What is prednisone?

Prednisone is in a class of drugs called steroids. Prednisone prevents the release of substances in the body that cause inflammation.

Prednisone is used to treat many different conditions such as allergic disorders, skin conditions, ulcerative colitis, arthritis, lupus, psoriasis, or breathing disorders.

Prednisone may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about prednisone?

Before taking prednisone, tell your doctor about all of your medical conditions, and about all other medicines you are using. There are many other diseases that can be affected by steroid use, and many other medicines that can interact with steroids.

Your steroid medication needs may change if you have any unusual stress such as a serious illness, fever or infection, or if you have surgery or a medical emergency. Tell your doctor about any such situation that affects you during treatment.

Steroid medication can weaken your immune system, making it easier for you to get an infection or worsening an infection you already have or have recently had. Tell your doctor about any illness or infection you have had within the past several weeks.

Avoid being near people who are sick or have infections. Call your doctor for preventive treatment if you are exposed to chicken pox or measles. These conditions can be serious or even fatal in people who are using steroid medication.

Do not receive a "live" vaccine while you are taking prednisone. Vaccines may not work as well while you are taking a steroid.

What should I discuss with my healthcare provider before taking prednisone?

Steroid medication can weaken your immune system, making it easier for you to get an infection. Steroids can also worsen an infection you already have, or reactivate an infection you recently had. Before taking this medication, tell your doctor about any illness or infection you have had within the past several weeks.

Other medical conditions you should tell your doctor about before taking prednisone include:

• liver disease (such as cirrhosis);

• kidney disease;

• a thyroid disorder;

• diabetes;

• a history of malaria;

• tuberculosis;

• osteoporosis;

• a muscle disorder such as myasthenia gravis;

• glaucoma or cataracts;

• herpes infection of the eyes;

• stomach ulcers, ulcerative colitis, or diverticulitis;

• depression or mental illness;

• congestive heart failure; or

• high blood pressure

If you have any of these conditions, you may need a dose adjustment or special tests to safely take prednisone.

Steroids can affect growth in children. Talk with your doctor if you think your child is not growing at a normal rate while using this medication.

How should I take prednisone?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Your doctor may occasionally change your dose to make sure you get the best results from this medication.

Your steroid medication needs may change if you have unusual stress such as a serious illness, fever or infection, or if you have surgery or a medical emergency. Tell your doctor about any such situation that affects you.

Measure the liquid form of prednisone with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

This medication can cause you to have unusual results with certain medical tests. Tell any doctor who treats you that you are using prednisone.

What happens if I miss a dose?

If you miss a dose or forget to take your medicine, contact your doctor or pharmacist for instructions.

What happens if I overdose?

A single large dose of prednisone is not expected to produce life-threatening symptoms. However, long-term use of high steroid doses can lead to symptoms such as thinning skin, easy bruising, changes in the shape or location of body fat (especially in your face, neck, back, and waist), increased acne or facial hair, menstrual problems, impotence, or loss of interest in sex.

What should I avoid while taking prednisone?

Avoid being near people who are sick or have infections. Call your doctor for preventive treatment if you are exposed to chicken pox or measles. These conditions can be serious or even fatal in people who are using steroid medication.

Do not receive a "live" vaccine while you are being treated with prednisone. Vaccines may not work as well while you are taking a steroid.

Prednisone side effects

• problems with your vision;

• swelling, rapid weight gain, feeling short of breath;

• severe depression, unusual thoughts or behavior, seizure (convulsions);

• bloody or tarry stools, coughing up blood;

• pancreatitis (severe pain in your upper stomach spreading to your back, nausea and vomiting, fast heart rate);

• low potassium (confusion, uneven heart rate, extreme thirst, increased urination, leg discomfort, muscle weakness or limp feeling); or

• dangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, confusion, chest pain, shortness of breath, uneven heartbeats, seizure).

Less serious side effects may include:

• sleep problems (insomnia), mood changes;

• acne, dry skin, thinning skin, bruising or discoloration;

• slow wound healing;

• increased sweating;

• headache, dizziness, spinning sensation;

• nausea, stomach pain, bloating; or

• changes in the shape or location of body fat (especially in your arms, legs, face, neck, breasts, and waist).

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

Prednisone Dosing Information

Usual Adult Dose for Nephrotic Syndrome:

Initial (first three episodes): 2 mg/kg/day (maximum 80 mg/day) in divided doses 3 to 4 times/day until urine is protein free for 3 consecutive days (maximum: 28 days); followed by 1 to 1.5 mg/kg/dose given every other day for 4 weeks.
Maintenance dose for frequent relapses: 0.5 to 1 mg/kg/ dose given every other day for 3 to 6 months.

Usual Adult Dose for Anti-inflammatory:

5 to 60 mg per day in divided doses 1 to 4 times/day.

Usual Pediatric Dose for Nephrotic Syndrome:

Initial (first three episodes): 2 mg/kg/day (maximum 80 mg/day) in divided doses 3 to 4 times/day until urine is protein free for 3 consecutive days (maximum: 28 days); followed by 1 to 1.5 mg/kg/dose given every other day for 4 weeks.
Maintenance dose for frequent relapses: 0.5 to 1 mg/kg/ dose given every other day for 3 to 6 months.

Usual Pediatric Dose for Asthma:

< I year:
acute: 10 mg orally every 12 hours.
maintenance: 10 mg orally very other day.

1 to 4 years:
acute: 20 mg orally every 12 hours.
maintenance: 20 mg orally every other day.

5 to 12 years:
acute: 30 mg orally every 12 hours.
maintenance: 30 mg orally every other day.

>12 years:
acute: 40 mg orally every 12 hours.
maintenance: 40 mg orally every other day.

Usual Pediatric Dose for Anti-inflammatory:

0.05 to 2 mg/kg/day divided 1 to 4 times/day

Usual Pediatric Dose for Immunosuppression:

0.05 to 2 mg/kg/day divided 1 to 4 times/day

What other drugs will affect prednisone?

There are many other medicines that can interact with steroids. Below is only a partial list of these medicines:

• aspirin (taken on a daily basis or at high doses);

• a diuretic (water pill);

• a blood thinner such as warfarin (Coumadin);

• cyclosporine (Gengraf, Neoral, Sandimmune);

• insulin or diabetes medications you take by mouth;

• antibiotics such as ketoconazole (Nizoral), rifampin (Rifadin, Rifater, Rifamate, Rimactane), or troleandomycin (Tao); or

• seizure medications such as phenytoin (Dilantin) or phenobarbital (Luminal, Solfoton).

This list is not complete and there may be other drugs that can interact with prednisone. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about prednisone.