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Prednisone

Prednisone is a widely prescribed corticosteroid that lowers inflammation and suppresses the immune system. It treats a range of illnesses and conditions, including arthritis, lupus, leukemia and other forms of cancer, gastrointestinal diseases, plus lung problems and flares of multiple sclerosis.

Last Modified: September 16, 2022
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What Is Prednisone?

Prednisone is a synthetic version of glucocorticoid, a natural hormone produced in the adrenal glands. It supplements low levels of steroids in the body and acts as an anti-inflammatory agent to relieve symptoms of a variety of conditions, particularly aches, pain and itching.

Prednisone is used for many conditions, including:
  • Acquired (autoimmune) hemolytic anemia
  • Acute exacerbations of chronic obstructive pulmonary disease (COPD) (delayed-release tablets only)
  • Acute gouty arthritis
  • Acute leukemia
  • Acute or chronic solid organ rejection
  • Aggressive lymphomas
  • Allergic conjunctivitis
  • Arthritis
  • Asthma
  • Atopic dermatitis
  • Contact dermatitis
  • Crohn’s disease
  • Drug sensitivity reactions
  • Fulminating or disseminated pulmonary tuberculosis
  • Herpes zoster ophthalmicus (painful rash in the eye)
  • Inflammatory bowel disease
  • Lupus
  • Multiple sclerosis
  • Nonsuppurative thyroiditis
  • Post-traumatic osteoarthritis
  • Psoriatic arthritis
  • Rheumatoid arthritis
  • Seasonal or perennial allergic rhinitis (inflammation of mucous membranes in the nose)
  • Severe erythema multiforme (Stevens-Johnson syndrome)
  • Systemic lupus erythematosus
  • Tuberculous meningitis
  • Ulcerative colitis
  • Vasculitis

Prednisone may not cure a condition, but it helps ease symptoms such as itching, joint and body aches, and pain. Health care providers consider prednisone a strong, reliable steroid.

You can take prednisone as a regular or delayed-release tablet or as a drinkable liquid. The medication is also available in generic form and under brand names Deltasone, Prednisone Intensol and Rayos.

How to Take Prednisone

Prednisone dosage depends on the condition being treated and how well someone responds to a prescribed dose. Drugmakers set no dosage levels on the drug label because doctors tailor dosages to each patient’s needs. Initial dosages vary from 5 mg to 60 mg, once a day.
Quick-release forms (tablets and oral liquid) work best when taken before 9 a.m. and with food or milk. Optimal timing for taking delayed-release tablets depends on the dosage, the condition being treated and the person’s stomach tolerance.

RECOMMENDED DOSAGES
Initial doses of prednisone vary from 5 mg to 60 mg per day depending on the condition being treated and individual patient response.

Some people may need antacids between meals to avoid stomach ulcers when taking large doses of prednisone. Swallow delayed-release tablets whole and don’t chew, break or divide them.

Prednisone immediate-release tablets are available in six strengths: 1 mg, 2.5 mg, 5 mg, 10 mg, 20 mg and 50 mg. Delayed-release tablets are available in three strengths: 1 mg, 2 mg and 5 mg. Prednisone oral liquid is available in one strength: 5 mg/5 mL.

How Long Does Prednisone Stay in Your System?

Prednisone has a half-life of about 2 to 3 hours, according to the Rayos drug label, though other studies place its half-life closer to 3 to 4 hours. Half-life is the time it takes for the drug level in the body to decrease to 50% of what it was when a person first took it.

For example, if a person took 5 mg of prednisone, the dose remaining in the body after three hours would be approximately 2.5 mg.

It takes about seven half-lives for a drug to leave the body. Based on a half-life time of 2 to 3 hours, it would take 14 to 21 hours for prednisone to leave the body. This is an average and may be different depending on a person’s age, weight and general health.

Can You Overdose on Prednisone?

Because prednisone has a half-life that is longer than some other glucocorticoids, overlapping doses or taking too much of it in successive doses increases the risk of an overdose.

Prednisone overdose symptoms include:
  • Abdominal pain
  • Burning or itchy skin
  • Dizziness
  • Drowsiness
  • Halting of menstrual cycle
  • Headache
  • Heart rhythm disruptions
  • Muscle weakness
  • Nausea
  • Nystagmus (involuntary movements of the eyes)
  • Overall weakness
  • Ringing in the ears
  • Vomiting

The chance of dying from prednisone overdose is low, although it has happened. Some people may have no symptoms, and others may have life-threatening health issues.



Side Effects of Prednisone

Side effects from prednisone range from mild to serious. Mild side effects include nausea, headache, fluid retention, weight gain and insomnia. Serious side effects include difficulty breathing or swallowing, vomiting, high blood pressure, seizures and fetal toxicity.

Many people experience little to no side effects from taking prednisone, although women are more likely to have them. The higher the dosage and the longer the duration of use, the more likely side effects will appear. Other factors that influence whether side effects appear are age, overall health and other current medications.

If you have any significant side effects after taking prednisone, contact your doctor immediately.

Prednisone Warnings and Precautions

People who are allergic to prednisone or have a systemic fungal infection should not use this drug.

Pregnant women, women trying to become pregnant or women who breastfeed should avoid prednisone. Multiple studies show that prednisone and other steroids can harm the fetus when taken during pregnancy, according to the drug’s label.

The medication also travels to infants through breast milk, although the U.S. Food and Drug Administration has no reports of adverse events. However, high doses of prednisone over long periods of time might cause growth problems in breastfed infants.

People who receive immunosuppressive doses of prednisone should not receive live or live-attenuated vaccines. Physicians can substitute inactivated vaccines, but the reaction to these vaccines is unpredictable. Your doctor should monitor you for allergic reactions and adverse events.

Prednisone Interactions

As a steroid, prednisone interacts with a long list of drugs and substances. That makes it important for anyone who takes the medication to communicate with doctors the full list of other drugs they take before starting on prednisone.

Women who rely on birth control pills with estrogen and take prednisone can experience stronger steroid side effects and potentially less-effective results from their oral contraceptive.

Estrogen enhances the effectiveness of prednisone, essentially making it a more potent dose than intended.

Patients should tell their health care providers about all the medicines they take and ones they may take.

Drug interactions with prednisone include:
Oral Birth Control:
Drugs with estrogen (birth control pills) may decrease the metabolism of the drug in the liver and increase the effect of corticosteroids.
Antibiotics:
A certain type of antibiotic called fluoroquinolones can cause damage to tendons. People who take corticosteroids while also taking fluroquinolones, or after taking fluoroquinolones, may be at higher risk for tendon damage. Isoniazid, an antibiotic for tuberculosis, may not work as well when taken with prednisone.
Diabetes Drugs:
People who take diabetes medications may need increased doses of those because prednisone can increase blood sugar levels.
Blood Thinners:
Taking warfarin with prednisone may cause the popular blood thinner to not work as well. Have your doctor monitor you closely to make sure warfarin’s anticoagulation effect works while you are on your course of prednisone.
Heart Medications:
People who are on digoxin, a drug prescribed for heart failure, may be at increased risk of low potassium levels, or hypokalemia. This can lead to heart rhythm issues.
Antidepressants:
Both bupropion and corticosteroids can make people more susceptible to seizures, so using them together may increase the risk of seizures. Prednisone also may lessen the effect of quetiapine. Higher doses of quetiapine may be needed to remain effective.
Corticosteroids:
Because prednisone is a corticosteroid, it acts similarly to other medications in the class. One exception is prednisolone, which has a half-life in the body that is shorter than prednisone. That half-life time changes with age. For example, children process prednisolone faster than prednisone.
Pain Relievers:
Using nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and salicylates such as aspirin may increase the risk of toxicity and gastrointestinal side effects when taken with corticosteroids.
Diuretics:
Using corticosteroids with diuretics and other potassium-depleting medications may increase the risk of low potassium levels, or hypokalemia.
Live Vaccines:
Anyone on prednisone should stop taking it before receiving any a live or live-attenuated vaccine. Prednisone may increase the replication of some organisms in live-attenuated vaccines. Patients receiving immunosuppressive doses of prednisone should not use live or live-attenuated vaccines.
Anticholinesterase Therapy:
Like any other corticosteroid, prednisone taken in high doses may make dementia symptoms worse, but prednisone can have a stronger negative effect.

Medical and drug research also shows other adverse prednisone combinations worth considering. For instance, drugmakers issued no specific label warnings about drinking alcohol with prednisone, but the U.K.’s National Health Service warns that drinking alcohol with the medication may increase the risk of developing an upset stomach.

Because prednisone treats several skin disorders, it can have a suppressing result for people who take it and need to have a skin test.

Finally, taking thalidomide while also taking prednisone can lead to a serious skin reaction called toxic epidermal necrolysis.



Please seek the advice of a medical professional before making health care decisions.
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