What is prednisone?

Prednisone is a synthetic hormone commonly referred to as a "steroid." Prednisone is very similar to the hormone cortisone, which the body manufactures. Prednisone is used to treat many illnesses.

How does prednisone work?

• In part, prednisone acts as an immunosuppressant. The immune system protects against foreign bacteria and viruses. In some illnesses, the immune system produces antibodies, which become overactive and cause undesirable effects. These illnesses are referred to as "autoimmune diseases". Prednisone suppresses the production of antibodies. This suppression can make it slightly harder for you to fight off infection but also stabilizes the immune system if it is overactive.
• Prednisone also works against inflammation to reduce the heat, redness, swelling and pain.
• When beginning prednisone, there is a small chance that it may cause serious increased weakness for a short period of time. Therefore, it may be necessary for you to be hospitalized for the first few days for observation.

What are possible adverse effects of prednisone?

Adverse effects do not occur in all patients and are usually related to the amount and length of time prednisone is used. Potential adverse effects will be monitored by your physician and include:

Insomnia and mood changes. Euphoria or depression may occur. The cause is uncertain. It is best to take prednisone it in the morning to reduce the chances of insomnia at night.

Increased appetite and weight gain. Prednisone increases the appetite. Follow a diet to maintain your weight. Develop an eating schedule and stick to it. If you eat when you feel hungry, you will be eating all the time.

Susceptibility to infections. Prednisone slightly decreases resistance to infection. Avoid individuals with infectious illnesses if possible. Notify your physician if you develop persistent signs of an infection.

Stomach upset (indigestion, stomach burning) or ulcer. Prednisone may cause gastrointestinal irritation. Take prednisone with meals, milk or antacids. Do not take it on an empty stomach.

Fluid retention. Prednisone can cause fluid retention. Your physician will monitor this process. Fluid retention can be caused by sodium retention and potassium depletion through frequent urination. A salt-restricted/potassium-rich diet may help reduce fluid retention.

Hypertension. Prednisone may cause a rise in blood pressure. Your physician can treat this, if necessary.

Hyperglycemia or diabetes (elevated blood sugar). Prednisone may increase the amount of sugar (glucose) in your blood. With periodic blood work, your physician can monitor this.

If prednisone is stopped too quickly, serious adverse effects can occur (nausea, vomiting, pain, fever, and/or flare-up of disease). Rapid withdrawal or stopping of prednisone may cause these adverse effects. Never stop or change your prednisone dose without your doctor’s consent. If you are planning a trip, always carry an extra supply.

How long will the adverse effects last?

If adverse effects develop, they will persist usually as long as the medication is continued. As the dose decreases so will the adverse effects. Some adverse effects are permanent and will not reverse after the medication is discontinued.

Are there any special dietary considerations?

Patients taking prednisone should be on high-protein, low-salt, low-carbohydrate diets and eat well-balanced meals.

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

You should try to avoid missing a dose of prednisone. If you do, follow these guidelines.

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

Skin changes (delayed healing of cuts or surgical wounds). Prednisone can cause a change in the condition of your skin. You may notice that your skin bruises more easily or that wounds take longer to heal.

Physical appearance changes. These changes may include swelling of the face or the back of the neck or the ankles, acne, thinning of skin, or skin stretch-lines.

Osteoporosis. Prednisone can make your bones become fragile by increasing calcium loss. This usually occurs after taking prednisone for a prolonged time. It may be recommended that you take a calcium and Vitamin D supplement or increase the amount of calcium-rich foods in your diet.

Cataracts and glaucoma. After prolonged use of prednisone, cataracts or glaucoma may develop. This condition can be monitored by periodic eye examinations.

Alterations in hair growth. Prednisone can cause a darkening and/or increase in hair growth. This effect disappears when the dose of prednisone is decreased.

Is it important for others to know that I am taking prednisone?

Yes, any doctor or dentist who is taking care of you should know you are taking prednisone. In case of an emergency, your family or close friends should also know you are taking prednisone. You should carry an identification card stating that you are taking prednisone and any other medications, plus your doctor’s name and phone number. This is valuable information should an emergency occur.