone may pose a small risk to the developing fetus. Consult your doctor or pharmacist if you suspect that you may be pregnant.
Use while breastfeeding: Short-term use is considered safe. Limit dose and duration of therapy, when possible.