Prednisone Side Effects And Warnings

Learn Facts and Information About Prednisone, Both Side Effects and Benefits

Drug Interactions of Prednisone

Drug Interactions of Prednisone

Prednisone is mainly used as an adjuvant therapy (to decrease the symptoms of illness) while primary/specific medications act to alleviate the sources of inflammation or infection.

However, since steroids or prednisone act mainly by modulating the immune functioning of the body and are generally prescribed for significant durations of time, it is very important to check with your doctor if you have a comorbid medical condition or if you consume a medication on a regular basis.


Why You Should Inform Your Doctor About Prescription Medications Before Using Prednisone

Prednisone is metabolized by the liver and can affect the concentration of metabolic enzymes in the liver and kidneys. This effect of prednisone can lead to changes in the metabolism of a variety of drugs. If no dosage adjustment is made, the following effects can be observed:

  • The toxicity of one or more drugs can result in normal recommended dose
  • Some drugs may not control symptoms at the recommended dose, ultimately requiring a higher dose to produce the same effect because of rapid metabolism. For example, you need a higher dose of insulin to control your blood sugar levels while you are on prednisone. The same is true for other hypoglycemic drugs.

Similarly, there are a number of drugs and medical conditions that may increase or decrease the potency of prednisone, thereby requiring a dosage modification or adjustment. Individuals with hypothyroidism require a lower dose of prednisone than an individual with normal thyroid function[1] (or someone who is on thyroxine therapy for hypothyroidism).

What Are Some of the Drugs that Require Drug Adjustment or Dosage Modification with Prednisone?

If you are consuming any of the drugs listed below, make sure to speak to your healthcare provider to prevent any issues or reactions.

  • Drugs that control blood pressure or cardiovascular functions such as digitalis, digoxin,diltiazem, verapamil, all types of diuretics.
  • Antibiotics and antifungals that include amphotericin B, telithromycin, clarithromycin, isoniazid, rifapentine, rifabutin or rifampin, ketoconazole, itraconazole, voriconazole and posaconazole, cyclosporine.
  • Certain over the counter herbs like St. John's wort.
  • Birth control pills (with prednisone, your birth control pills are less effective). It is recommended to look for alternative or additional options for contraception. This also includes other hormonal sources of contraception as well, like coils, intrauterine devices and others.
  • Medications controlling blood concentration, fluidity or coagulation like coumadin and warfarin.
  • Medicines for the management of chronic viral infections that mainly involve fosamprenavir, nevirapine atazanavir, efavirenz, delavirdine, indinavir, nelfinavir, saquinavir and ritonavir.
  • All types of anti-inflammatory drugs such as non-steroidal and anti-inflammatory drugs (NSAID) that include aspirin, naproxen, ibuprofen, diclofenac, meloxicam, celecoxib, indomethacin and others.
  • Medications that control central nervous system activity like carbamazepine, phenobarbital, primidone, oxcarbazepine, fosphenytoin, sertraline or phenytoin.

The list above is not exhaustive and it is highly recommended to tell your doctor all the details of medications you are consuming before taking prednisone.

How Can You Minimize Your Risk of Suffering Complications and Side Effects While on Prednisone?

In order to minimize your risk of complications or adverse effects, it is highly recommended to consume prednisone according to the recommendations or advice of your healthcare provider.

Other helpful tips include:

  • Store prednisone at room temperature and prevent excessive exposure to heat and moisture.
  • Healthcare providers prescribe prednisone only in situations of acute exacerbations or emergency situations. Avoid long-term consumption of prednisone unless it is absolutely necessary.
  • If you are experiencing stress, fever, an infection or a serious illness, it is advisable to seek emergency medical evaluation for dosage adjustment or changes in potency of the medication.
  • Never attempt to change the dosage by yourself. Always ask your doctor to increase or decrease the potency.
  • Always measure the dose of prednisone with a medicine cup or measuring spoon.
  • It is advised to swallow the whole tablet and avoid chewing, crushing or breaking it while consuming.
  • People consuming prednisone should have their blood pressure and blood sugar levels checked frequently.
  • Prednisone intake may interfere with the results of some medical tests; therefore you should inform your doctor that you are taking steroids.

References:

  1. Bergamaschi, S., Rusconi, R., Gervasoni, M., Rigamonti, A. E., Cella, S., & Bareggi, S. R. (2005). Pharmacokinetics of Prednisone and Prednisolone in a Case of Hypothyroidism: Effect of Replacement Therapy. Steroids, 70(11), 787-789.

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